“Every Who down in Who-ville, the tall and the small, was singing! Without any presents at all! He HADN’T stopped Christmas from coming! IT CAME! Somehow or other, it came just the same!”—Dr. Suess, The Grinch Who Stole Christmas

Memories are powerful things. They can fill us with joy and laughter, or they can cut us to the core with deep sorrow. While the holidays hold many joyous memories for me, they also hold some of my most painful ones as well. Not only did both of my parents die very young, but they also both died in the month of December.

One of the most intense memories that I have of my dad is hugging him goodbye on Thanksgiving day. He was terminally ill, and I didn’t want to let him go. You just never really think it will be the last time, but something inside me knew…this was it.

In 2008, celebrating Christmas morning with three small children running about with Christmas Pjs on and reindeer antlers atop their heads was most definitely the last thing I wanted to be doing that day. I was still in shock from my mom’s sudden death and had just attended her funeral only two days prior.

Years later I would experience that deep pain again in the form of separation and divorce. In my latest book, Common Threads, I share the added reasons for me now that the holidays are not the most wonderful time of the year. In a chapter aptly named “Holiday Hell”, I get raw about my intense struggles with the holidays following my separation:

As grueling as that experience {loosing my parents} had been, this year was simply unbearable. Could I just go to sleep and pretend Christmas never happened? Tear the month off the calendar and pretend it was January? My kids still give me a hard time about how we moved all the clocks up in the house for New Year’s Eve when they were young so they thought they got to stay up until midnight. Yep, I’m pretty sure at this age they would figure out if I literally skipped an entire month. -Common Threads 

Like it or not, life does goes on and the holidays do not wait for us to have our life in order.

Why can the holidays be difficult?

There are many reasons why the holidays can be difficult and, in some cases, lead to clinical depression.  Working as a family therapist in the months of November and December, what I hear in my office is often a stark contrast to the glossy magazine covers and holiday images in the media. Marriages fighting to stay together, deep family divisions, and parents that long to hold babies that will not be.

I am certainly not trying to be the Grinch and steal all your holiday cheer, but this is often a very overlooked topic. In a society that wants to only focus on positive emotions and bury negative ones, we need to get OK with experiencing all kinds of emotions even during the holidays. Let’s look at some of the issues impacting people during the holidays and how you can best help yourself or someone you love through this season.

Death

For some families, they have suffered the death of loved ones since they last gathered around the table for a holiday.  My heart is tender for some of my closest friends this year as they will be sitting down for the first time and looking at that empty place missing a parent. That is never easy.  Even when the loss has been years, some years are harder than others. My heart also hurts for all the parents I have counseled with over the years who have suffered the unthinkable pain of the death a child. This time of the year is especially difficult for these families.

Job losses, divorces, and loss of health status

Loss is not always related to death. There are also the losses that unless you have personally experienced them you may not realize the impact. While we are busy preparing for celebrations some families are in the middle of some of the most difficult times of their lives. Many of these things are so commonplace that we forget they create deep pain and that holidays often amplify the circumstance.

• Job losses create feelings of personal failure as well as the financial pressures.

• The holidays place a lot of pressure on families who are trying to navigate separation and divorce. This has certainly been the case for me over the last three years. Trying to keep holiday cheer and traditions can be extremely difficult and painful for adults and children. Just seeing decorations or hearing holiday music can send a cascade of emotions in play.

• Our health is certainly one thing that we easily take for granted and the holidays can emphasize these health issues as people come to grasp with not being able to do the things they once enjoyed with their families.

Chronic Depression

For people who struggle with chronic depression, the holidays can induce guilt like no other time of the year. As we are constantly marketed that we are supposed to be happy and joyful, it just reaffirms to those experiencing depression what a difficult time they are having. Attending events and pretending to be happy can be exhausting. It is difficult for some people to understand how people can be depressed amidst all the festiveness of the holidays.

Separation

Not all families can be together for the holidays due to geographical distances. This is a strong reality particularly for many of our military families who due to deployments endure many holidays apart.

Expectations and Hype

 At this time of the year, we are constantly shown images of “perfect families” gathered around the table for meals. What if your childhood was anything but wonderful? What if your adult family hasn’t matched your expectations? These images can cause distress as we compare ourselves to ideals that are more than likely not attainable.

How Do We Cope?

Feel all the feels!

I am not a trendy girl and generally learn all the latest “meme” language from children. However, the therapist in me does love “feel all the feels”. What this means is don’t try to hide your feeling from friends and loved ones. If this season is difficult for you let people know how you truly feel. Don’t worry about “ruining” other people’s holidays these are your personal feelings. Sharing your feelings with friends or family who can share your burden with you can be a huge relief. Often depression is the result of suppressing and stuffing our true feelings in and putting on that mask of “I’m fine’.

Embrace Change

Whatever you are going through if you just can’t do the usual traditions, them don’t do it! Change things up and start new traditions. This may be difficult for other family members, but you must take care of your own emotional needs. Letting go of the old ways does not mean you are forgetting or dishonoring it simply means that it is time for a change. And…if you need to, pull a John Grisham and “Skip Christmas”, I hear Cancun is very nice this time of the year! (P.S. …Take me!)

Honoring those we Love

There are many ways to honor those we have loved and lost. These are just a few:

• Make a special ornament
• Make a donation or volunteer with a charity they loved
• Write them a letter
• Create a special photo collage
• Leave a place for them at the table
• Make a special area with photos and light a candle at gatherings
• Take a special arrangement to the cemetery

Patience with Yourself

Acceptance of change or grief in our lives takes time. In our fast food, instant gratification world, we are expected to just move through things at lightning speed. The problem is that the heart was not designed to move at this speed. Healing takes time and we must experience the deep pain in order to come to the other side of healing. I tell all of my grief clients that it is like standing on one side of a river and needing to get to the other side. There is no bridge and the river is filled with alligators and all kinds of miserable creatures.  You know yourself, go at your own pace and don’t feel pressure to pretend that you are Ok if you are not.

Patience with Others

It is important to recognize that everyone does not experience situations or grief the same.  Keep your advice and judgement out of conversations with people going through difficult times. They just need for you to listen and to know you are there. Also, don’t hesitate to reach out because you don’t know what to do or say. Send a “thinking of you” card or just call them and admit you don’t know what to say or do but you are there. These things go a long way!

Seek out Professional Help

Talking to a trained professional can help alleviate many of the feeling that you are experiencing. Clients are often relieved to find a space where they can say whatever they want and not worry about offending anyone. A mental health professional can also help you determine what is normal and what may need other interventions such as medication referrals to help you on your healing journey. You can find providers by contacting your primary care doctor or your insurance company who can help you find resources in your area. 

We all have a little child inside of us that continually wishes for happy endings. I know I wish that I had my parents for longer, but over the years, I have learned to be thankful for the time that I did have them. One thing we can count on in this life is that we are going to face many challenges along the way.  Despite all of this, the human spirit has this incredible ability to experience deep, painful emotions and heal.

This holiday season let yourself feel all the feels because that is how we know that we are alive and we have loved deeply. As Dolly Parton’s character Truvy stated so well in the movie Steel Magnolias, “Laughter through tears is my favorite emotion”. Wishing you all peace and healing this holiday season. Namaste

Don’t miss future blogs! follow me at:

Resiliency Counseling and Consulting, PLLC 

Melissa Collins Harrell Author

Read more about Melissa C. Harrell and her work. She is the author of Common Threads: Why the Answers to the Present Lie in the Past.

The purpose of this blog is to offer educational information related to mental wellness. Resiliency Counseling & Consulting, PLLC and Melissa Harrell do not offer diagnosis or treatment through this medium. If you feel that you or a family member needs to access mental health services, first contact your primary care physician for assessment and direction in your area. If you need immediate help, please contact the National Suicide Prevention Lifeline at 1-800-273-8255.

After wrapping up Common Threads, a very personal memoir, my goal was to put my artistic energy into fiction writing. I felt that I had said all I needed to about my personal journey. I was eager to dive into creating new characters and chapters, preferably fictional ones that have little to do with my personal life. Nevertheless, each time I sit down to write, the only thing that pours out are the events over the last six months.

Hmmm…back to the old adage, write what you know. Even though I have written my whole life story for all to read (yikes!), each new story requires a fresh level of courage and vulnerability. Breathe in deeply…take a long exhale…..here we go.

My overall goal with Common Threads,  is to give hope to two main target audiences: those going through mental health struggles and those loving and working with them. The purpose of this blog series remains the same, with a particular emphasis on Post Traumatic Stress Disorder (PTSD). Sharing the raw truth about my continued struggles with PTSD, while incredibly difficult,  serves as a stark reminder for both the therapist and reader alike. While PTSD can be helped tremendously with treatment, we are never truly rid of the long lasting impacts of these traumas on our brain.

As a society we love to see the underdog prevail, hear the rags to riches stories, and use the pull yourself up by the bootstrap’s mentality.  While we celebrate these resilient triumphs, we often never know the deep, dark waters our heroine waded through to get to the point of success. Before people can rise from the ashes, there is the endurance of the flames of the fire. When we experience difficult times, we must give ourselves, and others, the permission to feel the emotions required to heal. We can’t just minimize the event, plaster on a smile, and say, “It’s all good”. Ah, but alas, even this veteran therapist looses sight of this in times of crisis.

The Epilogue of Common Threads is what therapists call a future script. After a traumatic event, to create hope, we ask our clients to write how they want to see their future after healing. In my future script I write:

“While my experiences have made me keenly aware that in this life there will be deep sorrow to bear, I know there is also joy to be found.”

This spring, after years in the proverbial desert and feeling zero hope for a future, I was, dare I say, optimistic. I had survived three years of hell and clawed my way out of a pit that I never thought possible, I was hopeful to see a period of sunny days before my next set of trials. In early February, I had already lived out the epilogue of my book by boarding a plane back to Guatemala to do the humanitarian work I love with Unearth Hope.

Yes, this was it, the winds were shifting, and I was adjusting my sails to head boldly into a new phase.  Professionally, I was on a high promoting my book and rebranding my speaking and consulting business. I was also engrossed in growing my EMDR therapy skills. This new skill made me feel a passion for therapy that I hadn’t had since I started the profession over twenty years ago. As client after client experienced healing from the most devastating events, I felt that God had truly made beauty from ashes.

In my personal life, I was wading into very uncharted waters, dating post-divorce. Have mercy, single life at almost 50, that will be a book all to itself. After my divorce, I began to search the web for a convent that takes divorced women who have children and who are also not Catholic. I will save you the search, one does not exist. However, stay tuned, I may be opening the Tipsy Nun Convent very soon. We will be praising Jesus while growing grapes and cultivating wine to support our charitable causes. In box me for details.

Yet, even with all the doubts and cynicism, as the universe would have it, I met someone unexpectedly. Someone who could ignore my neurosis, made me laugh, and made me feel that maybe, just maybe, there was life after divorce. Trauma be damned, the only place I planned on seeing trauma again was in my counseling office. Bye bye!

I desperately wanted to believe this truth along with these lyrics from Natalie Grant’s song Our Hope Endures:

You would think only so much can go wrong
Calamity only strikes once
And you assume that this one has suffered her share
Life will be kinder from here. 

Oh yes, Natalie, one would think that only so much could go wrong and that life would be kinder from here…sigh. However, per the Book of Melissa, that was not to be the case.  If you’ve read my book, you know I’ve made that mistake before, thinking I could just break up with trauma. Note: Melissa, please refer to your own book page 29…

Even though rationally I know there are no limits to the curves life can throw you, I still unconsciously believed there was a formula. After all the battles with family mental illness, losing my parents so early, and years of walking through the wilderness to find the path God was calling me to, I erroneously believed that I had been through my fair share of tests.

 No, apparently for me, trauma is like a stalker ex-boyfriend who refuses to go away.

In February of this year, after working a six-day stretch, I decided to give myself a day off from all things work. The self care expert was taking her own advice and making time for her needs.  I went to an invigorating yoga class and met some friends after for lunch. However, the yoga glow and ZEN didn’t last long. Just as I was finishing up, I got the call that every parent fears once your kid takes their first solo drive. My daughter who had only had her license for a few months had been in an accident. I arrive at the hospital to find her black and blue and shaken up but thankfully no major injuries. Relief…I could finally exhale.

These are the spaces where the therapist says to herself,  “Use your gratitude skills”. I told myself the things that must people would. Cars can be replaced and that her safety was the main thing. Seems like sound advice… well sort of.  I adore the work of  Brene Brown a psychologist who has done incredible work on the power of vulnerability and empathy.  If you have never seen her video on empathy versus sympathy, totally worth your two minutes! Here she shares that no empathetic response should begin with “well at least”. Yet, we do it all the time to ourselves and others. And that is exactly what I did in the days following her accident.  At least she was Ok…at least no one else was seriously injured…and so on.

For me, the “well at least” statements and gratitude were quickly replaced by the the financial pressures of being a single mom. Hospital bills quickly rolled in, and I had to replace a totaled car in an economy where inflation was out of control. Oh yes, and the increased premiums of car insurance for a teen driver who now has an accident on her record. No, not even that little annoying insurance gecko could help me out on this one. But, hey I told myself, accidents happen, and “at least” we are all OK.

In May, I watched both of my daughters achieve milestones in their lives. My oldest daughter graduated from her medical lab tech program and started her first big girl job. One baby bird launched, hallelujah!  My middle daughter graduated from high school and was headed to college. Meanwhile, my son completed his junior year and was the next on deck to walk through his senior year. These events are always momentous for a parent, but to watch my kids move from surviving to thriving after their lives were shattered, made my eyeballs sweat more than a few times.

Fast forward to late July of this year. I had just retuned home from presenting at a large medical convention where it seemed the entire medical world was finally understanding the impacts of trauma on health. I was exhilarated but also exhausted from an early start that morning and a 3 hour drive home at the end of the day, By eight o clock, I had yoga pants on, hair slung up in a messy bun, and was letting the Zen set in. I could finally relax as it appeared the winds were in my favor, pushing me closer and closer to my new goals and dreams.

Any parent of this generation of teens knows that if your child actually calls you versus sending a text, be prepared, it is definitely serious. Adrenaline is truly a remarkable hormone, and impacts the body at a rapid pace. A phone call from my sixteen year old son has me out of my bed in seconds and pulling shoes on mid flight down the stairs.  As I launch out the door and into my car I can hear these lines from my own book in head:

“Fight or flight brain shut down in 3 … 2 … 1. Deploy rational brain crisis counselor mode in 3 … 2 … 1.”Or in this case, deploy “Mama’s got it” mode.

His words echo in my head: Mom… it’s bad, it’s really bad…Mom…Mom…the car is on fire. I didn’t have time to process the true depth of what I had just heard,  I just had to get to my kid. I am the first to arrive to the scene of his car crash. He is standing in the center of the road, less than a mile from our house. He was pale, and his face had that distinct look of shock. With the sun setting behind him, the whole scene had an ominous feel like the start of an apocalyptic movie.

As I exit my car, my internal voice switches from my own to my former EMT instructor: Do you have BSI on? Is the scene safe? In the EMS world, this means don your personal protective gear before proceeding to the patient and make sure the area you are about to enter is clear of danger. I can’t tell you how many EMTs “die” during in class trainings because we walk right into situations where we get ourselves shot or mowed down by a car. Well, this is my kid so forget the BSI, but I was concerned about scene safety. Which made me ask him the obvious question… Where is the car? 

I follow his hand like Scrooge in A Christmas Carol follows the Ghost of Christmas future as he points to a wooded area. I was most definitely not prepared for what I saw. This crash scene could easily be used as footage in an EMS training or defensive driving class. That was the moment that disassociation set in. Disassociation is an automatic coping mechanism the brain turns on to help us get through traumatic events. We literally drop down from our thinking brain to our animal brain and become physically and mentally numb.

I turn back to look at my son, fully gripping his body but in a panic that he really wasn’t there. My brain could not justify these two images. Looking at that mangled car, he should be dead. Trauma reactions are based on how the brain reads an event and that night my brain read that scene as death. So much so that my brain had convinced me that if I let go of him and walked over to the car,  I would find what I feared most to be true. My son was actually not standing before me, but dead.

You can understand biology and how trauma impacts the brain to the highest level, but when it happens to you, the impacts can no more be stopped than you can stop a run away train. Say all the positive statements that you want, smile through the pain, but these responses will eventually come for you.  While I was grateful that his life was spared, I had no idea the biological chain of events that had been ignited in my brain.  Cradling my son in my arms, I am unaware, that neurochemicals are fast at work. This time “well at least he didn’t die” was not going to stop these biological responses.  Like a prison warden unlocking cell after cell, old traumas were being released one by one and setting the stage for a new PTSD battle that I was not prepared to fight.

Don’t miss future blogs! follow me at:

Resiliency Counseling and Consulting, PLLC 

Melissa Collins Harrell Author

Read more about Melissa C. Harrell and her work. She is the author of Common Threads: Why the Answers to the Present Lie in the Past.

Photography credits to David Cain of The Cain Gallery 

The purpose of this blog is to offer educational information related to mental wellness. Resiliency Counseling & Consulting, PLLC and Melissa Harrell do not offer diagnosis or treatment through this medium. If you feel that you or a family member needs to access mental health services, first contact your primary care physician for assessment and direction in your area. If you need immediate help, please contact the National Suicide Prevention Lifeline at 1-800-273-8255.

Write the book that you want to read. That is the adage drilled into writers. Today marks six months since Common Threads was published and over the last few months for me, that motto shifted from write the book you want to read, to write the book you will NEED to read.

As I share in my book, I always dreamed of writing more books after my children’s book Elizabeth and Stella Meet ZOE. However, Common Threads was not the next book I had envisioned writing at all.  From the day I brought my first child home from the hospital, I began to joke about writing a book. As a new Mom, on the days when I felt like I was nailing it as a parent (which were few and far between), I vowed to write a play book on the tricky art of mothering. This book, likely fueled by insane levels of caffeine, would contain mind-blowing information on how to rock this mom thing. The main purpose of this book was not so much to inspire others, but so I could read it the next day when I felt like a complete failure at the mom gig.

While Common Threads is not a parenting book, using my own book as a survival guide, came to fruition over the last six months. Nothing will hold your manuscript to the test like seeing if you can take your own advice. Initially after the book was published, I was on a high for the first three months. Like a mother laboring to deliver her child I had nurtured and birthed my book and it was a dream come true. I continue to be blown away by the connection that so many readers have felt to my writing. To me, it just demonstrates how many experiences we share but because we have no idea how much we have in common, we suffer in solitude.

I have enjoyed hosting beautiful conversations all over the state of NC around the book and normalizing conversations on mental health. Sadly, some of the most intense fallout from COVID are the mental health impacts. Common Threads and the conversations sparked by the book fill me with hope that strides will be made both here in the US and internationally to bring more awareness and resources for mental health.

In support of this global mental health effort, I recently returned from my third trip in ten months to Guatemala with Unearth Hope. Gleaning from years of service in rural Guatemala, a vision was cast to create a mobile medical clinic that could reach the most isolated communities. The images on social media, convey feelings of joy as we served that week. These are authentic moments shared with our in-country partners celebrating a goal we had all labored to see come to life.

But just like most images on social media, they don’t tell the story behind the story. Anytime you set a goal, there will challenges, however, this trip and the months that led up to it were about to give my previous challenges shared in my book, a real run for the money. If anyone should have known to cross check, place her seat in the upright position, and buckle her seatbelt, it should have been Melissa Harrell.

One of the chapters that I had the most fun writing in Common Threads, was on my dad. I share my memories created with him growing up in the heart of NASCAR country. In addition to stock car racing, my dad and I shared another classic NC bond; college basketball. Even though neither of us ever played the sport, as the chill of winter crept in, we were ready for all things college basketball.

On many Saturday afternoons you’d find us screaming at a square metal box, with full conviction that players and referees could hear our expert suggestions and coaching. As I reflect on the days leading up to my most recent trip to Guatemala and the successful launch of the mobile clinic, I feel it can best be illustrated by a college basketball play by play announcer. Just imagine Dick Vitale in the NCAA tournament and the mood will be set. It would go something like this:

It’s going to be awesome baby! We are going to Guatemala, baby!

Harrell takes the court; she has the ball and less than 72 hours’ notice to pack for an international service trip. 

Fans, there is no doubt that Harrell is feeling the pressure today. 

She pivots and packs knowing the possibility of hurricane Julia will likely impact her area of travel. 

Harrell, a former FEMA employee, knows this is probably not a good idea, but she proceeds anyway.

Fans, I am not sure whether it is grit or sheer insanity that drives this player, but you have to give her credit for her effort. 

She dribbles down the court with only 7 hours of sleep in the last 48 hours which earns her an initial foul. 

Harrell is an aggressive player which often leads her into early foul trouble. 

With the clock running, she arrives at the airport at dark thirty (AKA 3:30am) 

Twenty team bags full of medical supplies checked, and it’s time to board the plane. Harrell cannot find her passport and is almost ejected from the game. On a wild pass, her teammate saves the day and she remains in the game. 

Oh, look out, Harrell is slammed by a defender with an oversized carryon bag, that’s an intentional foul so she gets 3 shots

Harrell steps up to the foul line for 3 shots, folks, her free throw percentage this year is barely 50%, let’s see how her luck goes today 

Shot one is good: Flight one to Atlanta, Shot two is good: Flight two to Guatemala City, Shot three is no good with a 6-hour BUMPY bus ride, as the driver skillfully works around mudslides and damaged roads 

 18 hours later, half time is called, and she crashes into bed 

Feeling rested after half time, Harrell with a full court press awakes with her team to prep supplies for the launch of the clinic on Monday

 Hurricane Julia is boxing out all offensive moves and not making it easy for Harrell and her team as hurricane Julia invited herself right into the paint for a direct hit

 Time out is called by the team and intense discussion proceeds: Should we stay? Should we go? How will we get out? Plan A,  Plan B, Plan Z anyone? 

Frustration sets in and with four fouls Harrell benches herself. Fans, I don’t know how they get a win out of this one. With only seconds left on the clock it is going to take a miracle.

We pause for a commercial break.

At this point, I wish that this was just a game, but this was literally life and death for us, and for the people we came to serve.  I am asking myself for the thousandth time, “Why do I keep doing this to myself? Why can nothing go as planned?” Feelings of defeat and sadness overcome me…I just want to go home.

These feelings of defeat and sadness were easily triggered because these weren’t the first challenges that had almost sidelined this trip over the last few months. Challenges that had sent me back to read my own book, but often finding more questions than comfort. Where was this resilient woman in these pages? How can I ever feel that level of hope again? Really, God? Why me again? Why my children? Challenges that reawakened my PTSD to some of the most crippling levels I have ever experienced. Challenges that felt unbelievable on the heels of my recent traumas. Challenges that repeatedly left me face to face with my old nemesis, death, and the calls that no mother ever wants to receive.

To see new blogs and tips as they are posted, follow me at

Resiliency Counseling and Consulting, PLLC 

Melissa Collins Harrell Author

Read more about Melissa C. Harrell and her work. She is the author of Common Threads: Why the Answers to the Present Lie in the Past.

As we all anxiously await the release of my latest novel, Grounds for Return (September 2024), I wanted to share an updated version of one of my favorite blogs which was originally entitled, “What’s Your Cinnamon?” This blog chronicles my love of books, my journey to becoming an author, and how I was inspired to write my latest novel. Hopefully a good appetizer before the main course is served!

The town of Chatham, North Carolina, a small, rural town with a strong vineyard and tourist industry, is the setting of my forthcoming novel. This town is inspired by my hometown of Elkin, located in the foothills of western North Carolina. The fictional town name of Chatham pays tribute to the textile mill, Chatham Manufacturing, that was the heart of the town for many years. My childhood roots and experiences in Elkin are the heart and soul of this novel.

No matter the weather outside, readers will be transported to my childhood hometown and the beauty of the North Carolina foothills as summer fades to fall. They will then be drawn into a story that bounces between the late 1980s and fall of 2009 as lifetime friends reunite to share their stories of recovery, remorse, brokenness, and healing. Of course, no charming southern novel would be worth a hill of beans if it didn’t center around some good southern family recipes! I had so much fun crafting not only the plot, but weaving family recipes throughout the story. No matter where we grow up, food is an integral part of our story and invokes emotion and sweet memories.

As the fall season approaches, I get the urge to cook up some of my favorite family recipes. With the ease and skill of a circus juggler, I will have slow simmering soups on my stove top while a combination of apple and pumpkin recipes rotate in and out of the oven. The combustion of these intoxicating fumes quickly ground me as they fill the air and whisk me back to my childhood in Western, NC.

It is no secret, whether we own it or not, we all have a favorite comfort food or two. My go-to comfort food year round is macaroni and cheese. I know, not very original, but hot pasta dripping with cheese…what’s not to love? Whether it comes out of a box, or homemade out of the oven, the feel good neurotransmitters start with that first cheesy spoonful. From a psychological standpoint, the tastes and smells of food are attached to a memory or person that anchors us in feelings of love and security. A few bites in and I am enveloped in the love and comfort of all those who once filled my belly but now, years later, fill my soul with sweet memories of family dinners and holiday gatherings.

Once, while having a casual conversation with friends over coffee, the topic of bears came up. North Carolina has our fair share of these rascals, both black and brown bears. In the mountains of NC, the beloved Mildred the bear roamed in the Great Smoky Mountains for twenty six years capturing the hearts of children and adults alike.  Down east, the bear is the mascot for New Bern and every corner is adorned with unique bear statues.

From childhood, I have heard stories of bears wandering into places that are strictly for humans only and “no bears allowed”. Yet, these mischievous creatures, with zero stealth abilities, still take the risk in search of a tasty snack. Hey, you can’t blame a bear for trying! I can’t say that on those rare occasions that I forget to bring my lunch to work that I may or may not have explored my surroundings for snack possibilities. As this conversation evolved, I discovered that not only do humans have favorite comfort foods but apparently so do bears. However, their comfort food of choice was not what I expected at all.

Thanks to my favorite bear from childhood, Winnie the Pooh, I thought for sure honey was the “bear approved” sweet comfort food of choice. I mean anytime Winnie the Pooh had a “rumbly in his tumbly” it was honey that he needed to fill his ravenous void.  However, it turns out  that bears not only have a sweet tooth for honey, but also they quite fancy cinnamon. In fact, they love cinnamon so much, they will let nothing stand in their way. Many documented reports show bears tearing away board by board at cabins just to get to this delicious spice. Videos on social media show the disbelief of shocked humans as they stumble into ransacked cabins to find…wait for it… a small container of cinnamon licked completely clean.

This crazy fact about bears and cinnamon started a chain of racing thoughts in my head. I know, it’s truly crazy the things that spark the mind of a writer! Nonetheless, it really did start to make me think. What’s my cinnamon? What is the thing that I want desperately enough that I will literally tear away at every barrier to get what I want? After feeling so inspired over the last year as I wrote Common Threads, I have to admit I was experiencing a little let down and loss of writer libido. With this new nugget of info related to all things bears, I decided it was time to reflect on my journey as a writer and decide what I wanted to create next. 

In therapy, we ask our clients, “Tell me the earliest memory you have related to the issues we are addressing”. As my mind travels back in time, there is no doubt that  as a child, books were my cinnamon. I was a bookworm from birth and every single book was comfort food to my mind and soul. It was the typical book addict  progression. My addiction started innocently, as my mom read to me every single night. Of course, as would be expected, she was also knee deep in her own book addictions. From there, it was a quick progression on to Little Golden Books. Legend has been told in the hills of Western NC that I was known to be able to conduct exemplary behavior on grocery shopping trips just to get that coveted prize. The feel of that perfectly square book in my hands, perfect golden spine intact, and knowing I was the first person to crack open the pages of this book, sheer exhilaration. 

Next, it was on to Childcraft encyclopedias and then unashamedly chapter books. I read and reread every Beverly Cleary and Nancy Drew book penned, I just couldn’t stop myself. My book delinquency deepened as I read under the covers by flashlight at night, heart racing, just hoping to avoid being caught by my parents. As my addiction grew, I was a repeat offender at the local library, evidenced by the wear and tear of my library card. It was here that I stumbled onto the hard stuff and I began to consume every biography and literary classic I could get my hands on. No, there was no turning back now.

While my appetite for reading grew, so did my curiosity and love of writing. I was a young cub hungry to get that cinnamon and I saw no reason I couldn’t achieve that dream. In elementary school I wrote a short play and my cradle baby friend Misty agreed to act in the premiere of this play. We gave a sell out performance. OK, so it was just our Moms, but when you are ten, that is a sell out. This experience only fed my writing ego. In high school, I began to write ridiculous amounts of poetry and the thirst for this cinnamon increased. Soon, I was writing short stories and was falling more in love with the craft of writing.

When I was a junior in high school, my English teacher gave us a creative writing assignment to write a fiction short story. My first thought was, “Is he serious? This doesn’t even feel like homework because it is too much fun!” I wrote feverishly page after page (for the record with an erasable ballpoint pen and real paper) and was so excited about the story that I had created. A few days later, I  beamed with pride as I handed that manuscript over to my teacher as if it was the next New York Times bestseller.

Weeks later, I waited with great anticipation for my glowing review, but when I received my returned paper, the remarks were not what I had hoped. The neon glowing red pen remarks read something like, “This ending is too predictable, and not very original.” The sigh I am sure was audible as my writing bear heart was crushed. It was as if a supposedly “wiser bear” had said to the younger cub, “Give it up. Those humans have sealed that cabin and you will never reach the cinnamon.” Sadly, I believed that old, grouchy bear and didn’t write creatively again for over twenty years. Note: I wish I had his current address to send him an autographed copy of my latest book, in red pen of course (insert celebratory emojis)!

My inspiration to return to writing came in my early 40s while I was homeschooling my children. Yes, I said homeschooling, an insanity blog for another day. We did a unit on The Witch of Blackbird Pond by Elizabeth George Speare, which for the record is my favorite juvenile fiction book. It was during this that time that I discovered Elizabeth George Speare, like myself, had longed in her heart to write, but her duties as a wife and mother kept her from her cinnamon. Her first book was not published until she was 49 and then she proceeded to craft two Newberry medals, an honorary Newberry award, and Scott O’Dell award for historical fiction. I would say that that bear found her cinnamon, well done!

Inspired by her story, I decided it was time to start tearing away at that cabin that I had once been told was sealed. The number one question I get asked at book events is this, “ How do you have time to write?” Time has always been the number one challenge to my writing. Years ago it was the duties as a working  mother to three young children. Today it is the responsibilities of  a single mom with multiple jobs to support and launch adult children into the world. I have so many entries in my journals that start with …”The number one enemy to me writing is finding the time.”

Well, that is kind of the secret of writing or anything really, there will never be enough time. We have to make the time. My writing has truly become my cinnamon. Whatever it takes, I have to make it happen.  I will tear away,  sneak away, and make time wherever I can to feed this addiction. As a writer I have to embrace that my work is not for everyone. Full disclosure I love chocolate and ice cream but I despise chocolate ice cream (please don’t stop reading). I have also decided to silence all the grouchy old bear voices that tell me, “You don’t have time … No one wants to read that… You’re too old” and do what I feel compelled to do… just write.

If I had to sum up my writing motto in two statements it would be “Write what you would want to read.” and “Write what you know.” And that is truly the secret of how Grounds for Return came to fruition. I don’t look at what is trending or what I think will sell, I simply sat in places that intrigued or inspired me and wrote what stirred my soul. For me, the journey of crafting a novel is just as beautiful as the final product. I can precisely tell you where I wrote every chapter, and I have sweet memories attached to all those experiences. Whether I was sipping coffee tucked in the hills of Wilkes County watching cows out my front door, sitting by the water on a sunny day in New Bern as boats sailed in and out, or snuggled up on my couch deep in the winter in Swansboro, it was all bliss. Sure, there were times of frustration and moments of “What now?”, but in the end …there is nothing like writing a story that you want to read over and over. Yes, there is nothing sweeter to a literay junkie than falling in love with your own work.

So, what’s your cinnamon? What will you persist at until you get that sweet taste of satisfaction? Whatever it is, I invite you to join me on your quest to tear away, piece by piece, board by board, until you reach that delicious prize. Don’t let anyone tell you that your cinnamon cannot be reached. The only limitations that you have are the ones that you set on yourself. Now go, find your cinnamon, or macaroni and cheese, and lick that bowl clean!

Grounds for Return (available September 2024)

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Read more about Melissa Collins Harrell and her work as a mental health professional and author.

I told myself that I was not going to respond publicly to the tragedy in Texas. For once I was going to sit it out because today should be all about my daughter. Today is her high school graduation. “Stay focused, stay in your lane, and just keep doing your job helping the people in front of you today” I kept reminding myself all day. I wanted to put off my racing heart and ridiculous anxiety as all the excitement of the day. Then it hit me, the very reason that I should not remain silent is that tonight I will get to experience the joy as my 18 year old daughter walks across the stage to graduate. Yesterday, in a matter of minutes, many parents were robbed of ever realizing this moment in time for their child and while I bask in pride tonight, they will sit crying for their children. 

 Before you read further I am more than happy to be transparent about my disclaimers. I support no one issue or side; I claim no allegiance to a political, religious, or social agenda. The only cause that I support is that I am and always will be an advocate for children. Every day I work in the trenches with other child advocates on issues such as education, child abuse prevention, parent support programs, and health equity. We are like your computer antivirus running quietly in the background; most people don’t give a passing thought of the issues we work to change until something tragic happens to a child.    

 I am disgusted by the deep division and finger pointing on so many issues which continue to leave children in unforgiving places where nothing ever changes. I am disheartened that we have lost the art of conflict resolution and compromise for the greater good of our children. As a clinical counselor working with children and parents for over twenty years, I have had a front row seat to the slow demise of the mental well being of our kids, and this was way before COVID. While my mental health colleagues and I may not have all the answers, we have watched this erosion unfold over the years and have been sounding alarms that have been to no avail. I will say it loud and clear WE ARE AND HAVE BEEN IN A CHILDHOOD MENTAL HEALTH CRISIS!  

This crisis is far worse than not having enough mental health providers or funding to support mental health services. While these are current issues, it is not at the core of our crisis. If we want to stop violent acts, we have to back up the story and intervene way before someone puts a weapon in their hands. The root cause of substance abuse is not the substance. The solution is not seizing all the drugs and locking up the dealers. That makes us feel good and think we are addressing the problem but we have only cut the branches, not pulled up the roots. To truly eradicate substance abuse, you find out what is driving the need for the drug and address the problem at the root. Eradicate the need for the drug and you dry up the demand. So what drives the need of someone to pick up a weapon and wipe out nearly an entire class of students along with teachers? There is one psychological human element that allows another to kill … a lack of empathy, and the development of empathy begins at birth.

I have seen this gunman called a monster, a demon, and all kinds of names because we are only looking at this snapshot of time in his human development. We are looking at the branches of this tree, not the roots.  This individual at one time was an infant, walked the halls of an elementary school, played games, had a favorite food, possibly played sports, and all the other things that happen as we travel from childhood to adulthood. Psychologically, somewhere along the way, something failed this individual in his development. There are many social media expert theorists out there (yes, that should be read sarcastically)… so which culprit was it? Was it the parents, the schools, the church, the community, gun laws, video games, social media, drugs? It feels like a very dark game of Clue.  

If you want to know who failed all of these children including the gunman, we have to be willing to pull our pointing fingers back and look in the mirror. Point blank as a society we may say we value children but our national economics say differently. Any financial planner will tell you if you want to know your values and priorities look at your bank account. What are you spending your money on? Your spending habits tell you about your values and priorities. Here are some highlights of how much we value our children. 

Science is clear that the first five years of life is crucial to brain development, especially social and emotional development. We value the mental development of our children so much that we pay childcare workers barely over minimum wages to teach  twenty children in a classroom of three year old’s. We value children so much that we have sacrificed their mental well being to press down curriculum that is developmentally inappropriate and then turn up the pressure cooker to test them on material that their brain is not ready to absorb. We have created a society where children are defined by their GPAs and they feel pressure not joy to perform on stages and athletic fields. We value children so much that we have created an entertainment driven culture where fame is rewarded and forgotten how to teach our kids the gift of boredom.  

If we want to stop waking up to horrific violence, it will take more than removing the weapons. So, please do contact your local, state, and national politicians about reform for children but gun reform alone will not do it. We must rewind to the start of life and prioritize our children not just in lip service but by funding the areas that create emotionally healthy adults who have empathy, connection and compassion for others. Empathy…cultivate it… teach it…pass it on. 

 Read more about Melissa C. Harrell and her work. She is the author of Common Threads: Why the Answers to the Present Lie in the Past.

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The purpose of this blog is to offer educational information related to mental wellness. Resiliency Counseling & Consulting, PLLC and Melissa Harrell do not offer diagnosis or treatment through this medium. If you feel that you or a family member needs to access mental health services, first contact your primary care physician for assessment and direction in your area. If you need immediate help, please contact the National Suicide Prevention Lifeline at 1-800-273-8255.

Most of the recipes in this box are penned in my Mom’s handwriting which becomes more precious each year that passes without her.  This recipe was clipped from a magazine, long before the days of Pinterest. In case you are perplexed as to how people found recipes before the world wide web, we surfed for recipes in magazines. Legend has it that some people were driven to swipe a recipe or two from some magazines in waiting rooms when no one was looking. Now this is just what I have heard, certainly not a confession!

This holiday season I am so happy to share this recipe with you and your family as a part of The Great Quetzal Cookie Run. What is a quetzal you ask? A quetzal is a lovely bird with bold colors and is the national bird of Guatemala. As we all adjust due to COIVD 19, Unearth Hope is excited to bring you this virtual opportunity to have fun for a great cause. You and your family can do the race together any time between December 1-13. Run your best time, powerwalk, stroll, or simply sign up and just eat cookies!

The proceeds from the race will benefit Unearth Hope as we strive to provide support to our international partners on the ground supporting COVID 19 relief in Guatemala as well as preparing to send future medical teams in the summer of 2021.

My Mom had a compassionate heart to serve and she would be so proud of the work we strive to do with women and children through Unearth Hope. She also beat the odds of being a teenage Mom who later worked hard to achieve her childhood dream of becoming a nurse. That is the exact mission we long to fulfill through our work, empowering young women to live into their God given abilities through compassionate support that includes health and education opportunities.

I hope that you and your loved ones enjoy this recipe. Merry Christmas from our home to yours!

Magic Cookie Bars

Ingredients

• 1 1/2 cups crushed graham cracker crumbs
• 1/2 cup butter
• 1 cup chocolate chips
• 1 cup butterscotch chips
• 1 cup sweetened flaked coconut
• 1/2 cup chopped walnuts
• 1 (14 oz) can sweetened condensed milk

Instructions

• Preheat oven to 350 degrees. Spray a 9×13 inch baking pan with cooking spray and set aside. OR line your pan with parchment paper for easier removal and cutting.
• Melt butter in a small saucepan. Remove from heat and stir in graham cracker crumbs until thoroughly combined. Press into the bottom of a 9×13 inch baking pan to form the crust.
• Evenly sprinkle remaining ingredients one by one over the crust to form layers, beginning with the chocolate chips, followed by the butterscotch chips, coconut, and walnuts. Pour the condensed milk evenly over the top. Spread with a rubber spatula to make sure it’s evenly distributed.
• Bake in preheated oven for 25-30 minutes until edges are golden brown and the middle is set.
• Allow to cool completely before slicing. Enjoy and prepare to bake another batch for Santa!

Nutrition Who Cares! Sign up for The Great Quetzal Cookie Run and burn off all the calories! Want to support our work without the run? No problem…click donate!

Given that my Mom was only 17 when I was born, I also never expected to live most of my adult life without her.  Of course, no one thinks about their parents dying until it happens. Whether your parents are 30 or 95, loosing them is a defining moment in your life.  Since mine were so young when I was born, I just assumed they would be around for a long time. Sadly, that was not to be as they both died prematurely.

So here I am…doing the best I can…raising three kids without a Mom to share these joys and struggles. Some days I feel like I have it all together and I think that I should write a self-help “how to” book; but most days I feel like a complete faker just powering through high on caffeine and the Holy Spirit wishing I had written that stupid book the day before to inspire me today!

Over the last seventeen years of raising children, I have often felt like a not so hip rap star with a tune that goes something like this (DJ spin the record one time)….NO…STOP….DON’T …QUIT….NEVER….EVER. As I lay down my microphone at night, the noise in my head falls below the decibels of yelling, and I begin to actually hear my thoughts. YIKES!

It is then that the Mom guilt kicks in and I worry about the negative scripts I am setting up in their heads. Did I encourage enough here, did I push too hard here… am I making them independent enough? I think all of us struggle with this.  However, when you spend eight hours a day undoing people’s negative thoughts as a mental health therapist you actually get to see where you could really screw up your kids!

So of course, the next day I awake refreshed and speak perfect words to my kids…. WRONG…I usually begin with a repeat performance of my rap concert from the day before and probably all the while wearing a very embarrassing pair of Mom jeans. YES!!!!

Recently when feeling like I was failing at all aspects of my life, in lieu of cleaning my house or doing work I was woefully behind on, I was doing some mindless internet surfing. I came across this quote from poet Erin Hanson that I had not heard in years. The quote reads:

“What if I fail? Oh, my darling, but What if you fly?”

Immediately the tears began to flow, as I heard my Mom ‘s voice echo in these words.  I had honestly never thought about flying…the daily goal was to avoid complete and utter failure. How wonderful to be reminded of that voice that believed I could do more than just avoid failure.

As a child, I had no fiercer ally than my mother. She was the most encouraging and influential person in my life.  She did all the things that us therapy people would tell you to build self-esteem in children.  Whatever I wanted to try or be within the limits of what our family could do, she supported it. However, like all Moms that encouragement was sprinkled in with some very good rap concerts herself!

My first love was medicine. I watched Emergency, Marcus Welby and my PJs were MASH scrubs (I know you are jealous). In middle school, I made a sign that I proudly hung on my door (throwback fact using a dot matrix printer for my generation) that read: Quiet, future pediatrician at work. My entire high school career was dedicated to getting into college with the goal of medical school.

So, you can imagine the reaction from my father after two years of college when I announce that I would like to change my major from pre- med to ummmmm…get ready…DANCE. After a deep lecture of life instruction on how difficult it is to live out of a cardboard box my father stormed out to work in the garden or tinker on a car…anything but deal with me.

Before you write my Dad off as this evil Ogre, he grew up with a single Mom in poverty and he had worked very hard (often two jobs) to afford us better opportunities.  So I know now that he feared those struggles for his daughter, but hey…I was 20 and blinded by the lights on Broadway! (more jazz hands)

After he left, I turned and braced for round two from my Mom. It was not what I expected at all! She told me I had my whole life to do many things and that I should work in something that brought me joy. On a side note of wisdom she said…but only if you major in dance education. The education degree eventually opened the door to counseling…Mama does know best!

As my Mom’s battle with bipolar disorder raged over the next 15 years, it eroded her sense of self-esteem as well as her hope in the world. Our once vibrant mother who tackled nursing school with honors while raising two children barely had the confidence to get dressed. Just like Alzheimer’s eats away at the person we know and leaves a shell, so can many other mental health issues. Unfortunately for me and my sister, we were also the ones on the receiving end of many hurtful comments, negative letters, and heartbreaking events. Due to her mental illness, our mother died to us years before her physical body left this earth.

My midlife years and raising teens  brought many challenges for me and how I longed for the mother who was my cheerleader. To call her and hear her say…hang in there….and that I am doing a good job. To ask her advice…hey this is what I am thinking about doing…what do you think? To text her and share how her grandchild did the kindest thing.

Greater still to sit with her over a cup of coffee and apologize for being a know it all sixteen-year-old who now knows that she knew absolutely nothing! And to give her that greatest piece of information ever…her wish has been granted….I have a child just like me!

Take heart my mother friends, or anyone who is pouring into the lives of children, it is indeed true that the sum is always greater than the parts. We will not “ruin” our kids over one decision or momentary anger.  We are working to create a big picture and most of the stuff we beat ourselves up about will not even matter.

So what if we blow it here and there…it is the big picture that truly counts. We are doing better than we think and our constant presence and positive words will go far and will outlive our earthly bodies. We may not know the impact of our encouragement now but no matter if we are here or not, our voice will ring true at that moment when it matters most.

In case you were wondering, nope, I never made it to Broadway. Heck, I’ve never even been to NYC (gasp!) but I had a Mom who believed that I could try and that was all that really matters in the story. The complete Erin Hanson poem goes like this:

There is freedom waiting for you,
On the breezes of the sky,
And you ask, “What if I fall?”
Oh, but my darling,
What if you fly?

Oh, how wonderful to think of the freedom my Mom felt to be released from her mental health struggles as she flew to heaven all the while knowing that she had instilled in us a sense of worth and left us with the ultimate gift of faith.

This Mother’s Day give yourself a real gift…judge yourself less, slow down, stress less, enjoy more, and stop beating yourself up. At the end of the day, we are the best Mom for our kids. After all, that is why God assigned us the ones he did.

As always, may you be well, may you be loved, and may you know true peace.

Love this blog? Check out my book Common Threads: Why the Answers to the Present Lie in the Past.Read more about Melissa C. Harrell and her work.

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Resiliency Counseling and Consulting, PLLC 

Melissa Collins Harrell Author

The purpose of this blog is to offer educational information related to mental wellness. Resiliency Counseling & Consulting, PLLC and Melissa Harrell do not offer diagnosis or treatment through this medium. If you feel that you or a family member needs to access mental health services, first contact your primary care physician for assessment and direction in your area. If you need immediate help, please contact the National Suicide Prevention Lifeline at 1-800-273-8255.

The children clear the street and the school bus pulls away, but today, there Is no Jane. The mother walks out into the street to question some of Jane’s friends. They reassure the mother that Jane is OK because the bus dropped her off at the afterschool program at the church near the school. Relieved that her child is OK, but confused, the mother goes inside and calls the school. Why would Jane be at this program she has never attended before?

When Sue calls the school, she is told that the services that Jane needs are contracted with a local church, so they sent her there. Sue’s car is currently being repaired, so she finds a friend that can take her to the church to pick up Jane. When Sue arrives at the church, she is told by the program director that Jane is not there. Jane did not qualify for the program at the church, so she was sent to a local community organization down the street.

At this point Sue is beside herself with worry and frustration, she just wants to get her daughter and take her home. Sue and her friend arrive at the local community organization to find that the director has never heard of Jane…and her daughter apparently  never made it to the building. Worry turns to panic!

An Amber Alert is issued, and all hands are now on deck to find Jane. Teams of people meet and discuss the best way to find Jane. They construct elaborate plans with amazing accuracy about where they will look and at what times. Maps are created and search teams that consist of every type of specialist possible to find Jane. Copies of the maps are distributed to all involved, even her mother has a copy. There is no way she will not be found, every inch on this map will be covered.

Despite all these resources and all these advanced plans, sadly, Jane will never be found. Not because she was abducted and taken far away, but because she was hiding in plain sight…right on the back steps of the school. No one thought to look for her there because…well… it just seemed too obvious.

And that is where we find ourselves today my friends…where we have lost all common sense in problem solving. We have managed to transform our once inter working community agencies into a big bunch of bureaucracy that no longer effectively serves our children and communities.

While this is a fictitious story, it is intended to illustrate just about how ludicrous it is for families and professionals to navigate our current broken mental health system. Everyday I try to help families navigate their way through the various hoops they need to simply get some help. Meanwhile, my fellow colleagues and I have to stress about if we will be able to make enough money to stay in our chosen profession.

While each entity is planning and drawing boundaries, passing the buck to another system, or thinking that another group is taking care of that issue, precious children are lost in this system forever. THIS IS EVERYONE’S PROBLEM!

While I have been fired up about this for some time, yesterday just took me to a new orbit. The recent report card that was released on North Carolina Child Health, now ranks suicide as the SECOND leading cause of death of children age 10-17. Let’s just let that sink in…besides a car crash, your kid is the most likely to die from a 100% preventable death…at their own hand.

As if that was not enough salt in our wound, a recent study published in the JAMA Pediatrics found that  North Carolina is DEAD LAST in providing mental health services to our children. This study also found that 72% of children in NC diagnosed with a mental health condition were unable to meet with a licensed mental health provider in the last year.

North Carolina is my home state and I am generally a fierce Southern advocate for this state…but Governor Roy Cooper… this is absolutely beyond embarrassing and if I might be so bold …borderline criminal. As a mental health provider, I want to share with you all the barriers that are in the way of people accessing mental health but especially children in Eastern NC.

Access to Providers Who Accept Private Health Insurance

Particularly in rural communities, like where I practice in Eastern NC, there are just not enough of us to go around. The process that we must go through to become licensed is only the first hurdle to being able to offer services. As a Mastered level provider, once we complete our master’s degree ( depending on your board), you do about 3,000 additional clinical hours of training to gain your state license. No problem, people playing around in other people’s minds should be well trained!

Most people do not realize that the majority of mental health therapists are independent contractors.  Most of us make our income in the managed healthcare world as fee for services providers which means we are either paid by our client or paid by insurance companies to do our work. We are not salaried, we only get paid if clients show up, we have no benefits, no retirement, we are self-employed with all the pros and cons that comes with that life.There really are not many government agencies providing mental health services these days for providers to find jobs (more on that coming up).

Once a clinician is licensed, they are still not ready to work with managed care organizations.  We must then go through what is called “paneling” to be approved as a provider to serve and be able to accept payment from each insurance company. This process can take months to a year to complete. In the meantime, this provider cannot offer services to any patients with that particular insurance.

So, in order for a child to see a therapist, the healthcare provider or school must first find a therapist  in network with the insurance company. Once they find a provider then, the family has to deal with insurance co payments. Depending on the plan, the average office co payment for plans can range from $30-$90 dollars per session. For most conditions, a child needs to attend therapy a minimum of twice per month, sometimes more depending on the issue. What if you have two children who need these services?

Is your head spinning yet…hold on …. I am just getting started.

Access to Providers Who Accept Medicaid

Around 2001, North Carolina along with many other states moved from a community based mental health center model to Managed Care Organizations (MCO). Since them the state has gone from approximately 37 MCO agencies for mental health services to 6 and we are preparing for more change. So, for us as mental health professionals who serve multiple counties, we must contract with several organizations with different rules to take the same North Carolina Medicaid dollar.

That means a different set of paperwork, a different computer system to upload treatment information….I think you get my point. I am all for accountability and showing that I do good work and yes, Medicaid fraud is a big problem however these organizations have put a noose around the necks of mental health providers until we have all just had it.

In the last 3 months, I have had two well established therapists in my circle to be “kicked out” of the network due to errors on the MCO part, and it literally took getting a local politician involved to get one of them back in. Meanwhile, months go by and they have NO income.

THESE are the reasons that many providers do not accept Medicaid… it is not that they do no want to work with the patient…it is the fact that we lie awake at night in a panic hoping we can get paid and make enough to keep out practices open to serve our clients.

Seasoned Providers Are Leaving the Field

As if that wasn’t enough, to add to the deficit of not enough providers, seasoned professional are leaving this field in mass exodus. Yes, while working in mental health does have a high burnout rate on the provider, it is not the largest factor. In reading the reports I shared above you would think with two advanced degrees and a clinical license with eighteen years of experience,I would be the hottest tickets in town for hire. What if I told you that last year I spent over 6 months unemployed as I sought to work outside of the private practice system. There are truly few else places for us to work due to the privatization of this system, which given the state of mental health is absurd.

Also in what career field do you make less money with the more years of experience? That would be anyone who works in managed healthcare system. When the news stories flash up about politicians have cut Medicaid by 30% …the way they do that is they cut the amount of money they reimburse the provider. Most of us who have been in this field for the long haul can testify that we make significantly less money than we did years ago. This factor has run many great clinicians into other career fields to make a better salary with significantly  less stress.

Mental Health Services belong IN the Schools

Why yes, Governor Cooper thank you for asking…I do have an answer to this Beyond Broken System. Mental Health services belong in the school where children spend more time than sometimes their own homes. This cuts all barriers related to access as well as removes the stigma related to mental health.   We need more school counselors, social workers, and psychologists who are allowed to REALLY work with students…not required to push papers around. I was one school counselor to 800 kids in one elementary school…beyond ridiculous. I left the school system because I went to school to be a counselor not an administrator.

We also need more school-based health centers that fund mental health providers through grants or other state funding versus fee for service. I work once a week in one of these model centers where kids have access to a healthcare team that includes: nurse practitioners, health educators, nutritionists,and mental health.I love serving the kids in this integrative care setting, but as fee for services providers we cannot sustain a living here. A funded position would allow the counselor to work with students one on one, in groups, in classrooms as well as offer training and support to school staff who are overburdened with the mental health of their students.

Politicians need to understand that schools are more than academic regurgitation houses and allow schools to be relieved from this testing pressure nonsense. We have kids that have not had their basic needs met for the day such as food, shelter, safety, and love. Do you really think academics is a priority for this child?  No, survival is! We have to stop and get these issues settled before we can focus on learning algebra.

Mental Health Services belong IN the Communities they serve

Sometimes we have to be willing to say that we tried something, and it was an epic fail. If the changes to our mental health system were successful over the years in NC, the data would show it and it most certainly does not. We are in a crisis of gross negligence in mental healthcare.

The push back is always funding but prevention is ALWAYS in the long run cheaper than treatment. How much money is NC currently hemorrhaging to fund treatment for the opioid crisis?  Most of these addicts have mental health issues such as depression or anxiety that they are self-medicating due to lack of access in this failed system. Things that should have been addressed long ago…in childhood.

So, the report card is out, as politicians you hold our kids accountable by their test scores…well today they are holding you accountable and you failed. Something has to give.  We can either spend the money upfront to set our citizens up for success or we can spend it later treating mental illness, addiction and disability. The children of North Carolina deserve better than to to be lost in a sea of red tape or to show up as another failing health statistic. Our NC  state motto is “Esse Quam Videri”, meaning to BE rather than SEEM, Let’s not just seem like we are finding answers forming one task force after another,  let us be actually doing something about this today!.

Thank you for reading this, if you want to make an impact for children in NC on mental health, please share this with #wakeupnc and tag every person with any political influence.

As always, may you be well, may you be loved, and may you know true peace.

Read more about Melissa C. Harrell and her work. Like Resiliency Counseling and Consulting, PLLC

***The views I express in this blog do not reflect on any one employer or agency that I contract with, these are solely my opinions based on my experiences.

The purpose of this blog is to offer educational information related to mental wellness. Resiliency Counseling & Consulting, PLLC and Melissa Harrell do not offer diagnosis or treatment through this medium. If you feel that you or a family member needs to access mental health services, first contact your primary care physician for assessment and direction in your area. If you need immediate help, please contact the National Suicide Prevention Lifeline at 1-800-273-8255.

People are often surprised to learn when they open up to their friends about seeking counseling that their friends have done the same.  I hope this blog will help to dispel some common misconceptions about our profession as well as guide you to the correct professional for your current needs.

COMMON MISCONCEPTIONS OF THERAPY

I will have to lie down on a couch… Seriously people ask me this all the time! The short answer is…NO. Now, if you just must lie down to tell your story…feel free but totally not necessary. Hailing from the dark ages of Mr. Freud, these images come largely from media like cartoons or television. Just like police shows or medical drams, real life counseling bears little resemblance to how we are represented in the media.

I don’t need a counselor …I have friends…Friends are great and they are a vital part of our support system. The listening ear of a friend is a wonderful coping tool. However, our friends are often our fiercest allies and we need them to be on our side.  A therapist is a third-party person who has no stake in our choices or relationships. Professional therapists are also trained to pick up on things that a friend is not.

I am paying so the counselor will just tell me what I want to hear…This statement is about as true as saying because you pay your doctor, they will tell you that you don’t have cancer since that is what you want to hear. The only goal of a trained therapist is to help you achieve the therapy goals that you both have set together. Sometimes that includes confronting us with truths that we do not want to hear but are necessary for change.

Seeking mental health counseling conflicts with my religious values…As a Licensed Professional Counselor practicing in the south, this is something that I unfortunately hear often. While I do have advanced training as a Clinical Christian Counselor, I have counseled families who practice all types of religions and customs. It is important to understand that all mental health counselors spend a great deal of time in cultural awareness and ethics training. We are highly skilled in respecting all types of religious and cultural beliefs even if they are not ones that we believe or practice.

The first question I ask clients who request Christian counseling is what Christian Counseling means to them. Most people respond that to them it means they want the therapist to have the same religious views that they have. All counselors will work within your religious paradigm or refer you to another therapist they feel can best support you in this area. For some people, a specific faith-based counselor may be the best choice if the issues they are dealing with are rooted in their faith or as a couple they seek marriage counseling that reflects their faith customs.

The counselor will try to convince me to make decisions that I do not want to make…It is never our job as professional counselors to tell our client what to do. We are only able to take charge of situations if imminent danger is present for our client or others. Our job is to support and guide you through the decision-making process.

Now that you are feeling more confident about what professional counseling really is, let’s navigate the alphabet soup of Mental Health. What do all these letters mean and which professional is right for me!

COUNSELING
Licensed Professional Counselor (LPC/LPCS) or Licensed Mental Health Counselor (LMHC) These professionals have a master’s degrees generally in counseling or closely related field. After graduation counselors must pass a national board exam and then work under clinical supervision for around 3,000 clinical hours to achieve state licensure. LPC and LMHC professionals do the same type of work, the title just varies by state licensing boards. For example, in North Carolina we have LPCs but other states may license the same providers as LMHC. LPCs work with a broad range of ages and issues primarily in private clinic settings.

Licensed Marriage and Family Therapist (LMFT) These professionals have master’s degrees in marriage and family therapy. After graduation counselors must pass a national board exam and work under clinical supervision for around 3,000 clinical hours to achieve state licensure as LMFT.  Marriage and family therapists focus on the systems of a family and how these systems impact individuals and families. Like LPCs, these professionals work primarily in private clinic settings.

Licensed Clinical Social Worker (LCSW) These professionals have master’s degrees in social work. After graduation social workers must pass a national board exam and work under clinical supervision for around 3,000 clinical hours to achieve state license as LCSW.  Social workers spend much of their training in hospital settings and are viewed as more clinical experts in the area of acute mental illness treatment. However, they also work in many private clinics as well. 

ADDICTION
Licensed Clinical Addiction Specialist (LCAS) If you are looking for professionals trained in treating substance use or other additions, you will look for one of the providers listed above who in addition, has the designation of Licensed Clinical Addiction Specialist (LCAS). These clinicians have extra classes, supervision hours, and exams in the area of addiction. 

PSYCHOLOGICAL TESTING
Licensed Psychological Associate (LPA), PhD psychologist, PsyD psychologist These professionals have a minimum of a master’s degree and often higher. In addition to offering counseling services such as talk therapy, they are trained to administer and interpret numerous tests and assessments. These tests may evaluate intellectual skills, cognitive skills, personality characteristics, and neuropsychological functions. For example, a parent may wish to use the services of a psychologist to determine if their child has a learning difference, autism, or ADHD. Once the diagnosis has been made, the child may continue therapy services with the psychologist who conducted the testing, or the psychologist may refer the child to another provider from the list above for therapy. Psychological testing may also be needed in adults for various issues.

MEDICATION
Psychiatrist (MD), Nurse Practitioner, Physician Assistant  If you need a medication evaluation or management of medication for mental health concerns, you need a psychiatrist who is a Medical Doctor or other licensed medical provider such as Physician Assistant (PA) or Nurse Practitioner (NP) with advanced training in psychiatric medications. Often my clients are upset at how little time they spend with these providers but that is the unfortunate side of managed healthcare. The goal of managed healthcare is to use these providers strictly for medications and leave therapy to the master level therapists. So, don’t be so quick to judge these providers, they are often working under a huge caseload due to these demands and the great shortage of psychiatric providers, especially in rural communities.

No matter what mental health service you need, it is important to remember that every provider has a different style and personality. If you do not have a good experience with your initial provider, give another provider a try. The right match is very important in connecting and making progress in therapy.

As always, until next time, may you be well, may you be loved, and may you know true peace.

Read more about Melissa C. Harrell and her work. To see new blogs and tips as they are posted

Like Resiliency Counseling and Consulting, PLLC 

The purpose of this blog is to offer educational information related to mental wellness. Resiliency Counseling & Consulting, PLLC and Melissa Harrell do not offer diagnosis or treatment through this medium. If you feel that you or a family member needs to access mental health services, first contact your primary care physician for assessment and direction in your area. If you need immediate help, please contact the National Suicide Prevention Lifeline at 1-800-273-8255.

While I might be a Type A, overachiever, I am not a resolutions kind of girl. I think this probably stems from years of clinical practice and listening to the same resolutions year in and year out and rarely seeing these resolutions come to fruition.  As a mental health therapist and health educator, I truly believe that people have good intentions, they just need a better road map to reach these goals.

The actual definition of resolution is a FIRM decision to do or not do something. Maybe you already have a swirl of resolutions in your head. Some of the most popular ones include: losing weight, exercising more, quitting smoking, improving money management, better job, higher education or learning to relax more.

When working with clients, I often use the SMART goals method. This acronym stands for Specific, Measurable, Attainable, Relevant, and Time based to help outline and create a more solid plan for meeting your goal. No matter what your resolution is this year, following the steps below will help increase the likelihood that you will achieve that goal.

1. Specific

Begin by considering all the following Questions. The answers in italics reflects a weight loss goal.

What do I want to accomplish? Loose 20 pounds

Why is this goal important? I want to lower my risk of chronic health issues and feel more confident.

Who is involved? Myself and my family as I will be changing our cooking style and time away to work out.

Where is it located? Home, work, and gym

Which resources are required? Gym membership, healthy food expenses, tennis shoes etc.

When goals are too vague such as “I‘m going to loose weight or eat better” how will you know when you have met your goal and what does is really mean to “eat better”.

2. Measurable

There needs to be some way to see how you are moving towards you goal. For example, if you are aiming to pay down debt, there needs to be a way to see that you are making progress. Consider the following questions.

How much? $$$ certain amount of dollars to this bill every month

How many? Focus on one bill until paid off

How will I know when it is accomplished? When account is paid in full and closed 

3. Attainable

This is probably the step where most people set themselves up for failure. We are an instant gratification society, and this causes us to try to achieve goals either too quickly or that are not realistic.  If our goal is too restrictive or lofty, as soon as we see it out of reach, we will give up. It is better to set an achievable goal like lose 5 pounds and succeed than to set the goal too high and give up. This is true with financial goals as well. If you create a budge that is so tight you have no room for pleasure you will begin to resent the plan and drop it all together.

Our goals must also be realistic within the confines or our abilities and resources.  For example, if your goal is to become an engineer but you have struggled through every math class ever (yes…me!) then that goal might need to be revisited and realigned to your strengths. I mean at 45 years old, the likelihood the Rockettes are going to take me now are pretty slim, but I still have time for the Silver Sneakers kickline!

4. Relevant

Even though we should consider our abilities and resources, I am never a person to dump water on someone’s fire. My Mom started her family very young, so when she met with an academic adviser in the 1980s about attending nursing school, she was married with two young children. She was told by the adviser she met with that it would be too difficult, and she should just go home and raise her family. So, you know what she did? She graduated from nursing school number one in her class! Here are some questions you should consider before chasing that dream that seems against all odds. In italics I’ll use my Mom’s goal as an example.

Does this seem worthwhile? Nursing has always been my career goal

Is this the right time? My kids are now school age and more independent

Does this match our other efforts/needs? Financially in the future this will put our family in a better situation

Am I the right person to reach this goal? I did well in my science and math courses in high school. I am determined.

Is it applicable in the current socio-economic environment? School will cost initially but the need for nurses is high

5. Time Based

A big goal is met my setting many short- term goals that lead up to that big goal. Italics reflect your goal is to find a new job

What can I do today? Create a new resume

What can I do six weeks from now? Continue to search on job boards and apply

What can I do six months from now? Consider taking classes to increase my skills

When will I know it is accomplished?  New job is acquired

The number one killer of dreams is FEAR! I love this quote by Richard Wilkins, “Miracles start to happen when you give as much energy to your dreams as you do to your fears.” I recommend using a journal or a poster board to write out and follow your progress on your journey. For my crafty followers, you might enjoy decorating a vision board. Just don’t get lost in the crafting and loose sight of your actual goal!

Best of luck as you chase your dreams and passions in 2019! If your goals include reducing stress and learning to be more present in your life, please check out our JOY event on January 26, 2019.

As always, until 2019, may you be well, may you be loved, and may you know true peace.

Read more about Melissa C. Harrell and her work. Like Resiliency Counseling and Consulting, PLLC

The purpose of this blog is to offer educational information related to mental wellness. Resiliency Counseling & Consulting, PLLC and Melissa Harrell do not offer diagnosis or treatment through this medium. If you feel that you or a family member needs to access mental health services, first contact your primary care physician for assessment and direction in your area. If you need immediate help, please contact the National Suicide Prevention Lifeline at 1-800-273-8255.