Episode 88: Mental Health Care & Accessibility w/ Tori S. Dixon

Episode 88: Mental Health Care & Accessibility w/ Tori S. Dixon

Overview

Tori S. Dixon (MS, LPC) is the owner and practicing clinician of Graceful Journey Counseling in Arlington, Texas. A licensed professional counselor with a background in funeral direction, her specialty has naturally become grief and loss; she practices from the belief that any barrier to mental wellness is ultimately attributed to some sense of loss. Whatever the loss, she believes that grace and space to acknowledge and properly grieve loss is the first step on the road to true healing and emotional and mental wholeness. Tori adopted a theoretically-sound, culturally-competent and faith-based approach that focuses on engaging and meeting clients where they are on their journeys. Her goal is to provide the safe space her clients need to grow fully into who they were created to be — and to thrive in life and relationships. In this episode, we discuss mental health care from a chronic illness perspective; we also address the need for culturally-competent care, and for access to mental health care as an imperative.

Takeaway

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Transcript

Tori S. Dixon MS LPC Graceful Journey Counseling Uninvisible Pod Lauren Freedman

Lauren: Okay, guys, thank you so much for joining us. I am here today with Tori Dixon. Tori is a therapist in Texas. She's going to talk to us all about her practice, mental health, chronic illness and how these things all overlap. So Tori, thank you so much for joining us!

Tori: Thank you so much for having me, Lauren. This is such an amazing opportunity. And I'm just glad to be here.

Lauren: Oh, it's my absolute pleasure. I actually connected with you through Dr. Jessica Shepherd, who's been on the show. We love her. She is incredible.

Tori: She is incredible. She and I have been working together over this past probably two years, helping people manage both mental and physical wellness. And so we work together doing that.

Lauren: I love that, because I know when I interviewed her, she told me that she keeps up relationships with various therapists — whether it's for couples counseling or for individual counseling. And the fact that she's referring chronic pain patients for mental health is so exciting, because it's really hard sometimes to connect the dots to the mental health aspect of chronic illness.

Tori: Absolutely. And vice versa. I keep her at the top of my Rolodex … young people won't know what a Rolodex is, they'll have to Google that … but I keep her at the top of the list, because I have so many women come and see me and they are experiencing chronic pain. And it's happening in the reproductive areas, and they haven't had a connection. No one's ever made the connection for them. Some people are resigned that this is just the way it's going to be and I'm just going to have to live with it.

And for many of them, they haven't even gone to see a really good clinician who has said, “Okay, let's work on both sides of this to kind of figure out where we are in this.”

She’s been so instrumental in me being able to do that. And I'm grateful.

Lauren: I love that you guys are working together with your patients’ best interests in mind. It's lovely to hear. So let's start with your practice. Can you tell us about your practice, what you treat, and the areas that you can also practice in.

Tori: I actually started Graceful Journey Counseling back in 2019, February the 11th of 2019. So I'm just a year-and-a-half in private practice. As a clinician, I specialize in grief and loss. And that is because I have a 14-year-backdrop as a licensed mortician. And so when I transitioned over into counseling, what I knew was that there needed to be a bridge between the grief process and what's happening in the mental health side of things. There was nobody in the middle. And so I was, like, hey, why don't I be the middle person who's actually licensed in both professions that will be able to provide a great opportunity for families to heal after having lost a loved one. When I say the words “grief and loss”, people immediately associate that with death and dying. But I like to say that anytime we experience a loss, we grieve. So that may be the loss of a job, that may be the loss of reproduction, and maybe the loss of one's “normal” health. Feeling good every day and then going to a space where you don't feel good every day … there's a loss. There's a loss in mobility, there's a loss in sleep. So anytime there's a loss … it could be relationship, it can be a job, it can be foreclosure on a home, it can be bankruptcy. It can be any time you experience loss, you grieve. And I think we grieve more often than we actually do. And I believe that grief and loss ends up being foundational in other things that we work through — depression, anxiety, panic disorders. I believe that a lot of that has to do fundamentally with there having been some sense of loss — be it the loss of safety, or whatever it is, it’s created this space where our mental capacities have been harmed because of the loss. And then we have these symptoms that exhibit as a result. So my practice, that's basically what we do. I see couples, I see individuals, from anxiety and depression to panic to bipolar disorder. I see clients on an array of things, but certainly at the bottom of it all I dig for the loss. When I can find that space where the losses occurred, I know that's where we can start the healing process. And it changes other things and other aspects.

Lauren: Absolutely. And you are based in Texas, but you practice virtually as well, don't you. So, you’ve got practices in Texas and in Atlanta … or in Georgia, I should say.

Toni: My physical location is in Arlington, Texas. Right now due to COVID, we are doing all of our services via telehealth, and we just recently opened up our virtual Atlanta office. I have two clinicians out there — one who specializes in trauma, and the other who is a general practitioner. She specializes as well in young people because she's a school counselor. So she’s been around the young, the kiddos. And just an array of clinicians doing an array of things, but we're excited to launch that Atlanta office.

Lauren: Yeah, I think that's awesome. This is something that we're gonna get into later as well. But these are all also practitioners who are women of color. And being able to fill that gap so that, especially the Black community right now, when you're looking for someone who understands your experience. We know about apps like Health in her HUE, that have come up, providing resources that are for the Black community by the Black community. And you're very much along those lines. Of course, you can treat anyone, but you certainly are available in that respect as well.

Tori: Absolutely. And also, check out the Henry Health app, another app that is by an African-American man connecting African-American men to clinicians of color, as well. It's really awesome and amazing. So yeah, we are a practice of African-American women. The stigma of mental illness, typically, in the Black community … we are trying to stomp out the stigma because we want African-Americans to know … we want y'all to know that there are clinicians that are sitting in chairs and you can sit across the couch with someone who looks like you, and who completely understands the experience. Of course, we're not monolithic, but we are able to understand the experience of Blackness in America, even Blackness globally. I have another clinician that I work very, very closely with. His name is Desmond Shepherd, and he's actually in Oklahoma … the Shepherd name might sound familiar? He is in Oklahoma. Dr. Shepherd, she is Jamaican-Canadian, and it’s her dad. So even from a global perspective, we have access to all of these clinicians who are able to serve in every capacity in the Black community, and we're excited about the work that we're doing.

Lauren: I think that's really wonderful. And again, we'll get into this more later. But I wanted to also ask you, you’re dealing with mental health issues, which are largely invisible conditions, for the most part. So how are you balancing the occurrence of hypochondria, perhaps, with the reality of these invisible symptoms, if you will. Particularly as it concerns mental health and illness? Because I'm wondering whether you get people who come in, where it's all in their heads, they're making it up. Or whether you really look at that holistically and go, well, if there is something in their head, then there's something that we need to treat. Right? How are you dealing with those issues? 

Tori: That’s a great question. Even hypochondria is still a mental health condition, right? And if we look at it, it's all really rooted in anxiety. And so what we do ultimately is, we start to break anxiety down. I like to say separating the laundry.

We like to break that anxiety down a little bit into what's rational and what's irrational.

And for people who are dealing with hypochondria, typically, much of what they're dealing with are things that are irrational. These are irrational findings. And once we get to the root of the irrational findings, then now it comes time for us to help them unlearn the fear of irrational things, and how do we deal with that in terms of your own mental wellness. So a part of what's going on in our country right now, we have this invisible illness — we can't see it, we can't touch it. COVID-19 is unlike anything that we've ever experienced. It's not the flu; we know it's not the flu. And so, for a person who's a hypochondriac, they'll be like, “Well, I have to do this this many times, because this is what's going on.” And I’m, like, “Well, a part of that is true. Yes, there is some truth in that you do need to wash your hands. But you don't need to wash them 75 times. There's the ritual that you've adopted, that’s said to you that you have to do this this many times in order for this to happen. We're going to have to disrupt the ritual, so that we can have a talk about what's rational and what's irrational, based on how you formulated that ritual, why that ritual is there.” And much of that, too, is actually based in some sort of traumatic response. When trauma has happened, the first thing that we lose when we experience trauma is, we lose control. We oftentimes find ourselves when trauma happens, we're in a position where we've lost control. And someone else or something else outside of self is taking control and has harmed us. And so what I’ve said is, I'm not going to allow this to happen again, and whatever I need to do to control my environment, then that's what I'm going to do — even if it becomes irrational and to an extent where it's no longer healthy for me.

Lauren: Absolutely, it can lead to those obsessive behaviors for sure.

Tori: Absolutely.

Lauren: So what diagnoses are you finding to be the most recurrent in your practice? I know it runs the gamut. But are there treatments and diagnoses that you're most often recommending?

Tori: That’s a good question, as well. What we try to do in my practice is that there still is a very large stigma about mental health and mental illness and what that looks like in the real world. So we can sit in our office and we have these diagnoses. But then, if that is to be out into, say, somebody's work environment or a school application or somebody trying to get a job, we try to be very mindful of that. So I do a lot of adjustment disorders in my practice. Because what I do is, I look at it in terms of what's going on right now in this person's life. There must be some major adjustment, that may be causing a sense of anxiety, that may be causing depressed mood, that may be causing a mix of anxiety and depressed mood. I like to take it from that adjustment standpoint. And then once I've gotten a little bit more time with the client, there are some clients where we're seeing a lot of anxiety disorders, a lot of generalized anxiety that is going on. And much of it is due to everything that's going on, but I like to say that COVID isn't the cause of it. It certainly is impacting it, and what it's doing is kind of ripping off the Band-Aid, taking the top off of it. Before, we had what I would say healthy distractions. We had our jobs, we had commutes, we had social functions. And now that those things have been stripped away, we now have a little bit more time to think, to process, to wonder.

Lauren: To spiral. 

Tori: To spiral! To worry. To be anxious. And so we're seeing a lot of anxiety. That's probably been what's been going on for this year. There has just been a lot of angst going on with people, and I just reassure them that it's okay, that what you're feeling is okay. Let’s get to the root cause of it. But ultimately it’s okay.

Let’s get comfortable with feeling what we're feeling, so that we can get to the root cause of what's causing those feelings.

Lauren: And really understanding that so many of us are living with anxiety right now, that it's so widespread, that none of us are alone either.

Tori: Absolutely, that you're not one man on the island. All of us are dealing in some way with anxiety, because we don’t know what's going to happen next. We don't know how close the illness may get to our own families. And now that we have parents having to make decisions about going back to school, and going back to work. And then what does that look like if I don't send my child back to school, but I'm still working; how do we make this happen as a family? Do we have a support system that we've already created? Do we have an infrastructure of support that we've already created that's going to be able to support us during this time? And so yes, that comes along with a level of angst, not having all the answers, that comes to a natural level of, okay, what are we going to do? Rest in that. It's okay.

Lauren: I love that. So I imagine that there are patients who come to you who have maybe been shuttled between specialists. Especially if they've got chronic illness, but also with anxiety disorders, mental health disorders, there's often a lot of guesswork before they arrive at the solution, the doctor who's going to help them find the solution. Does that make a difference for you in terms of the way that you administer care? Does it mean that you're using greater bedside manner or empathy if a patient is living with some form of invisible or chronic illness in terms of how you treat them?

Tori: Absolutely. The first thing that I say all the time is, that listening is going to be the key. It's the key when I have clients that come in and they say, “I've gone to this doctor, and I've gone to this therapist, and I've gone and seen this person or that, and nobody believes that what I'm going through is what I'm going through.” They've run tests and for some, they've said, “They've run this kind of test, but I've been doing my own research, and I've been asking them about this kind of test, and they won't run that gamut of tests for me. They won’t do this exam. I’m not being heard.” And so in those moments, the first thing I do is, I sit down and I listen. And I just say, “Tell me what your experience has been. Tell me what you've gone through up until this point.” And that's kind of when the emotion comes in. There's a lot of tears and a lot of, “I don't understand why they won't listen to me.” And I reassure them that I'm listening. And I reassure them that everything that you have been feeling is real. It's happening. It's real. And the minute that I say that, you can see this load is just completely lifted because finally somebody says … even if I don't know exactly what's going on at that time … it's real. It's happening. Just for somebody to acknowledge and validate that what you are feeling is real. It's not a figment of your imagination. You're not just looking for attention. This is not just who you are, the sickly person. What you are experiencing is real. And the moment I say that … Lauren, it just changes the whole mood in the room, and the client is typically so much more open about how their feeling has been impacting their mental wellness. Because there is a mind/body connection. And they're so open to now telling me what's going on with them on the mental health side, now that I've validated that what they're feeling in their physical body is actually real.

Lauren: Has it also become part of your job in cases like that to empower these patients with tools to advocate for themselves, as well, if clinicians aren't listening to them?

Tori: Absolutely. And I say all the time, if you find a clinician who's not listening, either on the medical side of your health or the mental health side of your health, you find someone else. You go down the list and you find someone who is going to hear what you're saying. They may or may not agree with you, and that's okay. You need to be your own advocate. But by the time I see a lot of these patients who have chronic illness, they've already been beaten down so much, their voice has already been muted so much, and they feel as though ‘maybe there is something wrong with me, maybe I'm not seeing this clearly. Because if I've gone to three professionals, and they've told me they are finding nothing, then maybe it is me. Maybe there is something wrong with me.’ And so they lack the confidence, they don't feel self-assured. And oftentimes they don't even have advocates within the realms of their own family members. It's like, “Well, you've gone to four doctors and they're all saying that there's nothing wrong, so I don't understand.”

And you can see the weight of the despair. Because they feel as though no one is listening.

So that sometimes is the key. The first step is getting them to go to just one more doctor, and say, “Okay, let's just try one more physician.” To get them to say, “Okay, I have the courage now to speak out again about what’s going on with me.”

Lauren: Absolutely. And I imagine there are factors that also play into this concept of not being listened to in the medical system — factors like gender, and race, sexuality, these invisible layers. And I'm wondering whether you or your patients often experience undue either prejudice, or perhaps privilege, in the healthcare system in regard to the way that we're all presenting ourselves. I walk into a medical office, I'm a white woman. So I've got the layer of gender. Can you see people's circumstances being different based on the experiences that you're hearing about, depending on the way they present?

Tori: Oh my gosh, absolutely. It's unfortunate, but when we deal in the realm of systemic racism, I liken it to the blood that goes through our body. If you have a blood disorder, every major organ of your body is going to be impacted, based on what's in your blood. Because your blood is responsible for feeding every other area. So, from your brain health, to your vision, to your heart, to your lungs, to your kidneys, to your digestion … everything is impacted. And that's the way we have to really see what happens in our country, that this is not just an isolated incident with just one thing. It impacts the way doctors see patients. If you know anything about the history of gynecology, the gentleman who is the father of gynecology, he used enslaved Black women to operate on them to do hysterectomy procedures and to tie tubes. And all of these things were done without any anesthesia. And so when you think about that, and you think about the pain that was inflicted on those Black bodies, much of that same thought can be seen in the medical and the mental health side of things. That Black people don't feel pain, that there's an unusually high level of pain receptors that they have. And so when patients and clients come in to talk about pain, they're not necessarily taken seriously because there is this stigma, there is this racist ideology that says Black people don't feel pain the way white people feel pain. 

Lauren: Which is based on absolutely no science whatsoever.

Tori: No science whatsoever. When you talk about the Tuskegee experiment and how they refused to treat Black men with syphilis and gonorrhea and allowed it to run its course and for them to die, so that they COULD see what ends up happening — when it could have been treated with penicillin, a very simple antibiotic. Back in that day, they refused treatment for these men and many of these men were veterans. These were soldiers who fought for the country, and they were refused treatment in the Tuskegee experiment. So to say that people of color and Black people have a hard time with trusting the medical profession … Mental health is much the same way. All of the theoretical background and foundation of mental health was not done to consider the racial tension, what happens with race and ethnicity and with socio-economic disparities. None of that was considered. And so we have all of these theories that are based on white men or white people. And we're having to turn that into theories that work for us. So one of the really big research areas that we're doing now in mental health is understanding racial trauma. And what that looks like. There was very little research being done on it. But now, clinicians like us are going back into the classroom and we're developing research and developing studies that help understand how the historical and generational trauma of race has impacted the Black community. Mentally, emotionally, physically, psychologically, economically — all of it is being impacted based on race and what that looks like. So we're trying to do a lot of work here. And it's heart-wrenching, because I face it myself.

I'm a Black woman … you walk into a doctor's office, there's already a sense of stigma that goes along with that.

Sometimes, it can be a judgment based on whether or not you can afford to be there. It's a question of whether or not you're going to come in with a legitimate claim here. Are you going to actually listen to what's going on with me? Or are you going to assume that you know what's going on with me without taking in all of the information in the framework of that? And let's take weight and size into it. Because I’m not a skinny Black woman. And we measure ourself against a chart, about height and weight and size and what that's supposed to look like. So you are labeled with terms like, “You're morbidly obese,” and all the other factors that come along with that. But we don't necessarily consider the social environment and the social factors that impact health and wellness. We have food deserts in urban communities that impact how people eat; stress-related things that impact how people eat. So when a client comes in, and we have these discussions, I try and look at it from what I call an Eiffel Tower view. So if you're up at the top of the Eiffel Tower, you can see more of the landscape of what's impacting whomever is down there — as opposed to taking this very horizontal look at things.

Lauren: I love that you're talking about it from a perspective, though, of using research to work toward healing generational trauma. And utilizing what we have at our disposal in order to bridge the gap, to create more trust in the healthcare system, and to remove stigmas over time. It's this idea of unlearning. I know a lot of people have been hearing that buzzword a lot in the last few months, especially for people outside communities of color to understand that the world has been designed for them. And it is for communities of color to be able to have the space to stand up and be able to create structures that will support them going forward.

Tori: Absolutely, and here's the deal. We don't want to completely dismantle all that has been created in this space. What we want to do is use what has been created, and we want the support in order to, in many senses of the word, recreate or reinvent what needs to be done to help the Black community and help people of color. Because it's just so instrumental that we have tools and we have spaces that understand the necessity of us taking into account the panoramic view of how health, and mental health, are impacted. So that's really what we want to do overall.

Lauren: Absolutely wonderful. Would you say that racial and gender inequity, as well as sexual identity inequity … all the various forms of identity that we've talked about today … would you say that these issues in the healthcare system are a public health crisis?

Tori: Oh, my gosh, absolutely. It is absolutely a public health crisis. 

Lauren: We have this from a therapist, everyone!  We have this from a practitioner. 

Tori: This is a public health crisis. This is on the same scale, if not more, than this global pandemic that we are experiencing. Because what happens is, when we don't make the corrective changes, it impacts generations. It's not just what's happening today. It's not just for your children. It impacts generations. And so this is a probably a crisis of epic proportions. And I think what happened is … I've been saying this from the beginning … that Coronavirus, and COVID has shaken the pot a little bit. And what it's doing is separating the wheat from the tares. And it is giving us this opportunity to really see that the infrastructure of what we have been doing has not been working. It hasn't been working.

And here's the key. If it doesn't work for everyone, it works for no one.

Lauren: Yes. Thank you! I'm air clapping over here into the mic. I could not agree with you more. That is so well said.

Tori: There was a saying back in the civil rights era … none of us is free until all of us are free. And so if we do not see this as a crisis that impacts all of us, we will all be impacted by the crisis nonetheless. Whether it’s directly or indirectly, overt or covert, you will still be impacted by what happens if we do not take an opportunity to start to dismantle all of the lenses of discrimination that happen for everyone. If we don't dismantle it, it's going to impact us all, period. None of us can get out of this alive if we don't work on this.

Lauren: And if we don't do it together.

Tori: And we don't do it together. Absolutely.

Lauren: So, we’re talking about the health care system. We know that there are ways in which it's falling short — that we are talking about right now. We know that with any kind of layer of identity beyond white male, with each additional layer, patients are looking at a less positive experience in the healthcare system. So are there ways in which the current system is working at all? I mean, you're allowed to say there aren’t! (laughs) Is healthcare accessible in some ways?

Tori: Well, I think it depends on who you ask. The problem is that healthcare on every level is a privilege. And so this means, again, that if all of us do not have access to a system that would allow for everyone to have the same level of care, then that means that we, again, cause this chasm between those who have and those who do not have. So that means if a person who “does not have insurance,” if there is a different road and a different method of treatment for that individual, as opposed to someone who comes in with this top-notch care of treatment — like they have the best insurance plan, they have a zero deductible rate. Again, a deductible will keep you out of being seen, because if I have to match a $5,000 or $10,000 or $15,000 deductible, and my yearly salary is only $30,000 to $45,000 … and of course, that yearly salary is going to be dependent on who you are and what community you live in. Because I believe Black people earn 5% on the dollar, in terms of our white counterparts. So that deductible is going to keep me from going to the doctor. Which is now going to impact the level of care that I receive. I may have something urgent and I'm going to go to an urgent care instead of going to an ER because I know one is going to be $30,000 when I walk out the door and the other maybe $300. And I know what I can afford, because I know I'm going to have to treat my kids. So am I saying that none of the healthcare system is working? I'm not going to put that broad spectrum …

Lauren: I think we’re saying it's working for people who have privilege, which tends to be if you're white and male especially.

Tori: Absolutely, it's working for the people who are privileged to be able to participate in the system in a manner that fully expresses what the system is supposed to be for the people who can participate in it.

Lauren: Because it’s been designed for them. 

Tori: It’s been designed for them, so for them it’s working. As a clinician, I work on a sliding scale. So there are some people who come to my office and they have insurance and we will file their insurance and we'll go through that process. But then what happens to the person who calls me and says, “Hey, I have no insurance.” I work on a sliding scale. I've seen clients for as little as five bucks per session, and they get the exact same therapy, they get the exact same Tori that the person who has insurance can actually pay. And some people may say, “Well, Tori, if they don't have any money and you're advocating for the poor, why not just do it for free?”

Here's my thing … we assume that people who have less don't place value on the services that they are asking for, and that they want them for free. That, too, is a mindset that ends up causing this divisive space between us.

People who don't have, or do not have as much, they're not asking for things to be free. They're asking for them to be affordable, based on what they have. So when I have a client that comes in and they say, “You know what, I can't afford your services,” I know that and I say, “Well, can you afford 10 bucks a session?" And they say, yeah. They buy into it, and what it does is let them know that I have the power, that my $10 … it may not be $50, it may not be $100 … but my $10 still has the same power impact that anybody else's money has, and that this clinician is going to treat me with my $10 the same way she would treat anybody else. It restores the sense of dignity. The idea that people are just wanting to leech off the government and they just want free stuff. And this is fascism and all the -isms that make no sense. People who don't have much, they have more, oftentimes, than other people because they have dignity. They have dignity and pride in what they do have, what they can't afford. And when we allow them to show up fully in their space, no matter what that space is, it changes the dynamic of the relationship that we have.

Lauren: And it really reinforces a commitment to doing the work, doesn’t it. It creates an accountability when you invest in something, even if it's $10 and not 100?

Tori: Yes, absolutely. They get to buy into their own healing, they get to buy into rebuilding and changing their generation, their genealogy. So I can come to therapy, and I can change the way I see things. I know it's going to impact my children and that’s going to impact their children. My investment on that is my work that I put into this process, and my $10. And I freely take it, and we have sessions. And it’s amazing.

Lauren: I think that's beautiful. I mean, the other part of that is that it only works as well if there are people who are paying full freight when they can afford it as well. It's important that we recognize that these people who have privilege and can afford a higher rate are also paying the higher rate to even things out.

Tori: To even things out for the business owner. And I will tell you that I don't have any issues in that regard. Because part of my ethical responsibility as a therapist is to make our services accessible to all people. There are some things that I'll do … some Instagram Lives where those are free, and people will have access to them. I do some things on my Facebook page, where I'll pick a topic and I'll talk about that thing for 30 minutes, and I'll post it up there and people have access to that free information. People will call me and they say, “Hey, are there any resources for free?” I've given them information to other community centers that are offering programs. And not necessarily therapy; sometimes they just need extra support. Sometimes they just need a group. Sometimes they just need some activities to help them along the way. I love the work that I get to do; it’s just phenomenal.

Lauren: I love that it also was a natural transition for you. You were already taking care of people from the grief side, you know, moving into this more holistic approach. I think it's a beautiful journey you've been on and that you’re able to take people on, too. What about, also, this idea of work/life balance, which we know is also in flux right now because of COVID. We've talked about healthcare, but would you say that our lifestyle expectations are also creating problems in terms of our ability to handle stress and generational trauma and grief, and all of this kind of approach to mental health?

Tori: Absolutely. You said something that is critical, you said work/life balance. And what that indicates is that my work is always going to come first and my life has to accommodate my work.

What I like to say is life/work balance, because that's ultimately what it's supposed to be.

We're supposed to have lives where our work comfortably coincides with the life that we are trying to create for ourselves, for our families, for those who rely on us and impact us. But our society, our world, our American culture … it’s work first, life later. So work first, life later means life on the back burner, work first. We are now in a pressure cooker. We aren't doing work the way that we are used to doing it. We're not doing school the way that we're used to doing it. We're not doing family the way that we're used to doing it. All of this together is creating an unusual amount of stress for us in these spaces. We're hearing a lot about what happens when people who haven't been working are getting the supplement for $600 a week. And they’re, like, people are making more money on unemployment benefits than they are working 40 hours a week.

Lauren: Which is unbelievable to me!

Tori: Unbelievable!

Lauren: And when I say unbelievable, I also mean completely believable because I've been that employee who hasn't made as much money being employed as I have on unemployment. I know that experience firsthand, and it is incredibly demoralizing.

Tori: And no one stopped to just say that. That my work goes beyond just my time on the clock. That many of us are investing ourselves, the fullness of who we are. We show up every day for our jobs. We show up in a space and say that we're going to give the best that we have today. Today may not be 100%, but it may be 80 and that's the best that I have.

But you're telling me that when I commit to going to a job and giving the very best of who I am to this space for the time I'm supposed to give it, that I cannot make enough money.

That's not working in many spaces — being able to give my creativity or being able to just smile at someone. You’re telling me that I can make more not sharing the fullness of my personhood, doing my work — which all of us find a sense of purpose in our work — than I can at my job. That says a lot about the way that we treat work. And about the way we treat the people who do the work.

Lauren: And the socio-economic differences, too, the class differences, the way the middle class is eroding entirely.

Tori: Absolutely. It’s shocking to me. And then we don't realize how that impacts the mental wellness of an individual. To say that me doing nothing is worth more to my society than me actually showing up fully in the person of who I am and giving who I am to my work. 

Lauren: Yeah, it’s unbelievable to me, this expectation as well, that people are working 12- to 16-hour days. So they're spending more time at work than they are in their personal lives. And the stress this puts on someone, especially when, as you say, they can't bring their whole personhood to the table, and they're not making enough money working these three different jobs that they have to work. We know that money is the leading cause of divorce in this country. So it's not surprising to me if we can also make a correlation between money being also the leading cause of stress in general.

Tori: Yes. Economics and money and financial lack is one of the biggest issues and concerns that I see when clients sit with me. I'm having to make these very detrimental decisions. Do I do this? Or, do I do that? And it's all based on what is it going to look like for the bottom line of my family? And it’s a very, very difficult space to be in. And for those who may be struggling financially, and you don't know, literally, if there's a next paycheck. Our government right now is fighting each other over whether or not we should extend benefits. I read something this morning that 23 million renters are going to be out of a place to live by the end of this year because of what's happening with the global crisis. We are in crisis mode. And for those who are not in that category, if you think it's not going to impact you, that there's not going to be lots of vacancies in neighborhoods and property values are going to come down … again, if we don't get it to where it affects none of us, it's going to impact all of us. And so people have these real life issues looming over them. It seems to be so simple that there couldn't have been a mandate saying, hey, we're not going to throw renters out. We're not putting people out. You know, guys, find a way. I understand that there are subsidies to help people who are renters or landlords. We have to find a way because poverty is eroding us in so many different ways; it's harming us.

Lauren: And this mental health impact, it all comes back to invisible illness and this mind/body connection. That when you're stressed out, you're more likely to get sick.

Tori: You’re like more likely to get sick. If you're not sleeping well; you’re more likely to have a mental health episode if you're not sleeping. That means if you're not eating. If we're stressed, oftentimes, we're either eating too much of the wrong thing, or we're not eating enough at all. This leads to this feeling of anxiety, this feeling of worry, this feeling of fear, this feeling of panic, this feeling of sadness that's leading to this depressed mood. Where people are questioning a lot of the decisions they made at the beginning of the year … had I done this or if I would have done that, then this wouldn't be here. And so many of us, we have to kind of settle in and say, you know what, there was nothing that I could do to plan for this pandemic.

There was no way we could have seen this, or prepared for this, in any other way that we have and that we are now.

So, you're not alone. You're not by yourself. All of us are asking the question: Okay, well, what's going to be next? What is the next gonna look like for us? So, if you feeling anxiety about it, you're not by yourself. And reach out to a clinician to help you to be able to, like I say, separate the laundry. There's a part of this thing that you cannot control. We can't control how long this pandemic is going to last. We cannot control whether or not the Congress is going to extend benefits. We cannot control our landlords, we just cannot control so much of this. But a part of this is us making sure that the things that we can control … that we are diverting our energy from things that we can’t control over to the things that we can. And the things that we can manage, that we do the best that we can, in putting forth the best effort in doing that.

Lauren: Yeah, so beautifully said. Now, what about patients who you're prescribing a treatment or maybe some lifestyle changes to, some cognitive behavioral kind of approaches … Does a diagnosis mean that these patients need to upend their lives entirely? How disciplined do they need to be when it comes to these prescriptions for behavior?

Tori: It’s so funny that you asked that, because I'll have clients come in and they’re, like, “Now that I've had some time to think, I know that my life is in complete shambles. I need to make some changes right now, right here today, like now.” And I say, “Wait, wait, wait. Let's pump your brakes and slow your roll.” Because we are not in the ideal conditions that we were in a year ago. The pressure now, the environment now is different. We are in a situation now where we have less mobility and we have less support in the lifestyles that we have. For instance, parents, school is a support system for you. Because at least for most of us, barring those parents who have experienced loss due to some sort of violence that has happened in our school settings, for the most part, when you send your kid to school, you know exactly where they are, you know that there's reasonable level of safety, you know they’re being taught, they’re learning. And it allows you to function at your best, for the most part, on your job. That’s a support system. And now that you don't have that … now you are the parent and the teacher and the principal and the lunch lady and the janitor now … and you're still working … now that you're doing all these roles, I tell people, “You have a lifetime to make a change. Let's not try to get this done in two weeks. Because the pressure of making the changes that adds in with the pressure of the life that we have, it can be very much overwhelming.” And so I tell them, “Let's take this thing one step at a time.” A big part of us making change is actually just saying out loud, that there are some things that are going on in our lives that we are not happy about. So coming to therapy, and just having that first session and being able to regurgitate all that stuff and to get it out and actually say it and hear it … it’s just like a weight has been lifted. And so my first thing is, okay, grab a journal. That's the first thing you need to do. Grab a journal. Start to write some things out. There's probably some things that you've never told anybody. You've never put on paper. You've never said anything. Let's not think that we can go from one thing to who we are and do this total 180. And now we have a whole new different life. We're doing whole new different behaviors. We're on three different types of diet. We're doing keto. We're doing no meat. We’re doing vegan, keto. And we've stopped drinking. Let's pick one fight at a time. Let's do one thing at a time. If you're saying you want to change your eating habits, why don't we start with just adding more water to your everyday life? Start with baby steps. Listen … “I'm not drinking any more sodas. I'm not having teas. I'm not having anything sugar-related. I'm doing keto. And I'm being vegan.” Okay, well, that's too much. And then when you're not able to sustain that, when your expectation is not meeting your reality, you have this huge level of disappointment — in yourself, in your progress. It's like, okay, so I must not really be all that serious, because I'm not doing everything I said I would do. And I’m, like, “Let's start simple. Let's drink some water. How much water did you drink today?” And they’re, like, “Maybe two tablespoons.”

“Okay, Why don't we go to a cup? Let's get to one cup of water a day, for the next five days. And let's see if that makes you feel better, and see what happens from there.”

Lauren: And it's those baby steps creating consistency.

Tori: It’s those baby steps that creates the consistency. I was having a conversation this week with a few of my clients and I said this, and it's just been ringing all week. That in order to heal dysfunction, we have to create some disruption. And sometimes that disruption is something as simple as being consistent. That consistency is what's going to create the disruption that you need to heal the dysfunction. So the dysfunction is whatever you find that you don't like. So if you’re, like, I'm feeling a little lethargic, and I know I don't drink any water; I just don't do it. Okay, well, let's create some disruption in that pattern, so that you can heal that particular dysfunction. And the disruption is consistently drinking that one cup of water a day. Let's see how that happens. And then we can go up to two cups of water, and then now we're up to a bottle of water a day. You have to create some sort of disruption in the pattern that is sustaining the disruption in your life.

Lauren: I love that you use the word sustaining there, because if there’s a sustained dysfunction, it's about creating a sustained disruption. I'm a great example of that because I've struggled with exercise fatigue, for example, and I've just challenged myself to go for a walk for half-an-hour, three days a week. And you know who actually encouraged me to do that is GirlTrek, which is an amazing organization. I was, like, if I can do this three days a week and do it for a few months, get in a pattern, I'll add a fourth day. And eventually I'll be up to five days. And then eventually I can get on the elliptical, and eventually, I can get on a bike. It's just those baby steps and it makes all the difference.

Tori: Yeah, that makes all the difference. I say all the time, you’re one decision away from the life that you want. Not 55 decisions, not 7,500 decisions, just one. You're just one decision away from the life that you want. And that's whatever it is. That's consistently making one new decision, that's sustaining that disruption, So that we can heal whatever is dysfunctional that's going on in our lives. Just one decision away.

Lauren: I love that. So what would your Top Three Tips be, then, for someone who is maybe trying out mental health support for the first time, or maybe they're living with chronic illness and they need mental health support. What do you want patients to know? The best tips for managing mental health. I know you've mentioned them all throughout this interview, but if you can crystallize for us what those top three nuggets of information are.

Tori: The top three things … I would say, one is validate. We're going to validate your feelings.

Whatever you are feeling wherever you are right now today, is real.

It's happening. It's truth. It's your reality. And it's okay. You don't need anybody outside of yourself to tell yourself that what I have been experiencing is true. So, validating just how you feel, writing it down, being consistent about writing those things down and saying, “This is where I am today. This is how I'm feeling today.” That's one. Two … a part of it is, after you validate those feelings, if you are looking for a mental health provider, look until you find someone who is going to encourage you to continue to stand in the power that validation gives. 

Lauren: I love that. 

Tori: Yeah, look for somebody who is going to encourage you to do that. Because … and I love this statement … I was gonna write a book! … when you get comfortable with the narrative of your own story, you become less concerned about the version that other people choose to tell.

Lauren: Yes! All the air-clapping over here!

Tori: Yeah. When you become comfortable … and a part of what this therapeutic process is … is to first just let people get comfortable with the story in their own narrative, and empowering them. Because if you have that narrative, you are one decision, you are one sentence away from creating a new narrative that tells a new story about the life that you have. So, validate for yourself that ‘this is real for me.’ Find someone who's going to encourage you to own your story, no matter where you are in the process. And shop around for that person. Clinicians, there are a lot of us out there. There are a lot of websites to help you find someone. But if you see someone once and they don't necessarily fit with you, it's okay. Find somebody else.

Lauren: And many offer a very decent cash rate or sliding scale. So it's always worth asking.

Tori: Absolutely. Most of us just do our own ethical requirements. As clinicians, we are required to offer a sliding scale, because we don't want the practice of mental wellness to be a privilege. We want it to be a right. It's everyone's right to live healthy, both in your mind and in your body. To have total health and wellness is a right for you to have. And the third one I would say is, again, create consistency. Be consistent. I was watching a video about two or three months ago, and I promised that this was the last time that I was going to actually give this particular lady that I absolutely love credit for what she asked. Her name is Tracee Ellis Ross.

Lauren: Oh, we love her. 

Tori: Don’t you love her? Do you remember the show, Girlfriends?

Lauren: Yes, of course I do!

Tori: So she's been my girlfriend since Girlfriends. She has no idea but we're friends in my head. I hope she hears the podcast and then calls me.

Lauren: Please invite me! (laughs)

Tori: You’re comin’, Lauren, you are in there! She was doing this interview with a magazine. She was talking about her life and how she was trying to create her own space, not wanting to really live in the shadows of her mom. And having a really hard time with delineating between her daughter-ship with her mother and her own individuality — and what that meant for her. And so she said, one day, she stopped and asked herself this question: “Are you willing, am I willing to enter into an unconditional relationship with myself?”

What a question. Am I willing to enter into an unconditional relationship with myself? 

Lauren: That’s the one decision away from changing your whole life. 

Tori: Is that not the one decision away, Lauren? It's so true. So as you are validating your own story, as you are finding a clinician who will help you stand in the truth of that story, you have to go into this process asking yourself, “Am I willing to enter into this unconditional relationship with myself?” Because for so many of us, we've been in unconditional relationships with everything except ourselves. We've poured into jobs that are not serving us, we've poured into relationships that are not serving us. We've been inadequate in finding balance between parenthood and self-hood, that there is a necessary balance so that you can fulfill the role as best you can. But we haven't entered into this unconditional relationship with ourselves that says: Anything that doesn't serve me, that doesn't heal me, that doesn't propel me into being the person that I want to be … I'm going to have to let it go.

Lauren: Yeah, a lot of that is about shedding that excess. Getting rid of the stuff that doesn't serve you and focusing only on the stuff that does serve you. Absolutely. So true.

Tori: And what that means is having a really good understanding of what self-care is. I say self-care is caring for self first. Selfish is caring for self only. We’ve mixed up those two and we feel that self-care is being selfish. And it's not considering those of us around us who need us. But when you care for yourself first, you end up not pouring from your cup, you end up giving from the overflow of the saucer that's there. You’re giving from the excess. We give of our excess, not of our needs.

Lauren: And then you're creating from a place of abundance and joy.

Tori: And that goes back to me entering into that unconditional relationship with myself.

Lauren: So beautifully said. So what is your ask for listeners today? What can they do to support you in the work you do, to support the growth of removal of mental health stigma? What can listeners who are tuning into this episode today do to plug into continuing and supporting you and continuing the work that you're doing?

Tori: That is such a great question. And to be honest with you, many entrepreneurs don't get asked that question much. How can I serve you? If I had to do a broad picture, I would say take care of your mental health. Everything in our bodies, if we don't want them anymore, if they don't work, we can exchange it, right? We can get a new heart if it stops working. We can get new kidneys if they stop working. Lungs, we can exchange them out. People have even done new faces. We can do anything. Except your brain.

Your brain is the only organ that you will have from birth until death. Take care of it, at all costs.

If it's costing you your peace, if it's costing you your wellness, it's too expensive. That's with jobs, that's with relationships, that’s with goals … if we are trying to achieve things and our pathway to success is causing us mental angst … stop, you're on the wrong path. If it's costing you your mental wellness, it’s way too expensive. Take care of your mental health. Everybody needs a therapist. I have a therapist that I check in with, that I talk to; this is a professional who's licensed and he can help me with my problems. We've got to stop putting the weight of our mental wellness on our family members, on our friends who are dealing with their own issues, and who are not equipped enough to be able to help you solve problems that are deeply rooted in spaces of trauma that need to be worked through via a professional. Everybody needs a therapist, whether you're going through something or you're not. It's like having a PCP. You go for these checkups. You don't go to the ER for a mammogram. But you can't go to your PCP once you have eight or nine gunshot wounds; you're gonna have to go to the ER at that point. So take care of your mind. For me, share stuff. I have a couple of pages; you can find me at @WhenToriTalks on Instagram. You can find me @TherapistTori on Twitter. Again, we have two locations. We have a virtual office out in the state of Georgia. We have one right here, a physical location and virtual location here in Texas. Share that information. You can find me at Graceful Journey Counseling on Facebook. Get on there and post and share with us. And remember to keep us in mind when you're meditating, when you're praying. We do a lot of heavy lifting. I believe that we are also on the frontlines of what's going on. We talk about doctors and nurses, but mental health professionals are on the front line. As a matter of fact, I also am now temporarily licensed in the state of New Jersey, because they were having so many people who needed help that they petitioned clinicians around the country to please get temporary licenses in the state of New Jersey so that residents can have access to clinicians, and insurance companies have been open to allowing us to bill through people's insurance if they have it. Again, we work on a sliding scale. There are clinicians out there and you do not have to do this alone. You're not by yourself. You're not by yourself. During this time, we are seeing that suicide rates are going up. We're asking you, we're pleading with you … that the vehicle, the thing that you're going to need most in moving forward is your life. You're going to have to have it. You have to have your life in order to see some change, in order for things to get better. I think that's kind of where we are.

Lauren: What's next for you and your advocacy, and in your wellness journey? What's next for Tori?

Tori: What’s next for Tori? I'm working on a podcast.

Lauren: Yes!

Tori: Yes, so I'm working on a podcast. I'm trying to get together all the elements of what that entails. In my own personal life, I'm hiring clinicians. We have a clinician here in the Dallas office. Because ultimately, my goal is to see less clients and to be in the community, particularly the Black community, and saying, “Hey, we are here. Let's get our mental health together. Because this is going to be a part of the generational wealth that we have in building and creating the community that's going to function for our kids and our grandkids and for six and seven generations to come.” And so that's the next thing, working on a podcast. I'm trying to keep my own mental health and wellness together, keeping things in perspective. I don't see clients on Fridays. That's my day off. Friday, Saturday and Sunday, I'm off.

Lauren: Well, I've taken some of your Friday! Thank you! 

Tori: No, this is perfect! This is what I do on my Fridays. I try and spread the word of how important mental health is. And here's another thing, guys … stay grounded in your spirituality, whatever that is for you, stay grounded. Because the thing about your spiritual understanding and your spiritual grounding, those things are principles that typically do not change. Everything else around us is going to fluctuate and change.

But when you are grounded and when you are anchored in your spirit and in your soul and you know what your truth is for your life, it changes the perspective on how you're seeing everything else change around us.

So stay grounded in your spiritual work, whatever that may be.

Lauren: Tori, is there anything else you'd like to share with us before I set you free into your evening?

Tori: Well, I just want to say thank you. I want to remind us that we are a collective body. Even in church growing up, we learned that if you bang your pinky toe on something, everything hurts. So we can't let a part of our body hurt, and ignore the pain. We don't want to become numb to whatever is ailing our fellow brothers and sisters. And so if something is harming me as a Black woman, I want it to hurt you up at the top, in your ear lobe; I want the ear lobes to feel that. So whatever person is up there, whatever community is up there, I want you to feel that. Because we don't want to numb pain in our society. The pain of others should be very important to how we function in our own daily lives. And if you are watching people in pain — whether you understand the pain, whether you understand how the person hit their toe on the side of the couch, whether you understand how they got themselves in the predicament or position that you feel is not good or not healthy … you don't have to understand how they got there. All you need to know now is that they're hurting. And there's so many of us who are hurting. And I just want us all to, collectively as the body of humanity, to pay attention to our fellow brothers and sisters who are hurting. Don’t let us hurt alone. Don't let people hurt by themselves. Find a space where you can find the compassion and come alongside them and share in the joy of what grief and sorrow does to developing relationships. We can't just be addicted to people's lives when we see that they're going good. We have to join them in the fellowship of their suffering. This is when we really know who people are, when they're hurting. So if you see someone hurting, help. That’s been the mission of my work, to help.

Lauren: Absolutely. And I mean, while we're at it, protect Black lives. Black Lives Matter.

Tori: Please, and mattering is just the minimal of what we're asking for. We've been fighting for this for generations. I talked to my mom who just turned 70 in May. And she watches the news and she shakes her head, and she goes, “I thought we did this already. I didn't think that my daughter would have to do this. I didn't think that my son would have to go through this. I thought we did the work.” And to now know that we're pulling the Band-Aid off of so many injustices that have been going on. We've been crying out, we've been asking for help. Our Lives Matter.

We didn't say they matter more. We didn't say they were better. We just want them to matter.

Lauren: And to matter the same that white lives matter.

Tori: The same as white lives! The exact same, that's what we want.

Lauren: Real equity. Absolutely. Well, Tori, it has been such an honor to speak to you today. You're so inspiring. And I really look forward to releasing this episode into the wild and for all our listeners to get inspired by you as well. Because, man, the personal is political. It doesn't matter how you slice it. I truly appreciate the work that you're doing, the energy you've lent us today, and the time you've taken to teach us. So guys, let's listen up and let's take on what Tori is teaching us today.

Tori: Thank you. Thank you for allowing me to speak on your platform. I find it a privilege and an honor to be able to do such. 

Lauren: It is a privilege and an honor to be able to host you. So thank you.

Tori:  Thank you, thank you. And when all of this is over, I'm comin’ to California, and we’re going to hug like real people!

Lauren: Oh, please! A hug so big!

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