episode 220
“Passive Self-Injury Explained: Why It’s So Confusing”
This week on "Ask Kati Anything," licensed therapist Kati Morton explores why suicidal thoughts can be so confusing, how the age of our therapist impacts our therapy experience, and whether it's appropriate to ask a therapist for more physical touch. Kati also breaks down the differences between Patreon and YouTube memberships, offers strategies to overcome depressive symptoms, and explains how experiencing sexual abuse at a young age can lead to abusive behavior. Tune in for expert insights on these critical mental health topics.
This is a transcript of Ask Kati Anything podcast episode your mental health podcast #220 Please note that the transcript is computer generated, and may have errors.
Ask Kati Anything episode #220
Hey, everybody. Welcome back to another episode of Ask Kati Anything. I'm your host. Licensed marriage and family therapist, Kati Morton. I'm so glad that you're here. In today's episode, I am going to talk about our suicidal thoughts and why, even if they're passive, they can be around so much and why it can feel so confusing. Then I'm also going to talk about how the age or the way our therapist looks can affect us. Then, if we can ask our therapists that we need more physical touch, will they offer it to us? I'm then going to get into the differences between Patreon and YouTube memberships. I got a question about that, as well as how to overcome our depressive symptoms, and why sexual abuse from a young age can lead us to abusing others. Without further ado, let's jump right in. Oh, also, I wanted to let you know. I don't know why it posted the question asking for your podcast questions twice, and I'm assuming it's an error on my part. Although it looks like I only scheduled one, so I'm so sorry if your question doesn't get answered, you can always re ask it next week. I get through as many of them as I can. I double checked on the back end that the ones that are scheduled, there's just one, so there's no confusion around where to leave your question. for the podcast. Okay. And sorry about that.
Question number one says hi Kati, I have no plan or intent, but suicidal ideation consumes a lot of my thoughts. I've struggled with passive suicidal ideation for a while, but not usually as often, and I started doing things like cleaning my room just in case I die. Even though I know I have no plan. I don't know why these thoughts keep entering my brain, and I feel so confused because the thought of dying both calms me and makes me terrified at the same time. I'm too afraid to talk about it in therapy, and then I convince myself that it's not that big of a deal, so I don't say anything. I hope this makes sense because I'm confused by my own thoughts. Thank you so much for all that you do. Of course, now, when it comes to suicidal thoughts, I have a couple of pieces that I think are important for us to acknowledge and see if they apply to us. Okay, first, being that suicidal thoughts come out of a place of hopelessness and I believe, and I haven't looked into research, I probably should, but I believe that once we have these thoughts, it's almost like, oh, that's our weakness. In the same way that if we have eating disorder based thoughts or, self-harm based thoughts when we're stressed out or when we feel kind of exhausted, like our resilience is low, those thoughts can creep back in. It doesn't mean we have a plan or we want to take our own life. It's there because that's kind of like where our brain goes when we're having a hard time. Okay. Also, I think that it can be calming and it can almost feel like a coping skill. In the same way, eating disorder, self-injury thoughts can be. And so that's why it comes up. And it can feel kind of calming. But also terrifying because we're like, hey, this doesn't actually make me feel better. I don't want to do this. I have no plan. Right? It's almost like, a coping skill that doesn't really help us cope. But the thought that we have an out is usually where our brain goes, and that that feels like a relief or that is the way to cope. And so because of all that playing in our brain, right, because of the fact that it can creep up almost as like a weakness. And I don't mean weakness as like, oh, you're so weak. I mean, it is like it's our propensity for it, right? Like I said, comparing it to like, eating disorder, self-injury urges because it can creep up like that. It hangs around when we don't even want it, or we don't even understand why it's there just because our brain, like, automatically goes there. I also know that it my patients, when they feel like they don't really have that much control over their life in the moment, it can go there as well, almost like you take the control back so I say all of that to say that suicidal thoughts can come from a lot of different places for a lot of different reasons, and it doesn't always mean that we are hopeless, helpless feeling in that moment and want to take our own life. It can mean that we don't know how else to cope. It can mean that we're our resilience is low. It can mean, you know, that we feel like there's no we don't have any control over our life. And I don't know what would resonate with you, but I want you to hopefully be able to dig into this, be curious, not judgmental about it, and see what comes up for you. Even as I'm talking to you. Are there certain things that resonate? And I also would encourage you, if you can, muster it up, to talk to your therapist about it, because you have no plan. You're not wanting to end your life, but these thoughts are here and they're driving you crazy. And so we have to figure out what's triggering them. Like how long they're staying around and what we can do to make them go away. Are there other coping skills that we could try out and see if it lessens the amount of time we spend thinking about suicide, or when we feel like you said, I think you just said you have a safety. I know you don't have to define somebody else. That comment after that says it. but then you could create a safety plan with your therapist, including some of those coping skills that help you feel okay without, you know, going down the rabbit hole of suicidal thoughts. So bring it up because there is no intent. They're not going to hospitalize you. But you can be very clear about that. Be like, I don't have any plans. I'm not going to do this. They just hang around. I don't know why I don't like it. Oh, it feels icky to me. Or like what we call ego distorting meaning it does not feel like it's who we really are or what we really want, but it's here. So like, what the hell? Right? Bring that up. Be curious, not judgmental about why this is happening, and I think you'll find an answer in there as to why. Why the suicidal thoughts are hanging around as much as they are. And there was a comment on this, says Kati, when I am in a shitty place mentally, I feel like a failure because I haven't gone through with my suicidal plans. I've created a suicide safety plan and I'm in therapy. That's amazing. I actually have a video. If any of you struggle with suicidal ideation and you're looking for a safety plan, I have a video about how to create them. You can just look up suicide safety plan, Kati Morton. It'll come up on YouTube. that's a great place to start, and I think we should all have them in place if we've ever had suicidal thoughts. Okay, it could prevent the actual attempt, but I feel shitty because I'm quote unquote not even capable of putting my thoughts into action. And I feel the same way in regard to my self-harm struggles and in beating myself up because I'm not able to cut deep enough to need stitches. Interesting. I really want to be proud for not attempting suicide or harming myself that badly. But why does it feel like such a failure? I'm going to tell you my hypothesis, okay? Everybody's going to be different. But over the years when I've worked with patients similar to you, going through similar things, the reason that it feels like a failure is because we we believe that our self-injury or our, you know, taking of our own life proves the pain that we feel. And I mean that because we often feel so intensely, either because painful, terrible things have happened to us, or it could be because, you know, we have borderline personality disorder and we feel everything intensely. So it feels really overwhelming. We don't know how to cope, but either way, that feels like a representation of it. Like we're going to show people is going to you're going to see it and it's going to feel real to them to or they'll actually finally get just how much pain we're in, or we can even be doing it for ourselves. Like, this will be the final expression of me showing someone how much pain I'm in. And because suicidal thoughts in general come out of a dark place of not being enough. not feeling like were ever good enough, worthy enough, all of those things, then if we don't engage with them, it's just another reason that we can feel more depressed and even less worthy. Like, I have a friend of mine who is, an ER doctor, and he had someone come in who had attempted to take their own life and was not successful, but injured themselves badly, and he took care of this person, and he was talking about how how it almost made it worse that they weren't successful because of the way they talk to themselves about this quote unquote, failure. Right. And so just compounding the difficulty or upset that we're already experiencing. And so that's why you should talk to yourself because you're in a shitty place. Because if anybody doesn't realize suicidal thoughts are born out of hopelessness and helplessness, feeling there's nothing we can do, it's never going to get better. And so my advice to anybody struggling with any type of suicidal thoughts is to look for glimmers. Now, I know people talk about those when it comes to, you know, like nontoxic positivity, looking for the small things in life when it comes to suicidality, these glimmers need to be little bits of hope for the future. Meaning like, I am really looking forward to, my friend graduating. I really want to be there when my I don't know, when I'm able to buy my first home or when I can take my first international trip, or it's any kind of little hope that we have for the future. Could even be, hey, somebody smiled at me on the subway, or when I was walking down the street, or somebody opened the door for me at Starbucks. Any small thing, somebody let me go first. when I was waiting to find a line to go in the grocery store. Right. All of those things are glimmers of hope that people are loving and caring, that there's good people out there, that people could even see us as a good person, that we get to be there for X, Y, z in the future. Maybe it's a place I want to travel to, a thing. I want to see, a person I want to experience something with. Maybe I'd like to have children. Maybe I'd like to own my own car. Whatever it may be. I'd like take a solo trip. All of those things are things we can look forward to, and little glimmers we can catch along the way to remind us that life is worth living, that we are important, and the world deserves to continue having us here. I know it's hard to keep up the hope and suicidal thoughts can really get deep and dark and heavy, but just look for those things and let's put together some of those, you know, short term goals, more, longer term goals to to keep us hanging on. And like I said, I also have that safety plan video available. But that failure feeling I think is a compounding part of our depressive thoughts and our depression as a whole. And also the the fact that what I was talking about earlier with that first person's question that like our suicidal ideation comes from these different places, and if we're not engaging with it, it could feel like it's not, you know, it's not doing any good. We're a failure because we're not actually taking action. We're not helping ourselves feel better. We're not relieving us of the stress of whatever. It's just like an easy way for our depressive and suicidal thoughts to like, shit, talk us even more. And so I encourage you to distract your way out of that and look for those glimmers and that hope for the future. Okay? Also tell your therapist, and if you're not on medication, that could be another thing we look into as well. Also just know that alcohol, can be really depressant to our system, to our mood. That's why they call, you know, alcohol's a depressant. We don't want to do anything like that when we're already having a hard time, because it's only going to make it worse and compound what we're already feeling. Okay with it.
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And question two it says, hi Kati, my past therapists have been much older than me, but my current therapist is a few years younger. Not by much, but enough for me to feel uneasy. It's been a few years and I'm much more comfortable with her now. That's amazing. However, I still find myself screening what I say and I'm reluctant to share my struggles. In the last few years she's gotten married, had a kid, and lost a parent. I already feel like I've fallen behind in life because of my depression and my generalized anxiety disorder. I feel grief over missed milestones, experiences, and all opportunities which I feel I can never get back. So when I want to discuss certain issues like having a partner, loneliness, or such as not having a partner, loneliness and anxiety around losing my parents and not having any responsibilities after that, or a reason to live. They all seem inconsequential or stupid compared to where she is in life and the things she would be dealing with. Although logically I realize this may not actually be true. I've been having a lot more intrusive thoughts, but the more I talk to her about it, the more stupid I feel and the worse I get. I feel like this and other non-issues, especially in the absence of any major traumas or negative life events, are made up or exaggerated or should have been things that I sorted out earlier in life. Look at all this judgment you're slathering on yourself. I really want to understand my obsessive thoughts of self-harm and other behaviors, such as overeating and skin picking. Because Chesterton's fence, right? Yes. If you guys don't remember, the Chesterton's fence analogy is essentially like you can't remove something until you understand what purpose it's served or is serving, because otherwise we're just removing a piece of fence, not knowing that it's keeping something out or in. Right. and so we want to figure that out first. Says I've never learned to understand or express emotions. And I grew up downplaying everything so that people don't have to worry about me. As a result, I'm not used to sharing my feelings or struggles with others. She is really the first and only person I can talk to, and she's never done or said anything that caused me to feel this way. We have also talked about this issue in the past, and she asked me if it would be helpful for me to see an older therapist. That's fair. That's what I would have said to. I'm reluctant to bring this up again, because I'm afraid she will suggest that I see another therapist that is older, or because she feels she cannot help me. Do you have any suggestions on how I can overcome this, or the best way to approach this with my therapist? Yes, this is a great question. And first of all, for anybody out there who's looking for a therapist, picking a therapist is not a time to be politically correct. I talked about this in my book. Are you okay? If you want it to be female or male or part of the LGBTQ plus community, that's your prerogative. And you should pick somebody like that if you want them to be younger or older and you have the ability to pick between those, you should feel freedom to do that. We want to have a therapist that we we feel the most comfortable with, and we don't have to worry about the fact that maybe, you know, we don't think they get us because they don't look like us or they don't act like us, or they're not from the same type of area as us. All of that can be weighed and, you know, considered when we're trying to figure out if someone is a good fit. So again, it's not a time to be politically correct. It's time to pick someone who feels the most comfortable to us. Okay, just throwing that out there. But when it comes to your specific issue, the fact that you actually like this therapist, you have talked to her more than anybody else and you feel like she's really there for you. However, we have this hang up and I believe the way that I would approach this is from the stance not of her being younger, but of what that brings up in you. So what we would bring up in therapy is this intense grief that we feel about, milestones, experiences, opportunities because of our depression and anxiety. Can we talk about that and grieve that? That's what therapy is about anyway. It's not about comparing her life to your life. That's what makes therapy so amazing. When you don't know anything about your therapist is actually probably be better in your case. If you didn't know her age, you didn't know if she was married or had a kid or any of that. I mean, if she was pregnant during your session, she can't really hide that. But I'm just saying that it might be nice for you to not know any of that about her. but what's interesting is what is coming up for you, because you do. And that's what we want to dig into. It honestly has nothing to do with her age. So the way that I might approach it with your therapist is to say something like, hey, I know I brought up the fact that you being younger has, you know, affected me in therapy. I realize that I think it's because of this that I'm going through, and I'd like to really dig into that. Like, I don't really know how to grieve the fact that I feel like I've missed a lot of opportunities because of my mental illness or, you know, the, the judgment that I feel about the fact that I have or this feeling I have of being behind, like I'm behind the eight ball, I'm behind schedule, whatever this schedule is, you know, bring that up. That's really where this is. This is what it's it's affecting you this way. It has nothing to do with her age. It's what this her age does to you. You have this reaction because you feel like you're already behind. And this is like compounding that belief. So I would dig into why do we think we're behind and what is the right time frame for things. What is it that you feel like you should have accomplished by now, or even furthermore? Another question I would have is like what? Like when else in your life have you felt like you just couldn't quite keep up or that you weren't good enough? Or maybe that, you know, you're never going to get where other people get like probably part of that's like the negative self-talk. But when did that start and where does it come from? Is there something that exacerbate it? Have we always compared ourselves to other people? I mean, I know a lot of these questions were like Kati, of course, like everybody compares himself to someone else. Yes, but we need to figure out how that applies to us and why this is getting in the way of us utilizing our therapy sessions to talk about what we really need to talk about. Right? And so ask yourself these questions and also, you said there's this absence of major traumas or other negative life events like have you been told or made to feel small in life, like you can't take up space? Or are we like people pleaser because you mentioned that you always downplay everything's people don't have to worry. So I be curious. This is another I know I'm throwing a lot at you, but this is another question I would have would be like, what would it mean for people to worry about you? What if people really cared? What if I told you I'm worried about you? Keep me posted. I want to know how you're doing. What comes up for you, what's the story you tell yourself about someone caring enough to worry? I'm curious about that. Have we always downplayed everything? Were we ever told we were too sensitive, too much, too loud, too sad, too whatever? Were we a parentified child? Maybe. So we felt like we should take care of others so we couldn't have a tough time. See, there's a lot in here to work on in therapy and it truly has nothing to do with your therapist age. That just happens to be a trigger. And we want to utilize that trigger so that we can better understand it, so that we can go out to the world and not have that be so triggering when we see someone else who's younger than us doing things that we want to do at some point, we want to feel like happy for them and excited for our future simultaneously. Instead of thinking, oh, I'm missing out on so much. And that kind of self-deprecating thought process that we've been having. So that's really how I would bring it up that it's, you know, it has nothing to do with them. How do you how do we kind of untangle this? You know, what resonated that I mentioned to you? Can we bring that up to your therapist and say, hey, I'd like to explore, you know, my struggle with downplaying everything and feeling like I'm too much. Maybe that's where we start, but I don't know. I know I threw a lot at you, but hopefully there's something in there that that resonates.
Okay, let's move on to question number three. It says, hey Kati, how do you go about asking your therapist for more physical touch? Good question. I don't want to cross any boundaries that I don't know about. And at the same time, I worry that I'll feel awful if she says no. So I'm really afraid to ask. She is used, touched the touch in the past with me, like held my hand, placed her hand on my knee to remind me that she's still there when I was dissociating. But I'm scared to ask for it. How do I get over the fear of rejection from her, even when I know it will? It would just be a professional boundary. Thank you for these amazing videos. They've helped me so much. Of course, I'm glad I could be there when you need it. It's when it comes to asking your therapist. I mean, there's two ways to go about it. Number one, we just go right in and ask about it. But number two, and probably where you feel a little bit more safe is to talk about it with her, to let her know that when she put her hand on your knee or held your hand when you were dissociating, that was really helpful. And you think having some of that physical touch in therapy could be beneficial and ask her her thoughts on that? That might be kind of a sideways in without saying, like, hey, I'd like that more. And that could give you it can it opens up for conversation versus her potentially saying yes or no, and it's moving on. And I think that's really the key here, because obviously you have a need in therapy and therapist can offer physical touch or not, depending on the way that they engage in their practice depends on the style of therapy they practice and what they really believe in. So you're going to have to ask, and I wish I could tell you it won't be a problem, but everybody's different. I even am very cautious about physical touch because I don't want to trigger my patients. I've dealt with a lot of, you know, trauma patients in my life, BPD, where attachment could be an issue. So I have to be very careful. Right. but the fact that she already has leads me to believe that she does believe in it, because the ones who don't will not do that, won't offer that kind of touch. They'll expect you to figure out how to regulate yourself. So I think you're pretty safe to bring it up. I just want you to have an idea of what how it would help you and what you're looking for. Meaning? I found it really helpful when I was dissociating. Would you be comfortable doing that when you see me kind of slipping away, like not making eye contact. That's something to ask or are you wanting a hug after every session? I had a patient who, like that every so often. I told her not every session, but every so often, so that it wasn't something she would rely on again, attachment boundaries, things like that. I wanted her to be able to regulate on her own sometimes and talk about how that felt, all that stuff. but yeah, we have to know what we're kind of asking for, because I think if a patient asked me blankly like, can I give can you give me more physical touch? I would have questions immediately, like, what does that look like? What are you asking for? What do you need? When are you feeling kind of not supported? And that would give me an idea of where I can offer it. I am not opposed to it at all. I think it can be incredibly helpful, especially with dissociation. But again, like I said, some therapists don't. But the fact that she's already offered it makes me think that she wouldn't have any problem with it. So you can play it out, play it out. if you guys don't know, is a cognitive behavioral technique where we play out the best case scenario, worst case scenario, most likely scenario. That might be helpful here. Just kind of to assuage a little bit of that anxiety or concern about, you know, her saying no. And the rejection that we could feel is a, you know, result of that. That might be a helpful tool, but I really don't think you're going to get that rejection. But I think she will have follow up questions. So we want to have it thought through so we can answer them. That makes sense I hope so. Now there was a comment on the says as an add on. Kati, if my therapist didn't ever use touch in about three years of weekly therapy, is it possible for me to ask her to do so? Not in a friendly or romantic kind of way? just so you know, but really, to help me holding on when I feel myself drowning, being in recovery for an eating disorder, among other issues, I find it hard to hard to ground when my emotions feel suffocating, which happens once since my physical health has improved despite trying lots of tips. Only thing that has helped me a little is having my cat sitting on me. I love that, but in therapy she my cat can't be there. I am ashamed even just to consider, I might ask my therapist for this kind of help since I, and profoundly disgusted by who I am as a person and my body, look at that judgment. I'm also terrified to cross her boundaries. I feel disgusted to have that kind of neat look at all this disgust and judgment, since I just haven't been, I even I haven't even been traumatized and grew up in a loving family. I don't know why I struggle so much to feel worthy of help. What do you think I should do? Or my needs too much? Honestly, no, your needs are not too much at all. But I think you grew up in a space believing that they were and believing that you just being you is just a bad thing. There's definitely. I know you said that there. You haven't been traumatized. Something happened because this profound disgust you have for who you are in your body can obviously be related to your eating disorder, but an eating disorder. Remember, is a coping skill for something bigger. So something happened to you and I don't know if that's abuse from your household or if that's like bullying at school or where that came from. But something has happened that we want to numb out from. And there's a reason you don't feel worthy and you don't feel good enough and you feel disgusting. And that's really where the worth of therapy should go, where the healing should take place. So, okay, that's not the question. I'm getting off topic, so sorry, but the question is about, you know, if a therapist has never used touch, how is it possible for me to ask her to do so? Of course it is. I think the way that I would bring it up is just like you told me that. Like, the only thing that helps me when I'm just sitting at home is when my cat comes and sits on my lap. And so I'm wondering if there's a way for you to either, like, put a hand on my shoulder or, you know, if I can have a weighted blanket that actually helps a lot of my patients to a weighted vest or a weighted blanket you bring in. Or maybe they already have one, we can bring it up that way. And that's kind of an open conversation so that we can talk about it. Because if your therapist is opposed to physical touch, because it's like not the type of therapy they perform or that they believe in, then that's a conversation you can have. And I don't want you to think it has anything to do with you and any of the false beliefs you have about yourself. However, it might have to do with the type of therapy that they believe to be the most healing and helpful for people. Because some people think the physical touch from a therapist is like crossing a boundary and can make us worse as patients. So but let them give them an opportunity to explain that to you. But just say it like you said it to me. When my cat gets on my lap, I feel calm. I'm wondering if maybe, you know, you putting your hand on my shoulder. Whatever it is you're asking, when you see me dissociating or when you see me having a hard time, you know, could we could we maybe look into that or think about that or a weighted blanket, bring it up that way because you aren't going to cross her boundaries. It's up to your therapist to tell you where they are and to to communicate them. So you bring it up, gives them an opportunity to say yes or no and explain why. Okay. Moving on to the next item. It said this is a question that I have too. I have video therapy. And once when I was to come in person, we were working through my trauma history and I asked if she would be willing to hold my hand when I came and talked about those hard things, she didn't say no, but it was clear that she was uncomfortable, so she told me she think about it. Neither of us addressed it during the in-person session. Several video sessions later, she brought it up and I told her, never mind, because I felt humiliated that I asked as if she felt I was creepy for it. That's interesting. I'm a social worker myself, but I do in-person case management rather than therapy. One of my friends, Rocio, does that too. I have full on held clients in my arms as they were passing away, and particularly held their hands, patted their shoulder gently rub their arm and I've let many women cry on my shoulder. It's never once felt creepy, only humane given the circumstances. It's okay that my therapist has different values and views on the subject, but was wondering how you think about it. Is it inappropriate to ask for it in therapy? Is it wrong for me to offer this to my clients if they want and need it? I think personally, I'll speak personally and then I'll speak as a professional to professional. I personally have no problem with it. But like I mentioned earlier, when I have patients who seem to rely on it, I'm very curious about that. And that becomes then a deeper conversation, maybe about attachment or the therapeutic relationship and me prompting them to soothe themselves first, because I don't ever want to create a dynamic in therapy where a patient is dependent upon me to soothe because I can't be there around the clock either. But I do offer my patients hugs when they ask. I think 90% of the time one of my patients has was becoming really reliant on it. And so I told her, not this week, but next week, and I want you to journal about what came up for you. And I said that I know it's such a therapist thing, but it's the truth. Right? So I don't have any problem with it. But there are some limitations to it, only because I don't want a patient to become dependent on me, dependent upon me. And I want to make sure the therapeutic relationship stays sound. Now, I don't think it's wrong for you to offer that to your clients, and I don't think it's inappropriate to ask for it in therapy. I do know that other therapists have different thoughts about it, like some people believe in like kind of more of what I call like a Freudian style of therapy where there's like pretty much no contact with the therapist. It's more about you as the patient. You know, I'm not saying that your your therapist only does Freudian. You're like free associating all the time and you're facing different directions. That's how they used to do it, by the way. I'm just saying that, you know, they have different beliefs around it and some might not feel comfortable. But the thing that I'm surprised the most about is that she didn't bring it up right away. I do encourage you as a way to feel supported and to talk about this and to hopefully move out of this humiliation stage is to hear from her. Why? If I was her, I would have pushed to talk about it. I would have made a point of explaining it to you, and I also wouldn't have had to think about it. But maybe she's never been asked, I don't know. I find that just kind of surprising to be honest. Just clinician to clinician. I'm surprised she hadn't thought about it and hasn't didn't have an answer. And didn't push to bring it up. I don't think it's creepy. I think it's humane. Just like you. And I don't understand her reasoning. So I think for me, in order to like, give any other thoughts, I really need to know her reason. But there was nothing wrong with you doing what you did. And I want you to challenge that humiliation or judgment that you're experiencing as a result of it, because you didn't do anything wrong. So I'm curious where in your life you felt similarly, where like, you're what you need is too much, or what what you're asking for isn't something someone willing to give, and you feel devastated. What where else in your life has that happened? And that's something we should explore.
Okay. Moving on to question four. Hi Kati, I wonder if you can explain how you view your relationship with your patrons, community members? I been thinking of joining, but I'm a bit confused about what the relationship is. Thanks. Hope you don't mind me asking again. Of course not. You can keep asking until I get through as many as I can. Now, when it comes to Patreon, I have different tiers. You can get on there and you'll see for a dollar you can view and participate in the monthly live streams at the $20 tier and above, you get to ask a question, you send them in and messages and I gather them so you're insured that your question each month gets answered. and then there's an extra live stream every month where anybody can ask questions, and I get through as many as I can in one hour. Okay. Then there's the higher tiers, like our group hangouts and my one on one hangouts. So that's how Patreon works when it comes to community members and, YouTube membership. We have four. Well, it depends on your level. If you're in the psyched up 30 level, you get two 30 minute live streams each and every month. If you're in the psyched up 60 level, you get those 30 minutes and two more 60 minute live streams each and every month. and at the $5 tier or for 99 a month, you have access to the journal prompts, and I release those every Tuesday and Friday. and so that's kind of the tier. So it goes like the Inkwell Club, the psych, the psych, the 30 and then the psych, the 60. And so depending on your budget and what kind of support you're looking for, those are the ways that I engage there. and that's really it. I think of it as just like another layer to our community. There's you get more opportunity to get your questions answered, more opportunity to connect with other members of the community. I know a lot of you hang out on Patreon, has a discord server that I set up for our community, and there are like subcategories within it. So if you're wanting to, you know, get more support for, let's say, eating disorder recovery, there's one for that, one for depression, etc.. so that's really the way that I see them within YouTube community. I don't know if there's a way for me to hook anything up like that. I don't know if there is a way for, for you to communicate with one another, but you can in the comments below. Some of those community based post posts. So on the community tab, when I post the journal prompts every Tuesday and Friday, you can chat with each other in the comments below that, and that is private to the people who pay for that service only. So that least makes it a little bit safer. Okay, I hope that makes sense. Let me know if you have follow ups.
Moving on to question number five. It says, Hey Kati, happy Thursday, happy Thursday. I've been suffering from depression and anxiety for the last few years now. I'm constantly struggling with a very low mood. I feel like I'm trying to climb out of a dark hole as it is affecting the normal, everyday aspects of my life. What can I do to try and turn these? Turn these around? On a personal level, I have little to no energy or motivation every day, and I've tried thinking positively about different things, but I still have more negative thoughts instead of positive. I felt more sadness and happiness in my emotions and I honestly hate it. Please help. Okay, there's a couple of pieces here. If we're struggling from symptoms of our depression, anxiety or whatever you name it. So much so that we don't feel like we can do anything. Like if we're in therapy, we can't participate in it. We don't feel like we can share and cry, maybe in session and then out of session. We're like, I can't make any of the changes that they're asking me to, or I can't do the homework that they gave me. If that's happening, we need medication on board, meaning we need maybe to see a psychiatrist or, a psych nurse or whoever. It is a nurse practitioner or whoever you have access to in your area. You need to find a prescribing physician to prescribe you some potentially SSRI or a sunrise, otherwise known as antidepressants, because if we're drowning in the symptoms, therapy is not going to help us until we feel like our heads above water. Okay, so there's that piece. Then the second piece is the best thing that we know. Research. I know I talked about this last week to. But the best thing we know for depression to help alleviate those symptoms is actually what's known as behavioral activation. And this is a tool that's used because again it's just it's research back. And we know it's effective. What it means is that we do the things that we used to enjoy, even when we don't have the motivation. We don't want to. We like force ourselves to go to white knuckle. You got to push through. Now. Again, if me saying that leaves you thinking there's no way I can't, then that means you're drowning in the symptoms. That means we need something else. Like a medication on board, for example. Or maybe we need a higher level of care. Meaning, for seeing our therapist once a week. Maybe we need to go twice a week. Or maybe we need to go into a treatment facility for a little bit. All of those are options, right? But if we are able just to push ourselves, push ourselves to do the things we used to love, we find that that has the biggest impact on our low mood and can improve it. Also, random ways to kind of like shortcut this. We can go outside and get sun on our face for 15 minutes, no sunscreen being put, sunglasses on. I guess if you aren't getting that sun on your face first thing in the morning, I'm talking within 30 minutes of waking can drastically improve your mood because it triggers your brain and body to produce serotonin. Okay, so there's that. Then. Also, for feeling really anxious, we can do the double breath in. Feel it all the way at the top. Take another little sip of air in and then slowly breathe out. When we expel that carbon dioxide, it's relaxing to our nervous system. So those are just some of the ways to do it. Also, you guys know I love a full body shake or dunk in your face in cold water. Those are all kind of hacks for you to improve your mood, lower your anxiety or depressive symptoms, and help you feel better. Okay. Final question. Question number six says, Hey Kati, I'm not really sure if you would want to even talk to someone like me. Look at that judgment up front, you guys. But here we are. but here we go. So I guess me and my younger sister were both sexually abused by our dad from a very young age. My sister has started therapy recently and has been encouraging me to go to. I thought about it, but now I don't feel like anyone would want to have me as a patient. That is incorrect 100%. Not to mention the fact that that's why therapists are there is to help us navigate abuse, process it through, realize that it wasn't our fault. We didn't cause that to happen. Deal with the shame and the blame and the guilt and the embarrassment. All that stuff says our abuser recently passed away, and as I was going through boxes, I came across some pictures. I won't say what type, but I'm sure you can guess anywhere anyway, that there was one of me around three hurting my sister. I feel totally disgusted by myself and I don't know what to do. I don't even remember it, but I just can't believe what happened when we were slightly older, but still kids. I was always the one to try to persuade them to, leave me and my sister alone. But now I feel like I'm just as bad. I have a video about child on child sexual abuse. and I think it's called help. I abused my my my siblings or abused my my. Yeah, I think it was my siblings. You can look it up. on YouTube, just put in, you know, trod on child abuse. Kati Morton, it'll come up. You're not alone. And unfortunately, when we are being abused, abusers are incredibly manipulative. You were three years old. That is not a time in our life when we would want to hurt someone else. We could be sexually curious at that age. More than like, what do you have? What do I have type of things? Because children are naturally curious and want to learn about. The body has nothing to do with sex. It's not sexual at all. More general curiosity, but three is just so little you're still learning about like, what's the belly button and things like that. so what happened in my estimation, based on what I know, working with patients just like you is that we were coerced or forced in many ways to do that, or we were acting out the things that were done to us. But the fact that there's photo representation leads me to believe that it was coerced, if not forced, under threat. And I'm so sorry that you went through that. I'm so sorry that you came across this. I'm so sorry that your parent was so terrible, so heinous, so abusive that you and your sister had to deal with that. I'm glad that they passed away, but the wounds that your dad cause for both of you need to be healed. You have every right to access therapy. I encourage you to reach out. Child on child sexual abuse is not uncommon, unfortunately, because when we're groomed as children to act in certain ways or forced, under threat or manipulated in some other way, you know, we we do things because we don't know any better. We don't know what to do. This supposed to be our parent, the one that cares for us and loves us. Why would they want to hurt me? Right? Making sense of all that is what you can work on in therapy. You did not do that on your own. You were too young. You're taking on blame. That's not yours to take. I encourage you to get into therapy so you can start processing this because you are a victim as well. And I know it can feel like you're not. But trust me when I tell you that you are okay and with support it can and will get better. Okay. Thank you all so much for listening and watching this week. Thank you for sending in your questions. I know that, like I said, YouTube posted it twice. I don't know why. Feel free to ask your questions again. I tried to get through as many as I could today. but thank you for sharing this podcast. Thank you for leaving your comments and questions for this podcast. It really does help. Have a wonderful week. Do your homework and I will see you next time. Bye!
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Here are the loose “chapters” in this episode.
0:10: ⚖️ The impact of passive suicidal thoughts, therapist appearance, and physical touch boundaries.
3:42: ⚠️ Understanding the complexity of suicidal thoughts and the importance of seeking help.
7:33: ⚠️ Importance of finding glimmers of hope in overcoming suicidal thoughts
11:29: 💭 Struggling to articulate personal struggles due to perceived insignificance compared to friend's life milestones.
14:41: 💬 Exploring the impact of therapist's age on therapy sessions and the importance of addressing personal struggles.
18:39: ⚖️ Navigating boundaries with therapist regarding physical touch and fear of rejection.
22:04: ⚖️ Considering the possibility of seeking therapeutic touch for grounding during emotional distress.
25:36: ⚖️ Therapist-client boundary exploration through physical touch requests and responses.
29:17: 💡 Discussion on lack of understanding in a clinician's response to a query about self-injury and challenging feelings of humiliation or judgment.
32:59: ⚠️ Importance of considering medication for severe depression symptoms hindering therapy progress.
36:34: ⚠️ Confusion and guilt regarding past actions of child abuse towards siblings at a young age.
