How Mental Health Counseling Really Works

[00:00:00] Pete Waggoner, Host: Hi there and welcome to Beyond the Checkup, brought to you by Stellis Health, where Neighbors Care for Neighbors. I’m your host, Pete Wagner, ready to guide you to a healthier, happier life.

[00:00:10] Pete Waggoner, Host: Let me ask you something. Have you ever caught yourself saying, I’m just tired, or, I’ll be fine once things calm down, but. Deep down, you’re really not actually fine. Well, today’s guest, Tom Hawkins, Stellis Health says that might be your sign to check with a counselor. Tom joins us to break down what mental health care really looks like and why it’s more accessible and supportive than many people think.

[00:00:35] Pete Waggoner, Host: Tom thanks for joining us here today. I know it’s been a busy day. We were kind of going through our days and I really look forward to speaking on these types of topics ’cause I think it’s so important. And we know it’s taken more of a center stage in our world today, and I think it’s great to be able to talk about this.

[00:00:49] Pete Waggoner, Host: So thanks for joining us. Absolutely. Happy to be here. So let’s go right into this. If you can walk us through what a mental health counselor does and what [00:01:00] your role looks like here at Stellis Health. Absolutely. Yeah. So, 

[00:01:03] Tom Hawkins, MHPRAC – Mental Health: Mental health counselor, first of all, they can go by many names. Sometimes they’re called a therapist, psychotherapist, counselor, mental health provider, mental health practitioner.

[00:01:11] Tom Hawkins, MHPRAC – Mental Health: In general you get lots of different kinds of names and types of counselors different levels of education. You might hear different acronyms thrown around as you do elsewhere in the medical world. L-P-C-C-L-I-C-S-W-L-M-F-T basically we’ve got different specialties that focus on different things.

[00:01:28] Tom Hawkins, MHPRAC – Mental Health: Marriage and family substance use social work, but. The foundational knowledge of every mental health provider is the same. The framing sometimes is different, but basically we come from a lens of of understanding how the brain is working, how it’s not working where our behaviors and our thoughts and our emotions all kind of play together and how we can seek solutions to, to feel better.

[00:01:48] Tom Hawkins, MHPRAC – Mental Health: So a mental health counselor. Does all kinds of things, depending on where they come from. But at the end of the day they help you to understand yourself and to feel better where you’re at. Follow up on that real [00:02:00] quick. So 

[00:02:00] Pete Waggoner, Host: in the terms of the different kinds of names do all of you generally carry I don’t wanna say one size fits all, or are there focuses that you have specifically or others do? Yeah, 

[00:02:11] Tom Hawkins, MHPRAC – Mental Health: so, primary example is LMFT, that stands for Licensed Marriage and Family Counselor. So they have some of that foundational knowledge if you’ve ever taken like an introductory psychology class where they know about the different stages of development for all human beings, right?

[00:02:26] Tom Hawkins, MHPRAC – Mental Health: There’s some knowledge about the brand and about behavior that just applies to everyone, no matter your situation. However, they have specific knowledge about relationships how relationships go well, how they go sour and different solutions to, help relationships work in harmony, essentially.

[00:02:40] Tom Hawkins, MHPRAC – Mental Health: Sure. However this general set of classes, general set of courses. I’ll back up. Think if you think about it like a medical doctor, all medical doctors go to med school. But then after med school, they might specialize and become an OB GYN or they might become a psychiatrist.

[00:02:54] Tom Hawkins, MHPRAC – Mental Health: And so mental health providers, mental health professionals have some of that same foundational knowledge, but then they might [00:03:00] specify to different things that they’re interested in or are good at. 

[00:03:03] Pete Waggoner, Host: What’s one small thing that always boosts. Someone’s mood on a tough day. I think we all experience that, obviously. So what do you see in 

[00:03:11] Tom Hawkins, MHPRAC – Mental Health: that? Yeah, no, absolutely. There are little things that I suggest and that I do even every day. We use the word self-care a lot. That’s kind of a buzzword that’s thrown around a lot especially in kind of pop culture and popular media.

[00:03:22] Tom Hawkins, MHPRAC – Mental Health: Self-care boils down to what it says, taking care of yourself. It’s little things that you can build into your day to kind of make you feel better, make you feel more mindful. Something that’s enjoyable. Typically I like to recommend little things that get your body moving, going for a short walk standing up, doing some stretching.

[00:03:39] Tom Hawkins, MHPRAC – Mental Health: This could be spending some alone time. If you’re an introvert maybe you have a job that has you connecting with people all the time, but that’s not how you get your energy. Then your self-care is making sure that you set aside some time in the day to be able to recharge. Take that time for yourself.

[00:03:52] Tom Hawkins, MHPRAC – Mental Health: Connecting with your support systems, with your friends or family members. We know even just statistically that people with stronger support systems have better mental [00:04:00] health outcomes. And so if you can at some point in the day give your mom a call, then a lot of times that’s a boost for your mood, for your mental health.

[00:04:07] Tom Hawkins, MHPRAC – Mental Health: Mental health. And she’ll probably enjoy that too. And then that I call the two pack. Yeah, exactly. Yes. Yes. That helps. It helps everybody involved. Right, right. The last one is gratitude. Gratitude is something we kind of take for granted, but if again, this is something statistical that we know is helpful, but also just, it can pretty easily make you feel good if you give it a try. If you just make a short list of things that you’re grateful for, these can be things you’re grateful for in the moment, things you’re grateful for in the grand scheme of things then that can help really shift your perspective and kinda put you in a better mood, better mindset.

[00:04:38] Pete Waggoner, Host: Do you find that there are things people say or feel that, you know, maybe a sign that, you know what it’s time to talk to a counselor here?

[00:04:47] Pete Waggoner, Host: I mean, just through conversation where you might say, yeah, absolutely. 

[00:04:50] Tom Hawkins, MHPRAC – Mental Health: Kind of some. Initial red, not necessarily a red flag. Sometimes they call ’em a yellow flag, right? Where you’re like, okay, pump the brakes. Slow down. Let’s see, what else might be at play here? [00:05:00] Usually that has to do with some of the basics.

[00:05:02] Tom Hawkins, MHPRAC – Mental Health: Food, sleep things like that. So if you’re not sleeping enough, if you’re sleeping too much trouble getting asleep or staying asleep if you find that you don’t really have an appetite anymore or if you kind of have this increased appetite where it’s hard to stop maybe eating junk food, things like that.

[00:05:15] Tom Hawkins, MHPRAC – Mental Health: Those are really basic triggers that is our body telling us. There might be a little bit more going on. The bonus of my working at Stellis Health is that I share the building with a lot of primary care providers, family practice, other specialties. And so if there’s something going on with your thyroid, we can figure that out too.

[00:05:31] Tom Hawkins, MHPRAC – Mental Health: But if there’s mental health stuff going on, I’m your guy. Your mood is one. If you’re feeling irritable, like easily irritated. If you’re having trouble paying attention, if you’re getting easily overwhelmed and frustrated with things, if you’re noticing, this is a big one, a change from your baseline.

[00:05:47] Tom Hawkins, MHPRAC – Mental Health: So if you think about how your mood is, how you’re acting typically on a normal day, and then you start to notice that, you know, I don’t feel happy go lucky and productive anymore. What has changed. That might be your symbol. And then if others [00:06:00] start to notice too, if you’ve got a good friend or a spouse or a partner who says, you know what?

[00:06:03] Tom Hawkins, MHPRAC – Mental Health: You’re not really acting like yourself. Those changes can happen really slowly. And sometimes we are not our own best judge because it’s our own behavior, it’s our own life. Yeah. So if you’ve got a third party and outside person who’s saying, you know, you’re acting kind of strange lately, is everything okay?

[00:06:19] Tom Hawkins, MHPRAC – Mental Health: Then that can definitely be a yellow flag. The biggest thing that I would say is persistence. If you are having symptoms like that are persistent over long periods of time, that gets to the point of a red flag. Because we have things that happen in life we might lose a family member that’s a part of, we might lose someone that we love, a pet even.

[00:06:39] Tom Hawkins, MHPRAC – Mental Health: We might have a big change in our job. We might move. Those can affect our mood. That is typical normal mood reactions to life, however. If those reactions persist for a long time or if those reactions are happening kind of without some kind of stressor in the mix, that’s when we need to start looking for some [00:07:00] additional help outside of just maybe talking to a friend about a loss or working with our family to help with a move, things like that.

[00:07:07] Pete Waggoner, Host: How important is it for someone to have the ability to hear that? But not take it personal or get upset? 

[00:07:14] Tom Hawkins, MHPRAC – Mental Health: And that’s also a skill that, that we might work on, right? Part of what I do with people is skill building coping skills and communication skills. And that might be hard to hear, right?

[00:07:22] Tom Hawkins, MHPRAC – Mental Health: Whether it’s. Small and personal, or whether it’s a larger intervention. We, you know, we hear in pop culture about the whole family gathers in a room and they have an intervention. Usually the person who is being intervened is not thrilled about that. But know that if you’ve got someone that you love in your life who is making that kind of that kind of observation that they’re doing it because.

[00:07:41] Tom Hawkins, MHPRAC – Mental Health: They love you and they don’t want you to be uncomfortable or in a bad place. That it’s not coming from a not coming from a mean point of view. Hopefully, but that it’s coming from a place of love. 

[00:07:51] Pete Waggoner, Host: Wonderful. 

[00:07:52] Pete Waggoner, Host: What are the biggest myths or misunderstandings people have about receiving or getting mental health support, do you think?

[00:07:59] Tom Hawkins, MHPRAC – Mental Health: [00:08:00] Well, there, there are a couple big ones. The first is that, people don’t really think about mental health and physical health in the same column necessarily. But your mental health is your physical health. Your brain is a part of your body, right? The things that you do, the things that you think and the things that you feel are all intertwined.

[00:08:18] Tom Hawkins, MHPRAC – Mental Health: So not only that, but sometimes our mental health symptoms are embodied, which means that we feel our anxiety or our worry or our anger. Someplace in our body that might be a headache, that might be shortness of breath, might be panic attacks. Sure. Are often very embodied. So mental health, just because we can’t necessarily see it, we, you can’t see if someone has depression by looking at them, right?

[00:08:40] Tom Hawkins, MHPRAC – Mental Health: That doesn’t mean that it doesn’t affect their functioning or their life or their body, frankly. So mental health is physical health. That’s a big one. Another one is that mental health care is incredibly personalized. Mental health in medicine is a big gray area. Sometimes it’s called a soft science kind of like sociology or philosophy.

[00:08:59] Tom Hawkins, MHPRAC – Mental Health: [00:09:00] But mental health very much is a hard science because there’s chemistry at play. However, there’s not really a black and white diagnostic process. If you go into urgent care with abdominal pain and they do an ultrasound and you have a kidney stone. It’s yes or no. You either have a kidney stone or you don’t.

[00:09:17] Tom Hawkins, MHPRAC – Mental Health: But where you fall on the spectrum of depression or the autism spectrum or the schizophrenia spectrum, that’s, it’s not black and white. Right? And that looks very different because our thoughts and our emotions and our behaviors all contribute to how that looks. And none of us thinks exactly the same.

[00:09:35] Tom Hawkins, MHPRAC – Mental Health: None of us feels exactly the same. None of us acts exactly the same. So it’s very gray area. It’s very personalized. But that means in some ways I can feel a little bit better about my job because you are the expert. I get to sit down with you and we get to work together. I like to say that I work with you and not on you.

[00:09:52] Tom Hawkins, MHPRAC – Mental Health: Oh, I don’t come in and, right. Yeah. 

[00:09:54] Tom Hawkins, MHPRAC – Mental Health: I should trademark that one. 

[00:09:56] Speaker: I, I, you need to, yes. That’s really good. And work with you and not on No, that’s really [00:10:00] fair. Because I think sometimes I think when people are seeking help, they want to be, they 

[00:10:05] Speaker: Wanna be worked on.

[00:10:06] Speaker: Sure. And not with. I think sometimes fair. 

[00:10:08] Tom Hawkins, MHPRAC – Mental Health: Yeah. Yeah. If you’re going in for a surgery, you want your surgeon to work on you. I don’t know where my appendix is. Right? If I’m getting an appendectomy, I need my surgeon to know his stuff and to work on me in that way. However, if you come to the counseling room, I don’t know about your life, you have to tell me, and then we work together to get to the bottom of what’s going on.

[00:10:29] Tom Hawkins, MHPRAC – Mental Health: Great 

[00:10:29] Pete Waggoner, Host: stuff. What does that progress in mental health look like? I mean, how do you help and how do you know, see, feel when they’re getting 

[00:10:38] Tom Hawkins, MHPRAC – Mental Health: better? It’s an excellent question because as I said, you can’t always see it. It’s not like, if you go to ortho here, see Dr. Genji, you might be on crutches when you start and then not when you’re done.

[00:10:48] Tom Hawkins, MHPRAC – Mental Health: That’s very clear progress. But you can’t see if someone’s getting more depressed. That’s the black and white again. Right? Exactly. Yeah. Yeah. You either have a broken leg or you don’t. You’re better or you’re not. However. First of all, the [00:11:00] overall goal of me or any counselor is to work myself out of a job.

[00:11:04] Tom Hawkins, MHPRAC – Mental Health: It would be great, if my profession didn’t have to exist, that’d be awesome, but it does. So my overall goal is to make you not need my services anymore. 

[00:11:12] Tom Hawkins, MHPRAC – Mental Health: Sometimes that’s very clear. Sometimes that happens over a long period of time. Sometimes someone cancels on my schedule and I never see them again.

[00:11:19] Tom Hawkins, MHPRAC – Mental Health: I take that as a great sign. That means that I did my job. It also might mean that I see them two years from now and they say, I got some more stuff to talk about. But as far as tangibly in the counseling room, we start with what’s called coping skills. Like I said earlier, we can’t eliminate the stressors of daily life.

[00:11:36] Tom Hawkins, MHPRAC – Mental Health: So we introduced some skills right away to be able to cope with it. That can be like some mindfulness meditation that can be some grounding exercises. Very simple stuff to kind of work towards feeling better, being more regulated so we can do some deeper work towards insight. That’s kind of the second step is we’re looking for not what’s going on, but why it’s going on.

[00:11:56] Tom Hawkins, MHPRAC – Mental Health: And then what can we do? Do we need to process some stuff? Do we need to build some [00:12:00] different skills? Do we need to talk about communication skills with people in your life? Sometimes we also set tangible goals depending on what’s being worked on. Like I said it’s very individual to the person.

[00:12:10] Tom Hawkins, MHPRAC – Mental Health: That goal might be, I want to have a conversation with this family member without getting into an argument at least one time this week. It could be as simple as that. Or it could be I want to attend a social gathering with my spouse without having to leave early. There we go. Do you find 

[00:12:26] Pete Waggoner, Host: those goals are done together with the two of you, or is that mostly with the person that’s seeking your care?

[00:12:34] Tom Hawkins, MHPRAC – Mental Health: That’s definitely one of the collaborative pieces. Yeah. So some of the goals might happen in the counseling room. Where, you know, the goal is for you to express the emotion that you’re feeling. That would happen literally with me. Sometimes those goals are generated simply by the person. They come in and they say, I want to go to school and not have a panic attack.

[00:12:56] Tom Hawkins, MHPRAC – Mental Health: Okay, how do we get there? That becomes our job to work [00:13:00] together. Sometimes it might be based on my observations where I say, so here are the patterns that I’m seeing. What are your thoughts on that? Is that something that’s comfortable for you? Is that something that, that impedes your daily functioning?

[00:13:13] Tom Hawkins, MHPRAC – Mental Health: If so, how do we work to move beyond that? 

[00:13:17] Tom Hawkins, MHPRAC – Mental Health: How about some practical tools that you can give people to manage anxiety, stress, sadness, and things they can do even before they come to see you? Absolutely, 

[00:13:28] Tom Hawkins, MHPRAC – Mental Health: yeah. Honestly, as cliche as it sounds. Journaling is a really good way to help identify patterns and look for some of that insight.

[00:13:35] Tom Hawkins, MHPRAC – Mental Health: Sometimes that’s the first thing that I Why is that do 

[00:13:37] Pete Waggoner, Host: you think? 

[00:13:38] Tom Hawkins, MHPRAC – Mental Health: Because it is impossible to dissect something that you are a part of. 

[00:13:42] Tom Hawkins, MHPRAC – Mental Health: Which is why a counselor is good at their job because they’re not a part of your life.

[00:13:46] Tom Hawkins, MHPRAC – Mental Health: They are a neutral third party. And they can see the patterns that you don’t often see because you are the one in the patterns. Yeah. Does that make sense? Yep. So if you journal, that helps to get some of the things in your head down onto a page. [00:14:00] And then if you are seeing, okay, every time that I’m working at this location, these are the, this is the mood that I’m in.

[00:14:06] Tom Hawkins, MHPRAC – Mental Health: Or, you know, every time that I go to this person’s house, here’s how I’m feeling. That’s a pattern. That helps us to find some insight and then how do we build some skills and process that and talk about it. So journaling, truly does help. It can be as simple as writing down a number outta 10 at the end of the day and saying, I felt eight outta 10 happy today, or I felt two outta 10 happy today.

[00:14:27] Tom Hawkins, MHPRAC – Mental Health: And then you can look back on that and say, oh, it seems Monday’s our three outta 10 day. That’s a pattern. Then you come to me with that and we say what’s going on Monday so that we can talk about. So journaling is my number one. That’s fascinating by the way.

[00:14:40] Tom Hawkins, MHPRAC – Mental Health: It’s truly some of the simplest things have the biggest impact that, that you don’t, right, exactly. Don’t think of. Exactly. Yeah. Yeah. The other is gratitude. If you keep a little list of things that you are grateful for, something you can add to consistently, or one that you do daily.

[00:14:53] Tom Hawkins, MHPRAC – Mental Health: You say I’m gonna name three things that I’m grateful for at the end of every day. It’s also a little bit of a kind of journaling, so forgive me for [00:15:00] that. But that helps to shift our perspective away from maybe what’s wrong, to what’s going right. How can I get some more of that into my life?

[00:15:07] Tom Hawkins, MHPRAC – Mental Health: The last one is grounding grounding in mindfulness practices. Mindfulness is another buzzword that gets thrown around. But sometimes when we are overwhelmed, when there’s a lot of anxiety going on, when we’re very busy, our thoughts can tend to kind of spiral and approach a worst case scenario or to get bigger and bigger until it feels like they’re not in our control anymore.

[00:15:29] Tom Hawkins, MHPRAC – Mental Health: A way to combat that. Is to focus on some real tangible things in the room around you. One of my favorite examples it’s called the 5 4 3 2 1 grounding technique. I like it so much. I have a sticker of it on my water bottle. You do. And 5, 4, 3, 2, 1, because it’s the five senses. So you start with five things that you can see.

[00:15:48] Tom Hawkins, MHPRAC – Mental Health: You look at them around the room. You might name them out loud. You might name them if your head, if you’re in a public space, like on the bus or something. But this is something I do. In the counseling room with my clients sometimes. Five things you can see, you name [00:16:00] them. Four things that you can touch and then you actually physically touch them.

[00:16:03] Tom Hawkins, MHPRAC – Mental Health: It might be the smooth tabletop, it might be wool, sweater. Four things you can touch, three things that you can hear, and those are specific things. So this forces you to take a moment. What are some things that you hear in your environment? It might be a car outside the HVAC system. It might be your own heartbeat.

[00:16:21] Tom Hawkins, MHPRAC – Mental Health: Yeah. And what we’ve done there is we’ve taken us from those big emotions way up in the ether that we can’t touch or control or do anything about right now. And now I’m focusing just on what I can hear, huh? And then it’s two things that you can smell. It might be your own clothing the dryer sheets.

[00:16:36] Tom Hawkins, MHPRAC – Mental Health: It might be the perfume of someone who walked by in the hall. And then one thing you can taste could be your coffee from before. Breakfast could be a mint that I’ve got in my office. And. That brings you right back down to center that might happen in the middle of a session. And then that allows us to continue making good progress if we’ve gotten kind of too overwhelmed throughout 

[00:16:55] Pete Waggoner, Host: the, throughout the, oh, that’s just like breaking it down and simplifying. Absolutely. [00:17:00] Yeah. And quieting noise.

[00:17:01] Tom Hawkins, MHPRAC – Mental Health: 5, 4, 3, 2, 1. That. Do you give those out? I should I, you’re not the first person to say that. Yeah. You should. Yeah, I should have just a stack of those. But no, I keep it on my water bottle because I usually forget which number goes with which one, and we’re you, I can’t name five things that I can taste, so I’ve gotta remember that.

[00:17:18] Tom Hawkins, MHPRAC – Mental Health: It’s five things you can see and 

[00:17:19] Pete Waggoner, Host: On down the line. Exactly. Yeah. How about resources, apps, books, websites, anything you can recommend someone starting to explore their mental health that would supplement what you’re doing as well? 

[00:17:30] Tom Hawkins, MHPRAC – Mental Health: Yeah, absolutely. I’ve got a book, an app, and a blog that I’ll give you.

[00:17:34] Tom Hawkins, MHPRAC – Mental Health: The first is a book called Quiet. I forget the author off the top of my head, but that’s the only titles. It’s called Quiet and it’s about introversion and extroversion and how those contribute to mental health. The kind of the thesis of that book is that we, in the United States.

[00:17:49] Tom Hawkins, MHPRAC – Mental Health: Are a very extrovert focused society where we live for the people who are big and loud and influencers and good public speakers. And not so much for the people who are [00:18:00] quiet and thoughtful and behind the scenes, and that can make introverts feel not quite as valued. Kind of feel like they’re kicked to the wayside.

[00:18:07] Tom Hawkins, MHPRAC – Mental Health: But the book, quiet. Talks about why that has become the case. Talks about kind of affirming the fact that it’s okay to be an introvert. And then it talks about some skills that introverts can use to feel a little bit more at home, and some skills that extroverts can use to be a little bit more inclusive of those introverts in their life.

[00:18:26] Tom Hawkins, MHPRAC – Mental Health: The next is an app. The app is called Calm. Again, just one word, CALM. And that is one that has some guided meditation stuff. It has some some music and some calming noises that can help be one of the things that you can hear, right? Like in, in that grounding exercise that helps you to bring you into something a little more tangible and out of your own head with the things that are out of control.

[00:18:47] Tom Hawkins, MHPRAC – Mental Health: And the last one is the Stellis Health blog. Shameless plug. But we’ve got the Stellis Health blog that updates constantly. I was just in there the other day looking at kind of what other mental health stuff is in there. There’s another Dr. Beth Forge did a podcast focused [00:19:00] on seasonal affective disorder.

[00:19:01] Tom Hawkins, MHPRAC – Mental Health: And there’s other really great resources constantly updated obviously by people like myself and people who work with me who have good information backed by research that can help in day-to-day life. How much have you loved your 

[00:19:13] Pete Waggoner, Host: job? I absolutely love my job. I can tell. Is it, yeah. Is it obvious?

[00:19:17] Pete Waggoner, Host: It’s wonderful. No, I mean, you’re delightful. Refreshing. Thank you. I would say comforting you, you know what you’re doing, and I would just say being in the room with you, obviously with Tom Hawkins, your mental health practitioner, here at Stellis Health I would urge anybody and everybody to give you a call if they’re not feeling right, because you do love your job.

[00:19:40] Pete Waggoner, Host: I can feel it, and I think it’s really great. Thank you very 

[00:19:42] Tom Hawkins, MHPRAC – Mental Health: much. It’s been a pleasure to be here and not just here doing the podcast, but here at Stellis with the opportunity to do something that, that I do love making a difference. For sure. Yeah. 

[00:19:51] Pete Waggoner, Host: Thank you for joining us. Thank you for having me.

[00:19:53] Pete Waggoner, Host: Really good stuff here. That’s a wrap for this episode of Beyond the Checkup, brought to you by Stellis Health. We’re neighbors, care for Neighbors. [00:20:00] I’m Pete Wagner and I’m grateful you spent time with us today. If something in this episode made you pause, nod your head. Or feel seen. Don’t keep it to yourself.

[00:20:10] Pete Waggoner, Host: Send it to someone you care about. Start a conversation. That’s how we change the way we care for ourselves and each other. Subscribe to Beyond the Checkup for more real talk about your health. Until next time, stay well and keep showing up for yourself.