What is a Trigger?



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Recently  we are often hearing about trigger warnings and on social media, many people will post a  warning before posting something which may be disturbing to others.  Triggers are not something new however until recently many people didn’t think about how something could trigger someone else.  If someone gets triggered, it often takes sometime to get out of the the moment and not think about the memory that was triggered by what they saw, heard or smelled.   Unfortunately it’s impossible to know what will trigger each person and some triggers are unavoidable.  It’s important to know if something will trigger you and to try to avoid any triggering situations.   Triggers are activated through one or more of the five senses: sight, sound, touch, smell and taste.  Sight and sound tend to be the most triggering for people.



  • Often someone who resembles the abuser or who has similar traits or objects of the abuser will be triggering and bring back vivid memories of the abuse.
  • Witnessing someone else being abused.
  • The object that was used to abuse
  • Seeing a place or situation which reminds you of the abuse.


  • Anything that sounds like anger , pain or fear can be triggering.
  • Anything that resembles sounds that the abuser made for example . whistling,  or tone of voice
  • Words the abuser used.


  • Anything that resembles the smell of the abuser
  • Any smells that resemble the place or situation where the abuse occurred (ie. food cooking ,wood, odors, alcohol).


  • Anything that resembles the abuse or things that occurred prior to or after the abuse for example certain physical touch, someone standing too close or the way someone approaches you.


  • Anything that is related to the abuse, prior to the abuse or after the abuse for example. certain foods, alcohol, tobacco.

If you feel triggered  by something there are ways to help you to feel better.  Grounding exercises and deep breathing are usually helpful.  A good grounding exercise is to acknowledge that you’re being triggered, remind yourself that you’ll be ok and that you’re safe and not in the situation.  Think of some positive affirmations to repeat to yourself and most importantly be kind and compassionate to yourself and remind yourself that whatever happened was not your fault.

Understanding Borderline Personality Disorder




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Borderline personality disorder (BPD) is a often characterized by difficulties in regulating emotion. This difficulty sometimes leads to unstable mood swings, impulsivity and instability, poor self-image and difficult personal relationships.   A person  living with BPD  sometimes will exhibit destructive behavior, such as self-harm (cutting) or suicide attempts. It’s estimated that 1.6% of the adult U.S. population has BPD.   Nearly 75% of people diagnosed with BPD are women, but recent research suggests that men may be almost as frequently affected by BPD.


People with BPD experience wide mood swings and sometimes display a great sense of instability and insecurity. Signs and symptoms may include: Frantic efforts to avoid being abandoned by friends and family. Unstable personal relationships that alternate between idealization—“I’m so in love!”—and devaluation—“I hate her.” This is also known as “splitting.” Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships. Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, substance abuse or reckless driving. Suicidal and self-harming behavior. Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days. Chronic feelings of boredom or emptiness. Inappropriate, intense or uncontrollable anger—often followed by shame and guilt. Dissociative feelings—disconnecting from your thoughts or sense of identity, or “out of body” type of feelings—and stress-related paranoid thoughts. Suicide threats and attempts are very common for people with BPD. Self-harming acts, such as cutting and burning, are also common.


The causes of borderline personality disorder are not fully understood, but experts agree that it is the result of a combination of factors: Genetics. While no specific gene has been shown to directly cause BPD, studies in twins suggest this illness has strong hereditary links. BPD is about five times more common among people who have a first-degree relative with the disorder. Environmental factors. People who experience traumatic life events, such as physical or sexual abuse during childhood or neglect and separation from parents, are at increased risk of developing BPD. Brain function. The way the brain works is often different in people with BPD, suggesting that there is a neurological basis for some of the symptoms. Specifically, the portions of the brain that control emotions and decision-making/judgment may not communicate well with one another.


There is no single medical test to diagnose BPD, and a diagnosis is not based on one sign or symptom. BPD is diagnosed by a mental health professional following a comprehensive evaluation.  To be diagnosed with BPD, a person must have at least 5 of the 9 BPD symptoms listed above.


Treatment for BPD generally  includes psychotherapy and medications.   Psychotherapy, such as dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT) and psychodynamic psychotherapy,  usually works well for people with  BPD. Medications are often used in  treatment, but there is no one medication specifically made to treat the core symptoms of  emptiness, abandonment and identity disturbance. Rather, several medications can be used off-label to treat the remaining symptoms. For example, mood stabilizers and antidepressants help with mood swings and dysphoria. Antipsychotic medication may help control symptoms of rage and disorganized thinking. Short-term hospitalization may be necessary during times of extreme stress, and/or impulsive or suicidal behavior to ensure safety.

BPD can be difficult to diagnose and treat—and successful treatment includes addressing any other disorders somebody might have. A person with BPD may have additional conditions like: anxiety disorders, such as PTSD. bipolar disorder, depression or  eating disorders.  They may also have  other personality disorders or substance use disorders.

Helping Yourself

Although you may realize that your behaviors are destructive it may be difficult to control them. Treatment can teach you ways to cope. Here are some other ways to help manage your illness: Connect with others. Find emotional support from others living with BPD. It’s helpful to share your thoughts, fears and questions with other people who have the same illness. Use online message boards or groups found through social sites like meetup.com or Facebook. Avoid  excessive use of drugs and alcohol. These substances can disturb emotional balance and interact with medications. Take care of your body. Eat well and exercise. To relieve stress, try  activities like meditation or  yoga.

Helping A Family Member Or Friend

The support of family and friends is critical in the treatment of BPD, as many people with this illness may isolate themselves from these relationships in times of greatest need. Look for warning signs. BPD often shows in erratic behavior, shopping sprees, sexual or substance binges and blow-up fights in relationships. If a person is open to it, discuss your friend or family member’s past episodes with them so he or she can clearly recognize the signs early. Encourage continued treatment. Family and friends can be  helpful in encouraging someone to engage in proper treatment.

While this is a difficult condition to have or to have a loved one suffer from with the correct help, you or your loved one can live a stable life with BPD.

Caribbean Immigrants and Therapy

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Many Caribbean immigrants in particular first generation immigrants are very wary of going to see a mental health professional.  Problems are usually handled at home and many families have someone in their family who is mentally ill but has never gotten treatment and is often whispered about by others in the family and community.  Many immigrants are also very religious and feel that by going to church and praying  will make everything better.  Many Caribbean immigrants also believe that admitting to being depressed or anxious is a moral failing and won’t seek out help and will try to feel better on their own.   Many also wonder if a clinician who does not share their background will be able to understand their background and some beliefs such as “obeah” which is a form of voodoo practiced or believed in by some members of the Black Caribbean community.

Faith, Spirituality And Community

In the West Indian community, family, community and spiritual beliefs are often  great sources of strength and support.  Many West Indians  rely on faith, family and social communities for emotional support rather than turning to health care professionals.

While faith communities can be helpful at times they can be a source of distress and stigma if they are misinformed about mental health or do not know how to support families dealing with these conditions.


Reluctance And Inability To Access Mental Health Services

Less than 30% of West Indians  seek mental health care during their lives. Here are some reasons why:

  • Distrust and misdiagnosis. Historically, African Americans and West Indians  have been and continue to be negatively affected by prejudice and discrimination in the health care system. Misdiagnoses, inadequate treatment and lack of cultural competence by health professionals often causes distrust and prevent many people  from seeking or staying in treatment.
  • Lack of  West Indian mental health professionals.   Unfortunately there is a lack of mental health professionals who are from the West Indian or Caribbean community.  Many immigrants feel more comfortable and relate better to people who they perceive as being more familiar with their culture.

Provider Bias And Inequality Of Care

Conscious or unconscious bias from providers and lack of cultural competence result in misdiagnosis and poorer quality of care for African Americans and West Indians. .

West Indians, particularly women, are more likely to experience and mention physical symptoms related to mental health problems. For example,  describing  bodily aches and pains when talking about depression. A health care provider who is not culturally competent might not recognize these as symptoms of a mental health condition. Additionally, men are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders or PTSD.

Given this bias and the negative impact they have on your care, it is easy to understand why so many people  mistrust health professionals in general and avoid accessing care. While there may be reason to doubt whether professionals will mistreat you or not, don’t let this fear prevent you from seeking care..

Finding The Right Provider

For West Indian and Caribbean people it will be important to find someone whom they feel is culturally competent and understands them.  The therapist doesn’t have to be West Indian but should be someone who understands or is willing to learn the nuances of Caribbean culture.   When meeting with a  provider, ask questions to get a sense of their level of cultural sensitivity. Do not feel bad about asking questions. Providers should expect and welcome questions from their clients  since this helps them better understand you and what is important to you.  If a provider seems put off by being asked questions, they may not be the right provider.  Remember if you need help it’s ok to seek it and don’t feel ashamed about seeing a therapist.



Misconceptions about People who go to Therapy

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“Talk to your family and friends, why are paying someone to talk to you”.  “Are you crazy or something?”  These are phrases people often say to others when they hear that you’re seeing a  therapist.   Many people won’t seek therapy because they don’t want to be labeled as “crazy”.   Therefore in order to shed light on the truth about seeing a therapist and raise awareness, I’ve  complied a list of things you shouldn’t assume about people who go to therapy.

1. They’re weak.

Going to therapy is a very courageous and strong thing to do.  You have  to be open to facing every corner of your mind and heart and be completely open about fears, truths and experiences in order to really get the most of what a therapist can offer. This requires strength.  You need strength  in order to explore your own emotional and mental limits and boundaries, strength to be guided in directions you wouldn’t go and strength to learn and actively seek a better place.

2. They’re crazy.

Whether someone  is suffering from a mental illness or seeking help for overwhelming feelings/thoughts, “crazy” is never an appropriate term.


3.  Therapy is for rich people.

Therapy can be expensive, but there are different ways to pay for therapy.  Many therapists accept insurance and some have sliding fee scales.  Also Open Path Collective can connect you to therapists who charge between $30-$50 per session.

4. They have no friends.

Therapy is not a replacement for friendship, and a therapist is not a friend. Friendships are two-way streets, which can cause a very biased view of experiences and circumstances; therapy is a one-sided relationship with a professional who has the skills to guide and help you through your struggles and needs.  Most of my clients have many friends who love and care for them.


5.  They’re in a bad “place.”

Someone  does not need to be in a “bad” or “dangerous” place to see a therapist.  There’s usually a catalyst for deciding to go, but it could be a culmination of experiences or feelings, not necessarily that something bad recently happened to you.

6. There’s a set time frame for being in therapy.

Some people go to therapy for years while some only go for a few months to work on a specific issue.  The client and therapist will decide together an appropriate plan for treatment.

7.  They’re  on medication.

It’s common for people to believe that if you’re in therapy, you must be on medication.  While some people who are in therapy are also taking medication, many are not taking any medication.  Most of my clients in my practice do not take medication.

8. Their  therapist tells them what to do and what to think.

A therapist is there to help you  uncover your strengths, work through your struggles and help  you to lead a healthier, happier life not tell you  what to do.


It’s my hope that these common misconceptions will change and people will feel less ashamed about going to therapy.  Remember there is nothing wrong with reaching out for help.

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Some Good Reasons to go to Therapy


There are many misconceptions  about what it means to talk to a  psychotherapist. The need to talk about your emotions is sometimes seen as something to poke fun at, weak or shameful. That stigma is often why people often don’t seek help.

However, therapy is  incredibly useful  and  helps with a range of issues, from anxiety to depression to relationships to trauma.   Experts and research show that therapy is very helpful for most people.

 Here are a few reasons why you should give therapy a try:


1. You’re experiencing unexpected mood swings.

If you’re noticing you’ve taken on a more negative mood or thought process ― and it’s persistent ― it might be worth talking to someone. A therapist can help you get to the root of the problem


2. You’re undergoing a big change.

This could be a new career, a new family or moving to a different city. New ventures are challenging and it’s normal to need assistance with getting used to changes in your life.


3. You’re withdrawing from things that used to make you happy.

A loss of motivation often signals that something is up. If you’re normally a social butterfly and you’re suddenly pulling away from your weekly activities,  you could be experiencing something deeper. A therapist can help you to uncover why this might occurring.


4. You’re using a substance to cope with issues in your life.

If you find yourself turning to drugs or alcohol as a way to deal with what’s going on in your life, it might be time to reach out. Addiction and substance abuse are not character flaws.

5. You suspect you might have a serious mental health condition.

Serious mental illness affects almost 10 million Americans in a year. If you’ve been feeling off for a long time, reach out. Psychiatric conditions like bipolar disorder or schizophrenia rarely develop out of nowhere and people display signs for a while.


6. Your relationships feel strained.

Relationships, no matter what kind  are hard work. You’re not expected to have all the answers. If you’re with a partner, therapy can help the two of you explore better ways to communicate and any other issues that have come up.

7. You just feel like you need to talk to someone.

Bottom line: There’s nothing wrong with seeking treatment for any health issue, including mental health.   You go to the dentist for a toothache so you can go to a therapist too for  help with your mental health.

Media and Mental Illness

People with mental disorders are far more likely to be victims of crimes than perpetrators, but that is hardly the impression left by the media.  Television and films often portray people with mental illness as being volatile and violent.
People who commit a violent crime are frequently labeled “psychos,” “maniacs,” or “schizophrenics” by headline writers and newscasters,  this inaccurately links violence and mental illness in the public mind.

Surveys show that over 60  percent of Americans believe that people with schizophrenia are violent toward others, and over 50 percent describe them as unpredictable.
While the media often  blames mental illness  for violent acts, a closer look often reveals that there are many  factors which can cause a person to be violent.  Many studies connecting violence and mental illness are  biased because they come  from populations of prison inmates or from psychiatric patients.   However, these are only a subset of the mentally ill population and not representative of people with mental illness as a whole.

Deinstitutionalization has also been  blamed for  acts of violence that are committed by people with mental illness.    Studies by the American Psychiatric Association have shown that there has  been a very minimal  increase in violence by mentally ill individuals since deinstitutionalization, although they are 12 times more likely than others to be victims of crimes in large cities.

The effect of blaming violence on mental illness  increases  the  stigma against all people with mental illnesses.  That stigma is reinforced by sensationalized reporting or  stereotyping on television and in movies.  Media presentations often reinforces popular misconceptions about mental illness  which will deepen the fear and stigma and will deter people from getting help.

Even when media stereotypes do not focus on a link between violence and mental illness, they still often portray mentally ill people  in condescending and stigmatizing ways. If they are not portrayed as homicidal maniacs, people with mental illness are often  depicted as childlike  or unconventional free spirits.  They are rarely seen as just “regular” people.  Combating these  stigmas isn’t easy however hopefully as we move forward, mental illness will be portrayed in a more balanced way.



You can Pray and Go to Therapy

“Just pray about it.”  Those are words often told to  people struggling with depression, anxiety and other mental health struggles.    While praying can be helpful, many times it’s necessary to talk to a professional.   Unfortunately many religious people do not attend therapy because of the stigma it has in many religions, you’re supposed to turn everything over to God and it will be better however sometimes God sends counselors and therapists to help you.

Churches don’t often name the reality of its members living with experiences of mental illness.  Unfortunately mental health problems are often erroneously intertwined with weakness or lack of willpower.   People are also  often viewed as “weak and crazy”.  Many Christians  are not encouraged to seek counseling, but instead are encouraged to pray harder and have more faith.  This is something which needs to be worked against especially in Black churches.   These views  lead to many Black people  who experience mental distress not getting the  help they need.   Going to therapy doesn’t mean you don’t trust God, it means you’re getting some help to live and feel better.  If you have a physical illness it’s not looked down on if you go to the doctor and it should be  the same with mental illness.    If you’re struggling with mental health difficulties remember while it’s fine to pray, there is nothing wrong with also going to therapy.

When Words Hurt

When we think of domestic  abuse, we often think of someone being physically beaten but verbal abuse happens just as often. Unlike physical abuse, the participants in the relationship may not realize they’re harming each other– they may even find some transgressions to be “normal”.   Emotional abuse can happen between parent and child, romantic partners, among relatives and between friends.

In my  therapy practice, I’ve worked with many people who are being emotionally and verbally abused.  Many don’t realize they’re being abused and are hesitant to call what they’re experiencing abuse.  However as we talk and process the behavior of the other person and how it makes them feel it’s as if a light bulb goes off and they realize that yes it’s abusive and no one should be  treated this way.

If your answer is yes to these questions, you are most likely in an abusive relationship.

Does anyone regularly ridicule, dismiss, disregard your opinions, thoughts and feelings?

Does anyone make fun of you or put you down in front of others?

Does someone treat you as if you’re inferior to them?

Does someone make you feel that they are always right?

Does someone call you names and label you?

Do they blame you for their problems or unhappiness?

If you ever feel that you’re being emotionally or verbally abused, seeing a therapist may be very helpful for you.  Therapy can help you to understand the impact of an emotionally abusive relationship.   It can also help you to learn healthier ways of relating to others and caring for your own needs.  Remember no one deserves to be abused.


Why People Choose Online Therapy

When I think about why clients choose online therapy, the first answer that comes to my mind is about convenience: the comfort of being in your own office or home, no travel necessary, the time saved, and the time of sessions is usually more flexible.  I admit I was skeptical about doing online therapy but when I decided to begin my practice and I read about it, I realized that it is something I wanted to do in addition to seeing clients in a traditional office setting.  I have been providing online video therapy for awhile now and I do enjoy doing it and actually prefer it to working in a traditional office setting.

When I’ve asked clients how they feel about seeing me via video rather than in an office, they’ve stated that they feel comfortable working this way and it’s more convenient for them since they do not have to go to an office.  During a recent snow storm I was able to see 7 clients online, I would not have been able to do this in an office because it would have been very difficult for me or my clients to get to the office.

Another reason some people chose online therapy is that it gives an added layer of confidentiality.  With online therapy, no one else has to know that you’re going to therapy unless you chose to tell them.  I don’t feel as comfortable doing telephone therapy as I prefer to see my clients when we’re speaking however telephone counseling is also an option.

Some clients would not benefit from online therapy and do need to be seen in an office.  Clients who are schizophrenic and actively psychotic would not be good candidates for online therapy.  Also clients who have recent suicidal attempts would benefit from  in office therapy until they are more stable.

I have found the outcomes for my clients to be just as good whether I see them online or in my office and I’m so glad I made the leap and offer online therapy.

African American Women and Mental Health

There’s often a fear of putting our business in the street . . . of somehow revealing too much. Black women often perceive going to a therapist as something we don’t do.

African American women have the highest mortality rate for heart disease and stroke and the highest prevalence of high blood pressure and obesity. Recent research indicates that mental health plays a role in these health disparities. While many black women know and discuss the threats to their physical health, when it comes to mental health, there’s often silence and inaction.
Many black women are struggling with mental health issues but are not seeking professional help. Improving black women’s access to mental health treatment as a crucial element to addressing the serious, but often manageable, illnesses plaguing their physical health.

Women Who Need Care Go Without
Despite the emotional and physical consequences of mental-health problems, black women are less likely to seek treatment. The percentage of African Americans overall who receive needed mental-health care is only half that of whites, according to a Surgeon General report on mental health. By some estimates, only 7 percent of black women suffering from depression receive any treatment, compared with 20 percent of the general population.
The California Black Women’s Health Project, released the results of a study of more than 1,300 African American women across the state. The subjects in the study revealed that they tended to repress feelings, let frustration build and release tension through tears or conflict. The findings of the study, which included a series of focus group discussions across the state, led to a launch of a mental health initiative to improve African American women’s acceptance of and access to mental health treatment.

It’s important for African American women to realize that self care is not selfish and you must take care of you so you can take care of others. It is also important to recognize something is wrong and you deserve to feel well.

Many Black women have a distrust and place a stigma that black women on mental-health treatment, in part from their difficulty in finding a therapist to whom they can readily relate. African Americans comprise less than 6 percent of mental-health care providers nationally. Overcoming this shortage may be crucial to improving treatment outcomes for African American women. In my work in the mental health field, I have found from interviews with clients that mental-health practitioners “don’t get it when they are working with people who don’t look like them.”

African American women also struggle against the stigma associated with mental-health treatment.
One study found that the proportion of African Americans who feared mental-health treatment was more than twice that of whites, according to the surgeon general’s report. Part of the fear stems from wariness of the medical establishment that arises from past abuses, such as the Tuskegee experiment. (In 1932, the federal government sponsored a study to examine the impact of untreated syphilis involving black men. The experiment went on until 1972 without the test subjects’ knowledge and most of the subjects died without receiving treatment.) As a result of the distrust engendered by the now-infamous experiment and the stigma associated with seeking help, many black women rely on spiritual leaders and community members to handle personal problems. There’s also an added pressure from the ethic of the strong black woman, a cultural value that promotes toughness and self-sacrifice. They often think ‘My mother suffered. My grandmother suffered. It’s just the lot of black women in America. It doesn’t have to be that way.
There’s a deep-seated feeling that going to seek professional help is a sign of weakness. These ideas and feelings must change in order for all women to function at their best ability.