Men’s Mental Health

Elisa A. Escalante/ LCSW/ 6-7-2025

“A man will kill himself before he will ever speak his pain.” -EaE

All I can write about is my perspective as an outside observer to a group of people that exist; my male peers, my male family members, my male clients, and men I’ve dated. First off, there are two major things I’ve always felt sorry for men about. 1- The extreme amount of pressure they are given by society to be providers. (I was a provider for my last two exes including helping one of them with their children, so I know the feeling first hand. The crushing weight/ pressure to perform because people in a household rely on you. But rest assured, for a woman, that’s not the expectation) 2- The other social conditioning; that they are not allowed to cry in front of people. I myself am I cry baby and I couldn’t imagine having to force those tears down my entire life, no thanks. I started working in an Air Force mental health clinic by the time I was nineteen years old. Plenty of male clients. By the time I finished the military and completed social work school in NYC, I found myself working at the Brooklyn Vet center for the next 3.5 years. Vet centers have a strict eligibility; combat veterans and/ or veterans that have suffered from military sexual trauma. As a therapist, this means the highest possible PTSD caseload imaginable. It also means per caseload, the highest number of combat veterans to talk to compared to any other therapist in any other setting.

The Vet center transformed me as a clinician. For one, I was lucky enough to have a great first clinical supervisor who taught me more about how easily Veterans (especially male) hide their symptoms, even from themselves. Plenty of veterans went on to become law enforcement, corrections, fire fighters and other high adrenaline/ high stress jobs. In NYC, there was also the added factor of many of my veteran clients having either witnessed and/ or responded to the 911 attacks. Some therapists might call themselves ‘Trauma informed”, but I became trauma ‘oversaturated’. The first thing that helped bridge the gap is the veterans learned very quickly that I deployed too. But there was the added factor that I did not try to pretend I understood their experience. Truth be told, because I deployed to Afghanistan it just gave me more awareness. I was in a combat zone, but I am not a combat veteran. I was never on the front lines. I can’t pretend to understand, and I won’t try to pretend I understand.

The hardest part when therapists speak with men in general, the walls are already up from day one. It felt like this imaginary brick wall that they put up. Maybe they decided that the only way I would get any information from them is by tearing the wall down, brick by brick. Very slowly, and painfully. I was up for the task of course, in the military they were very guarded because they were literally not allowed to ‘be mentally ill’, it could ‘ruin their careers’.

“Do Not ask me to talk about my combat stuff! I will not come back if you do!“

“Do not make me do that prolonged exposure therapy, that shit doesn’t work!!”

“I will NEVER do cognitive behavioral therapy again! The VA kept making me do that crap and it was bullshit!”

Because plenty of veterans told me things like this from their initial mental health apt, I realized very quickly that I would need to take a different approach. What many therapists would consider a ‘backwards approach’. I would have to help these guys deal with and manage their symptoms first, and eventually if trust is built, we could link the symptoms back to their root causes; military and/ or childhood trauma. I developed the ability to help people with PTSD without requiring that they share their stories with me in detail. Because a lot of conventional ‘evidenced based’ treatment modalities are too harsh and too rushed. (The modalities that the VA are required to use)

My forbidden phrases:

“Tell me how you feel about that…..”

Consider that men already weren’t allowed to talk about feelings even from a young age. They were highly stigmatized and that question scares them, but the mask they wear might be anger. Especially if you ask them a silly question like that. My approach became to identify their emotion for them and to say it out loud, judgement free. A lot of my male clients appreciated this because I took away the burden. They didn’t have to think about how they felt and then feel added pressure to vocalize it out loud. Me: “Sound’s like you feel jealous”. Or, “Sound’s like a moral injury.” Them: “Oh shit yeah maybe you’re right….” (now moving on…..)

“Speak to your inner child”

I recognize that this is a more common line that comes up now a days in conventional therapy, but there is no way I would ever say this out loud to a male client. There is definitely a way to help people address stuck points, root causes with their trauma and their survival programming without having to converse with this ‘inner child’. Again, men are not necessarily comfortable with anything that feels too ‘touchy feely’. Try not to sound sensitive and try not to sound like you feel bad for them.

“I understand….”

You do not understand. You can’t. It’s okay too. Let’s not pretend to. Empathy means the ability to look at someone’s struggle and recognize that it does look/ and sound difficult. You can have empathy without understanding. If you pretend you understand but he knows that you have not ‘been in his shoes’, he might resent this statement. This goes for all clients, I won’t say I understand. (Even in some cases when I do, I still won’t go there)

Specific Questions:

Without specific questions, you might just miss out on some very relevant information. Questions like: “Have you experienced trauma?” are too broad. From the male clients lens, he may not even recognize that what he went through was ‘traumatic’. I avoided that question and instead asked questions like “What was the hardest part of your military career?” “What was the worse thing you experienced on your deployment?” “What did you like or dislike about your job in the military?” “What was the scariest thing for you?” Most of these questions require answers and do not necessarily require heavy emotional talk. We can be logical about it and just talk about the fact that some things were super stressful and hard.

Talking about Emotions from a purpose perspective

Society decides that there are ‘good emotions’ and ‘bad emotions’. For men, their list of ‘bad emotions’ is even higher versus what women are ‘allowed to feel’. But society cannot change the fact that all humans have a wide variety of emotions. Unfortunately, men are commonly taught to never process, discuss or acknowledge those ‘bad emotions’ and to essentially pretend they do not exist. I am to this day, still impressed by the amount of BS a man will put up with before he explodes and his entire life starts to fall apart. It’s a little scary and we as a society need to do better. So when I speak with male clients, I talk about emotions from a purpose perspective. This is what the emotion is for, this is the message it give’s us, and after interpreting the message, this is maybe what we ought to do about it. My male clients are often both confused and intrigued. As no one has taught them that yes, every emotion does have a purpose. And we can even engage our logical brain to decipher the message.

Sadness: Endorphin hunt, seek joy, seek adventure, do something new, seek social connection, get sunlight, move your body.

Anxiety: Analyze the threat around you, problem solve what you are concerned about, and/ or take precautions. And in some cases, use escapism activities

Anger: Fight the threat, protect yourself, justice seek, or walk away from threat.

Jealousy: Explore what you fear, explore what you are missing out on, or explore what you want/ need more of.

Guilt: Learn from the mistake, correct your actions and try to do less harm next time, have humility, have more integrity, or honor both yourself and others

Numb: Ground yourself to the present environment, use an external stimulus, seek adrenaline (safely of course)

Mental May

Elisa A. Escalante/ LCSW/ 05-15-2025

Every year I promise myself that I will take the month of May more seriously. As it is mental health awareness month. But life get’s the best of me. I was racking my brain on how I could possibly write a blog about mental health for May, as it is such a broad topic and a blog is so short. But it dawned on me. People should be aware of why people actually go get mental health treatment in the first place. I still read many opinions/ impressions/ judgements online about therapy, and why it is or is not ‘useful’. Many people still do not understand how beneficial mental health treatment is. So I want to provide some brief summaries on the many different reasons human beings might seek mental health counseling and why it could be beneficial in the long run.

Mental health conditions: a- Psychosis; Some people meet the criteria for a psychotic d/o which would include hallucinations: seeing/ hearing/ feeling things that are not actively present. Also present would be delusions; known as fixed ‘false beliefs’ that cannot be proven and are not a part of anyone else’s ‘reality’. (Schizophrenia would be a prime example, and this diagnosis has multiple sub categories and can show up differently in people) Sometimes psychosis requires inpatient hospitalizations and medications. Some people can manage psychosis with medications and outpatient therapy alone. b-non psychotic; The reason I want to differentiate, is because the old school mentality is that ‘mental health is for crazy people’. When people say the term ‘crazy’, they may be referring to psychosis. There’s also many people that get mental health treatment for non psychotic disorders. Sometimes these mental illnesses are debilitating. Sometimes people can be high functioning with them, depending on the severity and circumstances. This includes depression, anxiety/ panic disorders, OCD, Neuro developmental disorders (such as ADHD), PTSD (and/ or personality and attachment disorders which are known as sub disorders due to complex childhood related PTSD), sexual disorders, dissociative disorders (Dissociative identity disorder, formerly known as Multiple personality disorder, would be included in this realm), or mood disorders (such as Bipolar d/o; depressive and manic features).

Relationship stress– Marital, family, coworker, and friendship stressors are a significant portion of outpatient therapy. This comes up almost every single day I am at work. As certain as we are that there will be oxygen to breathe each day, there will also be a person in our lives that has the potential to stress us out, or even traumatize us! This includes relationships that are plagued with trauma bonds, codependency, lack of compatibility, abusive people, passive aggressive or aggressive work relationships, rushed marriages, complex family dynamics, blended families, parental stressors, infidelity & betrayal trauma, families plagued with mental health concerns, substance abuse disorders and/ or multi generational traumas.

Work stress (burnout)- Humans are plagued with heavy pressure to work, provide, consume, reproduce and to continue this cycle. We are pushed to generate things like money, wealth, progress, projects and more. Some people align work with their entire life purpose and identity. Many will admit work can be escapism from an ill mind. (The illness is then translated into the behaviors). Long work hours and/ or heavy emotional, mental or physical labor will erode the mind and body. But people may keep working well past burnout; especially if their livelihood depends on it.

Financial stressors– Despite the hard work being generated and money being made, our bills and debts will keep us in a cycle. Working hard and paying hard is what society has demanded we do. I never ask my patients about specific numbers but I do encourage them to open up about their money related stress if it is on their mind and exacerbating their mental health symptoms and relationships; it often does. And, not everyone get’s relief. Not everyone has generational wealth. Some people were not taught anything about money besides how to spend it fast. Some people do not make enough to sustain themselves. Some people make ‘just enough’ to barely survive, but may not qualify for social welfare resources. It’s brutal out here.

Grief- Loss is an inevitable part of life. “It’s normal”, and yet so excruciatingly painful. It is not talked about enough. Society is not patient enough for those that are grieving. We may also grieve a multitude of things such as: job loss, loss due to death of family members, friends, pets or lovers, loss of people due to break ups or moving, loss of abilities due to illness or natural aging, loss of purpose, loss of identity and more. I would dare say that there are not enough bereavement days for the grievances that we as humans must endure.

Caregiver burnout- There is also the brutally slow and painful type of loss. Such as caregiving for a loved one as they are painfully dying. This can be weeks, months or years. Caregiver burnout/ depression/ grief is significant and complex. The people that take on these roles I would describe as ‘guardian angels’ that walk the Earth. It’s one of the hardest things someone can do and yet there are people that step up and do it. Out of love and out of fear. The people who have fallen ill will suffer, their caregivers suffer just as much, sometimes even more. They often forget about their own self care as they learn to balance their new life. Many work, balance finances, caregiving and may not have time for much else. They may also be met with a lot of resistance from their loved one; someone who is grieving as they are now limited in physical/ mental capacity. They may be lashing out due to the shame of requiring help and feeling like a burden to others.

Medical conditions that exacerbate mental health– Because I am now a behavioral health consultant for a Primary care clinic, I now have the added responsibility of being well versed in various different medical conditions and how they impact people’s mental health on a daily basis. I have learned a lot more about chronic medical and pain conditions such as: autoimmune disorders, diabetes, chronic musculoskeletal injuries, nerve pain, seizure disorders, heart/ lung/ liver conditions, sleep disorders (both components of medical and mental health s/x perpetuate sleep problems), gastrointestinal conditions etc. It’s important to see people through a holistic lens; we are our biology, our psychology and our social environments. And yes, every medical and pain condition can/ and often will exacerbate mental health symptoms.

Post partum states– Pregnancy, labor, delivery and/ or C sections. Then the post partum state itself; hormonal factors combined with busy parenting demands, recovery pain, fatigue, & flair ups of depression, anxiety, anger and sometimes acute traumas. Social environments can make or break this process as well; does the new Mom have a supportive spouse and family around her, or a toxic non helpful one? In primary care I receive many post partum referrals. The last three years have been a learning experience for me as I have never been pregnant, and I am childfree. This is a very fragile and vulnerable process and it is met with so much strength and resiliency. I am very impressed and horrified all at the same time. Mom’s are incredible beings and they deserve post partum care. There is so much that can go right or ‘wrong’ every step of the way.

Addictions and eating disorders– Addictions, obsessions, compulsions, regret, shame and physical/ mental health consequences. Humans are susceptible to addictions and eating disorders due to biopsychosocial factors as well. These are disorders that are heavily shamed, judged and misunderstood. Since they are also secondary conditions that have various underlying mental disorders and social environment triggers, they must be handled with care. Also known as a dual diagnosis; a mental health condition combined with a substance abuse disorder. People deserve praise for showing up to get treated for these conditions, as they are severely judged in the public eye. Due to this the addictive or compulsive behaviors are often done in secrecy. It’s important to note that they are also the deadliest mental conditions known to humanity; opioid overdoses and eating disorders lead to the highest death rates amongst mental health patients.

Transitional/ adjustment stressors– People grow through life. People change and go through changes. We deal with different stages of development in our upbringing, we go through puberty, we move, we switch jobs, we end relationships and form new ones. We create families, we blend families. We as individuals might change; identity, purpose, ideas, preferences, needs, personality traits and more. We will experience stress and growing pains throughout life even if we do not suffer from a mental health disorder. The human experience involves suffering. Change can be uncomfortable. In my line of work, I’ve also helped people navigate very rare transitions such as coming home from war zones, getting out of the military, marrying into the military, being far from family all of the time because of the military. People learning very rare jobs that most people do not understand… in the military. Spouse’s that have the challenge of more single parenting responsibilities, because of the military missions.

Therapist responsibilities: Mental health clinicians are responsible for performing psychosocial assessments on clients. We assess, we diagnose, and we build treatment plans that are tailored to the patients needs and mental health conditions. The treatment plans are often required to be ‘evidenced based’. Meaning there was already a board approved research study conducted that had proven that the interventions do provide at least some short term relief on mental health patients. We also need to be flexible, adaptable and roll with resistance. Patients might change their minds. Or their life circumstances could change in an instant. No where in this process do we use our opinions and judgements. Nor do we vomit out the mouth with poor advice. (Ideally) Rarely do we ever talk about ourselves (unless it is helpful & relevant to the patients needs/ situation) Our education, our ethics, and our empathy must combine to create a beautiful blend of therapy. There is nothing else like this experience for the patient. There is no other profession like this profession. Friends, family, life coaches and online influencers may try to emulate it. They cannot. Mental health therapy is an art and a science.

Staying in the Lanes

5-1-2025

Interviewer: Elisa A. Escalante LCSW/ published author

Interviewee: Kody R. Escalante @Lanewhisperer/ Two sanctioned 300’s & Sanctioned 299 Bowler (And also my little brother!)

Q- I distinctly remember the time I knew that your bowling skills were above average. I was sixteen years old, and you were 8, and you beat me in several games that night. I’m curious about what you remember about bowling at the age of 8 and through childhood? What drew you into bowling and how were you able to maintain the passion?

A- As you know Dad would take me every other weekend when I would come visit the family. It was my favorite family hobby and good bonding time with Dad. Maintaining passion wasn’t too hard due to how fun bowling is. The other major factor is the amazing support from the people around me. The bowling community is everything.

Q- How did you fine tune your technique, and were there people that tried to steer you away from the technique you wanted? Especially since you are still a young bowler.

A- I remember a few people suggested I put my thumb in the thumb hole growing up. But, my instincts told me not to. I was already used to it and from a visual standpoint, I always enjoyed watching the bowling ball spin. Figuring out my exact hand placement would come later.

Q- When I watch your competitions, I find it interesting how although all the bowlers are competing against each other, you guys/ ladies are so kind to each other through the tournament. Does it feel like a competition? Any temptation to diss your competitors?

A- (Laughs…) No, your own worst enemy is going to be you. There is no defense in bowling. The objective is to get your strikes and pick up your spares. Or even when you shoot many strikes; you shoot for better strikes, and learn to get better at sport patterns. The strategy is to make the least amount of mistakes possible.

Q- I recall you had a long dry period (Ages 18-24 y/o) where you stopped bowling for a while. But then when you picked back up, you went at it with a vengeance. Was this a break you needed and did intentionally? Was it circumstantial to life stress or any mental health stuck points?

A- In that period I was going to college and focused on working. I still knew I had the talent, but my priority was saving up money for my first car. I had a lot of other expenses that came up right after high school. Bowling fee’s, even just to practice or have fun, they add up. For example, to prep for a tournament would require I practice at least four times a week, and I must pay to play.

Q- And how did you go from hobbyist to competitive bowler?

A- One of the managers at my go to spot, Canyon Lanes at Morongo, suggested I join a league. It was enjoyable and we started traveling and practicing frequently. Our league saw the advertisements and flyers everywhere. My very first tournament was in Morongo in the Fall of 2022. The experience was humbling; many people were far better. My thought was “wow, I have some work to do”; and it drove me to want to learn more. I met pro bowlers at the tournaments that also gave me very helpful pointers.

Q- What type of mental and physical preparation goes into getting ready for a bowling tournament?

A- I try to stay calm and not get angry at myself. I have to shake off the feelings and not hyper focus on the scoreboard because that leads to overthinking. The physical is about the equipment. I like to prep the surface of the bowling balls. I must also take into account which type of bowling ball I am using while simultaneously paying close attention to the lane conditions.

Q- Walk me through how it felt for: Your first 300 game and your 2nd 300 game as well as your 299 honor game. (Kody earned two 300 rings in the years of: Nov, 2022/ Sept, 2024. And just last month (April 2025) Kody bowled a 299, which is considered an honor score. This will be rewarded with a plaque)

A- For the first sanctioned 300, I had only one ball for everything. It felt like muscle repetition. I did the same thing over and over again. The biggest challenge is consistency. By the tenth frame I was shaking. By the second 300, though it was nerve racking, I already had it in mind that I had done this before and I can do it again. I had more confidence by then. Follow up: And the 299? What was the feeling the moment you got 9 pins vs ten in that final strike attempt in the final frame?? (pause) It was disappointing, only because I felt like I threw a pretty good shot on my last strike attempt. Dad was there, and he witnessed it. He said he brought me ‘Good luck.’ (Laughs)

Q- I can’t help but notice that even when you bowl a strike, you look disappointed in yourself. You mention that there is a ‘better way to bowl a strike’ and perhaps something about the technique? Are you too hard on yourself? Or is it all a part of getting better?

A- It’s definitely a process. Even though I say that I throw a bad shot, it’s really about the placement of where my ball is set on the lane. Sometimes I know that I did not throw the best shot but I know deep down that the lane was forgiving and helped me get that specific strike despite me feeling ‘off’.

Q- How do you manage anxiety when you are competing? And because I have wondered this for a while, are you more nervous when me and/ or Dad are watching you??

A- I don’t really feel the nerves when others are watching. I do my best to have fun. If I am doing bad, I will cheer others on. The only time it feels nerve racking is in a PBA (Professional bowlers association) style event where there is an audience in the stands; ‘EVERYONE’ is watching to include strangers. There’s also a lot more rules during PBA events, and it get’s quieter in the alley so we can concentrate.

Q- And how about your first Nationals tournament in Louisiana?? (March 31st-April 1st of 2025)

A- That was also another humbling experience. They laid out the hardest oil patterns I had ever experienced. They don’t give away the patterns until the very end of the competition season, and it becomes more eye opening on what adjustments ‘should have been made’ had we known. Everyone is bowling ‘shots in the dark’ essentially. We did get to practice and have a feel of the lane, but sometimes it takes a whole game or two to figure out the oil pattern. (Kody is referring to the oil that is laid out on the bowling lanes. The oil serves as a protection layer for lane wood. But, oil may be laid out in different patterns so that bowlers have the added challenge of finding the right technique to bowl a strike in said unique oil pattern.)

Q- As of now, what are you working on/ fine tuning in order to improve your overall game? You have been an amateur bowler for 3.5 years, do you have professional bowling in your sights down the road?

A- I am trying to diversify my shots. What I mean by that is I have a certain sport pattern. A house shot is the easiest pattern and it is very forgiving. But a sport shot requires more precision; this has a lot to do with the oil patterns we discussed before. In tournaments, there are no handicaps and only raw scores; the stakes are higher. I’m playing around with different types of balls and discovering what they do at different angles. As far as professional bowling, I intend to go that route. What I have researched so far is that I must hold an average of 200 or higher for my past 30 amateur games. Follow up from me: “Easy work for you!!!!!!”

But Why?

Elisa A. Escalante/ LCSW/ 4-20-2025

Our mind will go to places that defy the laws of radical acceptance, & life itself. The reason that I ‘why’ my patients, and sometimes my friends to death, is because the mind is reaching for every answer to every possible scenario. Or the mind is fixated on sticking with the rules that the mind believes are ‘cemented in stone’. The mind may not stop until it get’s to the conclusion it needs, or when it wills the body to do the action it needs. This is especially common with anxiety, OCD & PTSD patients. I conclude almost every radical acceptance intervention with the question of: “Why do you want to predict the future?” The answers include: “I want to be able to plan and be prepared…” or “If I know for sure what will happen, then I will not be nervous about it or confused”. These answers indicate an underlying avoidance of helplessness, suspense or confusion. The opposite of helplessness is control. Attempts to control what can’t be controlled perpetuates… more helplessness. The ultimate goal would be to surrender.

Patient A: Pt- I have to have a training partner when I go to the gym… I can’t go alone because I have panic attacks. Me- Why? Pt- Because when I’m alone I am more afraid of people at the gym staring at me and judging me… Me- Mind reading? Why do you believe they are for sure staring at you and judging you? Pt- I was made fun of a lot growing up, I was bullied for being overweight. Me- Let’s paint your worst case scenario then. You are at the gym, one of the women is giving you judgmental looks. Pt- (Face clearly in distress already) Even worse if it’s a woman… omg! If she tells me I have an ugly outfit, and I’m out of shape and I’m not doing the workout correctly!” Me- Okay so this fit lady comes up to you, she tells you “You are fat, your outfit sucks, and you are not doing the workout correctly. Then what?? Pt- I would either punch her in the throat and run away. Or cry and run away. Me- Are you thinking about consequences? And are you thinking about what it means about her to say such a cruel thing to you? Pt- Yea I would not actually punch her I don’t want to get in trouble. I’ll cry and run and be mortified. But… if she does judge me then yeah, maybe she’s…. Me- Judgmental? Envious? Projecting some type of envy back onto you? Maybe even jealous and trying to put you down….? And… would you hide again? Pt- I might… Me- So in order to avoid judgment all together you decided you would hide away? (Agoraphobia) Pt- Yes.

I wrote out Pt A’s survival program: “I am terrified of continued judgement therefore I will hide away”. Pt agreed that she believes in this sentence entirely. (A survival program is often created by our mind in childhood to protect us from physical or mental danger and when it is reinforced it will become the control center for our thoughts, emotions and behaviors) I wrote out a Pro/ con list for pt to identify ways in which her survival program helps her and harms her. Pros: I was less judged overall because I hid in my home with my pets/ I bonded a lot with my pets and they received a lot of attention Cons: I don’t take many risks due to my social anxiety/ I am more sedentary & getting less sunlight; bad for health/ I have so many regrets due to not going after my goals; shame & poor self esteem.

Patient B: Pt- I am failing science class. Me- Why have you been failing? Any idea what can be done so that you can pass? Pt- I am just really confused and not sure what to do. Me- Have you been asking the teacher questions or inquiring about make up work you can do to catch up? Pt- No, I am afraid to… Me- Why? Pt- I worry that the teacher or other kid’s will think I am stupid… Me- What’s a teachers job as a teacher? Pt-…. to teach…. Me- And what is your job as a student? Pt- to learn…. Me- And to paint your worst case scenario… what if a student happens to come up to you and tell you “Hey I can’t believe you asked questions, you are stupid!” What would you do?? Pt- (Laughs out loud) I guess I would just say something back to them or maybe ignore them. Me- Is this common for you to not speak up or ask questions due to a fear of being criticized? Pt- Yes…

I wrote out pt B’s survival program: “I must not speak up or ask questions, or I will be criticized.” I also inquired about the root cause of this survival programming. Pt identified being judged a lot for asking questions from both parents and teachers throughout her childhood. Pt was also agreeable to a pro and con list regarding her survival program. Pros: When I am quiet no one even looks in my direction/ I was less critiqued overall Cons: I rarely asked questions and I remain confused/ I did not learn to express myself or self advocate/ I am failing a class and sabotaging my progress out of fear/ I am future predicting & overthinking.

Patient C: Pt- I have been having more arguments with my husband. Me- Why? Pt- They never do chores unless I ask, and if they do chores, they do them wrong. Me- Any specific examples you can give me? Pt- Well for example if he does the dishes, maybe he only does half of them. Or he does not clean them thoroughly. I also hate how he loads up the dishwasher. Me- Why does the dishwasher have to be loaded a specific way? Pt- It just makes sense to, I was raised to do it that way and I have to do it that way. Me- Why? Pt- Well because if it isn’t done the way I am used to doing it, it will drive me crazy. Me- Why? Pt- (Pauses to really think about this answer) I just can’t relax unless the chores are done immediately and correctly. If they pile up, I cannot relax. Me- How long has this been an issue for you? Pt- As long as I can remember, I had strict parents and they had high standards on cleaning. It’s how I learned to be. Me- What happened if you did not clean to their standards? Pt- I would get in a lot of trouble, spanked, yelled at and grounded.

I wrote out Pt C’s survival program: “I must clean immediately and perfectly, or else I will be severely punished” The patient also acknowledges that not only does this impact her life, but she has projected the same expectations onto her spouse. Because, well, she lives with him and his messy behaviors impact her mental health too. Pros: I have great work ethic/ I get compliments on how beautiful my home looks when guests come over/ I temporarily relieve my anxiety after I clean up. Cons: I burnout and experience a lot of fatigue/ When I try to relax I feel tense and anxious instead/ Me and my spouse have ongoing arguments because he cannot live up to my standards of cleanliness/ I am a perfectionist which leads to shame if I can’t be perfect.

After patients walk through their deep seated fears, explore their survival programs and make their pro/ con lists, I tend to have follow up questions. “Is this an outdated survival program? Does this survival program now harm you more than it helps you? Can you abandon it or modify it? Is it hard to let go of? Can you recognize that it was built out of fear due to toxic environments?”

Conclusion: An effective therapist does not tell a patient what to do. They will ask why? And why? And why again. We use the curiosity approach to ask the right questions. There are many stuck points that people remain in because they rarely have the opportunity to sit down and unpack their thoughts/ emotions/ behaviors. How many times have they been told the right answer but they do not have the tools to execute what they need to do? Or, their brain paralyzes them to a point they feel incapable of doing what they truly want? Therapist or not, before giving someone an answer or a solution, ask why first. Ask them why it’s hard. Then you will find out that it’s not a matter of them being physically incapable, it’s a matter of them being mentally frozen.

After Ever After

Elisa A. Escalante/ LCSW/ 04-01-2025

“Love is the chemical reaction. The relationship is the construct/ contract that’s meant to trap it. Will the relationship nurture the love or kill it? Only time will tell.” -EaE

The Prince and Princess get married and turn into the King and Queen. The ceremony, interactions, and celebration feels/ looks perfect. Everyone is happy for them, they are elated. They ride off into the sunset into the perfect Honeymoon. Somewhere warm and beautiful where they will take the most amazing pictures to show off to their friends/ family. It’s the perfect precursor to a happily ever after story. But, what really happens after the “Ever After”? Why is that part never shown in the Disney movies or Romcoms? Reality destroys the illusion of fantasy. Raising kid’s in reality might destroy their ability to hope for the best case scenario in their life. Best case scenario (presumably) being that they will grow up healthy, get a good job, make good income, get married, have a family, and be happy most days. Most people will be conditioned to hope/ strive for this, but very few will be able to pull it off successfully.

After Ever After looks like:

  • Living with the same person every single day. This person won’t likely be a prince/ princess/ King or Queen, they will be a regular human that could be prone to bad moods and health problems. They will have human limitations and require rest, recovery, time off to decompress; sometimes in solitude.
  • Ongoing attempts to split chores throughout stressful work weeks. Who’s cooking? Who’s cleaning? Who’s running errands? Who’s shopping for new items? Sometimes this will turn into a competition for relaxation time. Chances are; both people are tired/ stressed and need time off. This may also involve bias; socially conditioned gender ‘norms’. Some people enter their relationships under the impression that the ‘man will provide’ and the ‘woman will naturally do all of the cleaning/ cooking’. Chances are; one person has higher cleanliness standards than the other partner. This leads to a dynamic where one partner becomes the ‘nag’ and the other partner becomes the one that is pestered.
  • A gradual decrease in dopamine levels over time as the novelty/ ‘honeymoon phase’ wears off. This often coincides with getting into a sustainable and sometimes monotonous/ boring routine. After dopamine depletes, it is common for people to go into dopamine withdrawal, and they may seek it out elsewhere.
  • A need to compromise/ collaborate. Everyone is now living by two sets of rules; their own rules as well as their partners rules for them. The arguments that do not get resolved might turn into perpetual arguing overtime; leading to resentment. And, just because they stop arguing about it, does not mean they resolved the issue. They may have just given up/ withdrawn/ or numbed it out because arguing get’s exhausting.
  • Sometimes the decision to have a family; many more things to agree on and/ or fight about. Splitting up daily parental responsibilities. Decisions on parenting styles and how the kid’s will be raised; socialized & educated. More daily exhaustion/ sleep deprivation which will impact mood. As kid’s get older, there is a chance that they might ‘triangulate their parents’ by playing favorites or lying to them to create a scenario that is in their (the kid’s) favor. Another common thing that parents argue about in therapy.
  • Settling. The common term of ‘settle down’ literally has the word ‘settle’ in it. In a traditional heterosexual monogamous relationship; he is settling for her, and she is settling for him. This means that most needs must get met solely by the partner, with very limited ability to outsource. In therapy, the common theme is people venting about how their partner does not fulfill “X,Y,Z’ for them, and the question of ‘how can they get their partner to change’. Which often times cannot happen; as it would be a violation of consent and/ or coercion at a minimum! The cardinal rule still applies: We cannot change people.
  • The possibility of infidelity. Quantitative data already shows us that cheating is a lot more common than people want to admit. Also, it is likely under reported as it is done in secrecy and shame. The cheater lives a lie, which can perpetuate anxiety and shame. The victim of cheating is also living a lie, and will likely suffer from betrayal trauma when/ if they find out. No one wins.
  • The possibility of perpetual disappointment. Remember that as children, most of us are fed a fantasy full of unrealistic expectations. Chances are, no one can live up to these expectations every single day, 24/7, until death. Overinflated expectations lead to high hopes. High hopes lead to higher frustration/ shock when things do not work out the way we thought they would.
  • Shifts in Power/ control dynamics. It’s not uncommon that people in relationships will assign rules to one another. However, we cannot control other humans. There is always a chance that those rules get violated. When rules are violated, many people are tempted to tighten the reigns on their partner; practicing more control. There’s the assumption that control prevents betrayal and discomfort. It’s merely a band aid. Some people have an inner rebel; which would lead them to do the very thing you are trying to prevent. Alternatively, if you do successfully control someone; that’s abuse. Then, the relationship is no longer a loving relationship of free will. Rather, it’s an abusive relationship; abuser & hostage.
  • Disagreements on money. It’s not a glamorous topic and some couples pretend that they are ‘above fighting over money’. Or ‘money isn’t as important as love’. But, because money provides stability, and a lack of money perpetuates stress/ instability; plenty of couples will argue about finances. Chances are; someone has looser spending habits. Someone might be more frugal. This can become an ongoing compatibility issue that erodes a happy marriage.
  • The possibility of living “Miserably ever After”. It’s easy to tell people: “Just get a divorce”. But some people put the value of ‘married until death do we part, for better or worse’ very seriously. This can also be rooted in cultural, religious and family values. Some people will choose vows over their personal happiness. I have seen this come up many times in sessions. Some couples decide to transition into platonic room mates, but sleeping separately and living separate lives. Some couples lie by omission, and put on an act anytime they are around each other; not living genuinely as themselves anymore. Worst case scenario is domestic violence, even sometimes, murder.

Conclusion: I will not tell someone that ‘they will find the one, and live happily ever after’; because this is not probable. It’s actually quite rare. I won’t tell someone to ‘choose their partner wisely’. Why? Another important cardinal rule: we cannot predict the future. You can attempt to ‘choose wisely’, but you cannot guarantee that person you married won’t change… next month, next year, or after a decade or more of marriage. You also cannot guarantee that you won’t change. We cannot force feelings to remain, as they are fleeting; and yes this includes loving feelings. There is an ever growing divorce rate accompanied by the ability to catch people in lies due to social media; higher odds of shattering our illusions/ delusions. If you do decide to marry, may the odds be ever in your favor. But, it’s probably just as difficult as winning the lottery.

Toxic Influencers

Elisa A. Escalante/ LCSW/ 03-10-2025

You scroll through social media and within several hours, you may have already received contradicting research, information and/ or advice from influencers. Influencers could include healthcare professionals, life coaches, fitness fanatics, celebrities and so on. I know that there are different definitions of the term. I see an ‘influencer’ as someone that can shape/ persuade people to see things ‘in a specific way’ or shape our ‘worldview’ so to speak. And, the more famous someone becomes, the more power they have. Followers turns to views/ attention, which turns into impressions/ insights. It can be harmful if the ‘wrong person’ speaks about the ‘wrong thing’. If an inexperienced person tries to speak on something they are not educated on while their followers listen. A large number of people taking bad advice can be dangerous; we have seen this time and time again.

On Dating– There is an abundance of love coaches, dating ‘experts’, marriage counselors, match makers, love language and attachment theory enthusiasts all over social media giving what they believe to be ‘the right recipe for love and relationships’. I myself have chosen to become ‘TheBreakupTherapist’ on TikTok. This isn’t to push everyone to break up. My niche is about helping people with break up recovery grief/ trauma; with psychoeducation, humor, and/ or creative writing. Why? Break ups are inevitable. They are actually a lot more common than a ‘happily ever after’. Some of the new influencers will try to insist that in order to solidify a forever relationship, people should try x, y and z. And sadly, there are people that are vulnerable enough to believe what is out there. Some are pushing women to hunt for rich men, some are pushing for women to avoid men all together. Some are pushing for men to go for subservient women; maids, or sex servants. Some discourage 50/50 and insist that it can never work while pushing for traditional gender roles. While other influencers demonize traditional roles, and insist that everyone become hyper independent. If a dating influencer has a lot of ‘black and white’/ ‘all or nothing’ rhetoric that polarizes their audience, I would say… red flag! If the influencer is simply pushing a lifstyle that ‘worked for them’ and appears to be under the impression that it can work for everyone, also a red flag. Pushing people to follow a specific love/ dating recipe would be like me as a therapist pushing all of my patients through the exact same intervention. We are all all unique!

On Mental health– I entered the mental health field in 2008 at the young age of 19 y/o. I worked in a military mental health clinic as one of the techs, and the stigma was quite strong. It was not easy convincing people to go to mental health back then. In the past 17 years, I have seen a massive shift; especially since 2020. Just like that, my profession went from being stigmatized and avoided to becoming popular and encouraged. We (therapists) even started getting paid our worth… kind of. Mental health discussion is everywhere now. All over social media there are therapists making content, life coaches, regular people that suffer from mental illness openly discussing their personal experiences. Diagnostics and symptoms are more well known; but sometimes over diagnosed. That being said, many people are out there giving mental health advice and diagnosing themselves and each other on the internet. Clinicians are taught to never try to diagnose anyone outside of professional treatment, the rest of the world does not follow these ethics. Wrongful diagnosing is harmful. Giving someone poor advice for their ‘wrong diagnosis’ is also harmful. Spiraling into a google black hole of mental health research could perpetuate depression and anxiety. Even though mental health has been the career I have devoted myself to, I recognize the importance of stepping away from it and having doses of reality; being in the moment. It’s also important to note that mental illness is not actually ‘unique’, but quite common. Some people believe that there is a ‘divide’ that exists between the helping professionals and their clients. Therapists may have a reputation of being a ‘super human’ with super abilities. But rest assured, your therapist may not ethically be allowed to ‘burden’ you with their issues, but it does not mean they are symptom free.

On Fitness– There are many wonderful fitness experts/ coaches/ nutritionists etc. But there are a couple of things the majority are not well versed in; food addiction vs eating disorders, and the different styles of cravings some human’s may suffer through. Keeping in mind that when you have a large audience of people, and you are pushing a diet and fitness plan onto them, some people will not take well to that diet and it may perpetuate an eating disorder. The underlying emotional themes could include: deprivation, obsessions, perfectionism, rebelliousness and shame. The behavioral themes could include heavy restricting/ tension, cravings/ binges, purging and obsessive checking in on: scale numbers, clothes sizes, mirrior reflections, tape measures etc. If the person with a food addiction and/ or eating disorder ‘crashes and burns’, the shame might eat them alive. Healthy minded people are taking well to the diet and fitness plan, people with eating disorders are suffering all over again, usually in silence. Since I rarely find eating disorder friendly fitness influencers, I tried to become my own. I am what is called a ‘number free athlete’, which means I refrain from numbers & rigid rules so that I can stay in shape without perpetuating the ED cycle. I also like to focus on the healthy meals I do enjoy, versus the foods I ‘cannot have’ (forbidden foods are frowned upon in ED treatment) which would lead to a risk of my brain gravitating toward deprivation/ craving/ rebellion mode. I encourage all fitness/ nutrition experts to become well versed in ED’s and cravings; hunger cravings, appetite cravings and emotional cravings.

On Career- There was a time that it was the norm to tell the kid’s to get good grades, go to college, get a good job and get married. Today, the options are unlimited. There are people that are literally making money from their phones everyday while not going to a ‘conventional’ office. There are people doing Vanlife; traveling the country and vlogging their experiences. There always have been tradesmen & women, and we are finally making the effort to destigmatize trades, as they can offer great pay/ entreprenuerial opportunies. Speaking of entrepreneurship, now more people are talking about creating their own jobs and working for themselves. Though people are still tempted to ‘warn people’ about what to do and what not to do, the fact is that these expended career opportunities are happening. If they are happening, that means that they are possible. There are people that have become walking/ living proof. I like to encourage people to nurture the field that pulls their interest, and to seek out good role models/ mentors so that they can educate themselves on how to become what they visualize. If a child/ teen wants to become a real estate worker one day, why would they listen to someone pushing them to get a four year degree? If someone wants to work in repairs, why would they listen to someone who doesn’t even know how to use a hammer? If someone aspires to have a career that requires an advanced degree, why would they listen to everyone tell them ‘that it is too hard, and too expensive’? And, if someone wants to own their own business one day, they ought to talk to someone who has, themeselves, owned and operated a successful business.

IN conclusion, when people are watching you and taking in your content and advice, that is a huge responsibility. Trying to put your message out there while trying to help, and not trigger as many people as possible is quite a job. Also, weeding through the trolls and negativity. I believe that if I am helping even a handful of people, then maybe it is worth it.

Euphoria

Elisa A. Escalante/ LCSW/ 02-16-2025

“Let’s just admit that we don’t want our ‘highs’ to end. We don’t want to sink into the lows. We want to chase a feeling and make it permanent. We want to hold onto a moment while life moves on.”- EaE

Roughly 6 years ago, I had traveled to California with my ex-fiancé (from NYC). It was the vacation of his lifetime; he admitted this shortly after our breakup. Naturally, we went through my old hometown of Yucca Valley. I remember how excited my father was to see me. So was my best friend since junior high as well as some other friends/ acquaintances. I remember how everything felt the same, and we carried on with the same tradition that my beloved small desert town loves: Karaoke, Mexican food, and alcohol.

We had so much fun together with a night of food, conversation, singing, dancing and …. well, drugs. My family and friends were so hyped that I was there. They begged me not to head to San Diego just yet… but to stay with them for another night. I did not really want to, as I had hoped to have an extra day in San Diego, my favorite city. But they were begging, so I reluctantly agreed. The very next night we did the same thing. Karaoke, margaritas and Mexican food. But something had changed. The people were not as lively, the songs didn’t seem as fun or exciting, the food was blander. Everyone was tired and couldn’t even force their smiles. The dancing was nonexistent. People left the restaurant much earlier than they had the night before.

A theme that is common amongst most humans; when we find joy in something, we cannot help but want to hold onto it or repeat it. Over and over and over again. But it will lose its luster. We cannot hang onto a special moment, and the more we try, the more we suffer. For example, if you try to cling onto a special person; you could chase them away. You try to repeat a ‘night to remember’, that night won’t be the same. How can you repeat something that felt like ‘magic’??? The moon, the stars and the planets aligned to give you something special, and there you are trying to recreate something that is not fully in your control.

Because of my own abandonment wounds, I have struggled with ‘the art of letting go’. I am no stranger to being attachment anxious, clingy, and sometimes pushy. As I have gotten older and wiser, I have modified these behaviors. However, I could still feel the tension in my body and the spirals in my mind when I feel like something good is about to slip out of my grasp. But now, I know that I have to let it go and sit with the feeling of letdown and loss. Maybe we aren’t taught that ‘it is okay to miss something or someone?’ That you can miss something without trying to force more to happen?

Great moments are meant to be enjoyed and then appreciated after the fact. The gift of memory lets us hold onto it, even after it’s long gone. What happens to people that chase euphoria and have difficulty sitting in boredom? Compulsive behaviors, addictive behaviors, sabotage, codependency, perpetual disappointment, strained relationships and difficulty with self-regulation. Because instead of living a well-balanced life, you become victim to the part of you that wants to chase something that makes you feel high, while escaping your own internal struggles with boredom, loneliness, sadness and fear.

I believe I am starting to see this as a lack of confidence in myself to handle those difficult feelings to begin with. How many emotions do people run from before they run full circle? Right back into those difficult emotions. They will smack us in the face eventually. The party has to end sometime. We have to sit with ourselves in the discomfort. Euphoria will end, and post euphoria depression may hit us like a ton of bricks. A test of someone’s fortitude has everything to do with how they handle the harder times. When we are lonely, when we must sit in silence, when we are ill, when we are in a deep depression or when life keeps throwing us challenge after challenge and not letting up.

I like to encourage everyone to look at every emotion, circumstance, and encounter as an opportunity and/ or a teaching moment. Everything may have some purpose or value. Yes, even the harder emotions and circumstances. For example, people hate boredom. But boredom also means peace; nothing crazy is happening if you are bored. People don’t like arguing. But an argument also gives us a lesson, if we are willing to pay attention to it. People think that being lonely is the worst thing in the world. But when you are alone, you can do whatever the heck you want, no one is stopping you. Anxiety will alert you to a threat, push you to take precautions or push you to problem solve your life/ future. Sadness will prompt us to endorphin hunt or seek adventure. We may also learn overtime that we have it in us to do it on our own; without other people around us 24/7.

If you want euphoria, and you do something wild and harmful to get it, forgive yourself. It is human. Just remember you cannot stay there. See it as a wonderful memory while remembering that your natural state is healthiest when it is balanced. Not chasing a high, or a memory, or a person. Don’t become a slave to your mind in a high-speed chase toward something it cannot hold onto. That pattern is destructive and harmful. Stay safe and ride the waves, hopefully with elegance, wisdom and grace.

The only other thing is Nothing

Elisa A. Escalante/ LCSW/ 01-21-2025

“When you don’t want it anymore, but you don’t know anything else. It’s a loop of hell that consumes you. When you free yourself, you strip away the torture, but you strip away your identity along with it.” -EaE

Thirteen months ago I had my more recent break up. I remember, as usual, I would go to work with dread. I wanted to get through those difficult work days so badly. After all, I was grieving while talking to mentally ill patients. When the work day ended I remember feeling a sense of relief, only to feel dread right after. I was sad to go to work. I was sad to be at work. I was sad while heading home because home reminded me of the traumatic aftermath of that break up. Home was haunted. The break up I had in Brooklyn (My ex ex) at least offered me a glimpse & sliver of hope, as I was moving from NYC back to CA. But this time, I had no hope. I either felt completely sad and hopeless, or I felt nothing at all. There was no connection. There was no more love. There was no more purpose. What was scary is that I did not feel the slightest bit compelled to try to regain anything back. I was done. I went on autopilot. Going through the motions of the days in a situation that felt like it would last forever. My father was my rock during this time.

I made sure to get myself back into therapy ASAP. And through the months I reached out to my friends and family when I wasn’t hiding in my shell. I traveled, I talked to people. I worked out more regularly, once again. I went on a dating app, but that did not last long. I didn’t feel the urge to meet anyone. I started to write darker poetry. I read some self help books. I made sure that this time when I felt lonely, I actually sat in the lonliness without giving into the compulsion to immediately hunt for a dopamine source. My therapist helped me work tirelessly on my new non negotiables and boundaries because, clearly they were not working for me. As my dating history showed a reoccuring pattern of me giving into what my exes wanted only to be stuck in situations I was not happy in. This is also known as fawning and self abandonment.

When someone has a history of serial dating/ relationships, and they finally commit to being single for a good while, they learn new things about themselves. I would say very quickly I learned why I compulsively dove into relationships head first. That initial feeling of lonliness is excruciatingly painful. Even when you know it’s for the best (the break up), your body and mind will still go through severe withdrawals. This part of the experience is so miserable that many people will take their exes back, or they will jump into rebound relationships with new people rather quickly. Because anything feels better than ‘nothing’. Sometimes ‘misery feels better than peace. Sometimes, suffering feels familiar while ‘peace’ will build tension/ suspense. Relationships for me were no longer bearable, therefore I chose what I considered the ‘lesser of two evils’; singlehood.

I changed other aspects of my life as well. When I wanted to do more drugs, I chose to do less drugs. When I wanted to look at a man until he got the hint and flirted, I instead chose to avert my eyes and act like he didn’t exist. When I wanted to give in and help someone, I chose to walk away and let them figure it out for themselves. When I felt compelled to overwork, I chose to sit in more silence. The hardest thing of all? When I wanted to run away from my life, I forced myself to sit in the normalcy of it. Work, pay bills, come home, workout a bit. Write, and maybe cook…. and do other important chores that I had been putting off. The best thing I’ve done in the past thirteen months? I nearly eliminated all of my to do lists and my financial debt. This could only be accomplished because I had no one else to think about except for myself.

Minimize and Shrink

Deep down, I know that it is not my fault what happened. I provided for and took care of my ex to the best of my ability, and yet he still chose to drug binge and sabotage our relationship. However, I have a natural guilt that I have carried since toddlerhood. It stems from a sense of never being wanted, and feeling like I was a burden to those around me. Hence, I still blame myself to some degree. I was in the relationship too… after all. I didn’t feel deserving of the house I had bought. I did not want it either, as it felt haunted by the ghost of boyfriends past. I sold it. I chose to move to a much much smaller place, I do not ‘deserve anything lavish’. I also did not want the responsibility of too much space, or too many things. I decluttered and got rid of soooo many items. Good riddance. I also broke up with a former friend who was also suffering from a substance abuse issue and kept pushing/ coercing me into enabling their habit. I just kept shedding and shedding and getting rid of things until my entire environment and my entire life looked completely foreign and unfamiiliar.

‘Why do I deserve good things when so many people are suffering?” This is still a question that haunts me. Why is ‘having nothing’ so terrifying, that I settle for misery loves company instead? Why did I fear that peace and solitude would lead to misery? And why did I seek out things that actually led to misery? The only other thing beyond chaos appeared to be, nothing at all. And so many times in the past thirteen months, I have sat in nothing. No stimulation. No boyfriend. No dates. No prospects. No attention. No drama. No problem to solve. No fire to put out. Nothing but my own chaotic thoughts. But, beyond the sense of having nothing and being lonely, there is room for growth. Think of it in the sense that a fire scorched down your entire land and left you with nothing. Something new will grow, but it will take time. And if we’re being smart about it, we will not let it grow back exactly the same. A new foundation may require new crops. Change. It’s not ‘nothing’, it is something completely different. But, it feels like nothing when you are freshly grieving.

What stops many of us in our tracks? Fear. We suffer a lot because we fear that on the other side of suffering is an even deeper type of suffering. But, this keeps us frozen and unable to find better for ourselves.

Here are some other great quotes on this topic:

We tend to prefer the certainty of misery to the misery of uncertainty” – Virginia Sati

Adversity is like a strong wind, it tears away from us all but the things that cannot be torn, so that we see ourselves as we really are.” – Arthur Golden

A picture I took when I ventured out to the Salton Sea (also where me and my ex got fake married)

You’re probably slacking on your New Years Resolution, aren’t you?

Elisa A. Escalante/ LCSW/ 01-15-2025

“Growth/ maturity is getting older and realizing that everything you feared, and everything you judged, will happen to you. And the best qualities that you can have during your humility journey are grace and gratitude.” -EaE

There is no such thing as an endless supply of motivation. So, if you are wondering why you are not motivated to meal prep, workout more, read more, journal more, walk more, self care more, hustle more, there is no need to wonder; it’s called being a regular human. Humans have limitations. Where motivation ends, discipline takes over. If you don’t have the discipline for it, it could be because: a- The goal was extremely unrealistic and unnattainable, b- You actually do not care for the goal, you just set it because it is something you ‘oughta do’/ c- your life changed unexpectedly and subsequently, so did your priorities/ d- You forgot/ or e-you’re struggling with what are known as ‘mental stuckpoints’ that impede on your ability to accomplish the goal.

A: The goal was extremely unrealistic and unnattainable. An example of this could be someone that is going from ‘not working out at all, to trying to workout 5-7 days a week’. From no momentum to too much momentum; soreness and burnout. This can perpetuate overdoing/ underdoing cycles. This by default, will make it very hard to become consistent. The underdoing part of the cycle can also promote shame and lead to quitting. Good goals are boring goals. They won’t necessarily get your brain dopamine spiked up, but they will be practical enough to stay consistent. If you don’t workout, I would recommend starting with 1-2X a week and maybe work your way up from there. If you want to cut out sugar or carbs, I wouldn’t recommend cutting them out completely. Maybe start with one sugar/ carb snack that causes the urge to binge more. One small step at a time. Change is hard, and too often people try to make drastic changes in short periods of time. ‘Crash diets’ and ‘crash workout plans’ crash for a reason.

B: You actually do not care for the goal, you just set it because it is something you ‘oughta do’. Do you actually want this goal? Why? What is the purpose and why does it matter to you? Go back to your why. Refocus. Explore your intentions. If you really do not care for the goal, why did you set it in the first place? Societal pressure? Peer or family pressure? Is it because ‘New years told you to do so’? (Cultural/ traditional pressure) If you establish that you do not care for the goal, would you be willing to set a different goal? One that actually pulls at your curiosity and gives you an inkling of passion?

C: Your life changed unexpectedly and subsequently, so did your priorities. This just makes sense. It happens. I’m sure some of the fire victims in L.A. had resolutions, but now, their lives are drastically altered and they have been forced into survival mode. And there are many people around the country and the world that are going through natural disasters, job loss, financial crisis, domestic violence, losing people & dealing with grief etc. When life throws a crisis at you, plans must change. Now your basic needs for survival are the priority and a self development goal is a luxury reserved for those that are still in stable/ good standing. I’m sorry for your troubles and I hope you have a positive/ strong support system to help you through these times.

D- You forgot. It happens, maybe you are often forgetful. Or maybe you are very busy right now. Maybe you are on autopilot because of a very busy lifestyle, so you really just forgot. What’s the barrier(s) to the goal? Why are you forgetting? What is distracting you? Netflix? Social media? Family? Friends? Is working taking up most of your life? If it’s not an external thing, is it a mental or emotional distraction?

E- You’re struggling with what are known as ‘mental stuckpoints’ that impede on your ability to accomplish the goal. Yes, our brain can actually stop our body from taking action. Our brain can prevent our body from moving. I often tell my patients that “The mind can force the body, but the body cannot force the mind.” Meaning, we can push ourselves with mental fortitude. An athlete can use their mind to push themselves past exhaustion. A college student can deprive themselves of sleep to cram for a test even if they’re tired. A person can accomplish a work task that they have never done before. Maybe it’s scary and makes them anxious, but they can harness courage and intelligence to learn and get it done. However, if our mind does not want to, it cannot make our body do anything. If your mind does not want to get up, your body won’t move. If your mind does not want to learn a new instrument, your body cannot make it. To go more in depth on how mental illness can perpetuate stuckpoints, I’ll expand a bit.

E1: Anxiety forces people into an unpredictable future, it can stop a person in their tracks. It can start with anxious thinking. “What if I try to accomplish this goal but I fail?” “What if it’s dangerous and I get hurt?” “What if people judge me while I try?” These are thoughts that could perpetuate fear to a point that a person decides ‘it is not worth the risk’ all together. It can lead to procrastination, or giving up entirely. Then there are the physiological s/x of anxiety which include labored breathing, muscle tension, chest palpitations, headaches, shakiness. The mental impacts the physical, the physical turns right back around and impacts the mental more. The only way to build the confidence to counteract the anxiety is to set mini goals and accomplish them; proving to yourself that you do have the capacity to set a goal and see it through while staying safe. I had a client that was so agoraphobic that going outside felt impossible. She started by going to check the mail. Then by going down the block. Then one day going around the block etc.

E2: Depression robs people of the ability to engage in positive thinking or even feel a sense of hope and purpose. If the mentality becomes ‘what’s the point?’, or “I don’t even care”, then it would be very hard to feel motivated to accomplish any task. If basic daily tasks become exhausting, then self improvement will feel impossible. I usually call my walks ‘zombie walks’. Where I would force myself to put my shoes on and force myself out the door to walk. Since my depression impaired my psychomotors, I looked like a zombie trying to wobble my way toward a food source. Depression/ low motivation requires the ‘elimination of as many barriers as possible’. Putting on shoes and tying them feels too hard? I have slip on sneaker shoes (Barefoot is one of my favorites to recommend). Putting on a sports bra is hard and exhausting? I have ultra stretchy sports bralettes. (Aerie) You cannot fathom doing an intense workout while exhausted? Try mild to moderate. Warm up into it and see what you can do.

E3: PTSD robs people of the present moment. The body and mind are so heavily triggered and focused on survival that ‘nothing else can matter’ besides surviving. Safety first. Are you in a safe environment that affords you the luxury to accomplish your goals? Can you maintain focus or are you triggered which results in your brain/ body getting hijacked with adrenaline, cortisol and racing intrusive thoughts? Are you surrounded by safe people that encourage you to go after your goals and rarely interfere? Are you able to prioritize your health/ self care? Are you able to acknowledge your limitations and work around them? And though it is hard to maintain fitness and/ or hobbies when you have PTSD, I would also say that because you have PTSD, it means you need to do it more. Your mind needs a break and a distraction from ‘being in your head 24/7’ with traumatic memories.

E4: ADHD disrupts focus as well as the ability to complete tasks. Now that I have been working with ADHD more in primary care, I’ve learned something very important. If someone has ADHD, it ought to be addressed and/ or medicated first. If the ADHD does not get managed, it’s next to impossible for the patient to work on any interventions and/ or any other mental health concerns they may have. Many people with ADHD go through bouts of hyperfocusing on one thing and forgetting about/ neglecting everything else. Or, the inability to focus at all, which causes them to run around only accomplishing 1/4 – 1/2 of each goal. But, they are then unable to complete anything all the way through. The same thing might come up for a New years goal! Like all other mental health conditions, if this has become debilitating, seek professional help in the New Year!

Let’s make this a great 2025!

My Sound Bath

Elisa A. Escalante/ LCSW/ 12-23-2024

Starting yoga a few months ago was not something I was doing out of excitement. It was something I was doing because I felt a need that I figured only the art of yoga might fulfill. The art of letting go, surrender, clearing my mind in a way that nothing else could. I needed to drown out & silence the outside world. But, more importantly, I needed to get my mind to shut the hell up. The stretching felt good, the peace and calm felt great. But something surprised me even more. The sound bath. One of my favorite instructors likes to do this sound bath at the end of most of her classes with the large white bowls and instruments. I was shocked the first time I experienced this. I felt the loud noises move through my body, and involuntary spasms started to occur. I also noticed heavy emotional reactions as well as intrusive trauma memories; like a fast slide show of my trauma memories were flashing through my mind at a rapid pace.

There was a part of me that wanted to reject this process, but, I chose to lean into it. I started eagerly going back to yoga for more relaxation followed by my intrusive memory sound baths. They became more vivid. I remember in my first Yin & sound practice my body went into a deep state of relaxation. When the sound bath occurred I remember the large bowl creating a ‘siren’ like noise that sent me back to my Afghanistan deployment back in 2012. It sounded a lot like the siren that went off when we were being bombed/ attacked by enemy combatants on our FOB. My mind started to flash with visions/ memories.

Memories included being under a concrete cinderblock staring up at the moon through the crevice as people squeezed in from left to right; crushing me as the bombs kept hitting the base. Then flashes of other images during the deployment. Me being startled awake by a VBIED threatening the barrier of our base. An F16 jet and Apache helicopters shooting down at our enemy combatants to rescue us. Seeing a dead man on a litter and a soldier comforting an Afghan local because the dead man was his friend; solemn. Seeing our patient’s hopeless eyes before he left the clinic, and eventually shot himself later in the night with his M16. Seeing his coffin with a flag draped on top of it being carried into the C17. The whistling sounds from mortors, gun shot sounds. The Afghan national army soldiers and the way they looked at me (and all women in the military). The jarry feeling of walking or driving by people with guns that will not stop staring. And you are told that they are the ‘ally’, but you never know, they could ‘be the enemy so always watch your back.’

My eyes flutter, my body convulses a bit. It is not voluntary, it’s an energy that is piercing through me. And for some reason, my mind has to process these traumas again per the music from the bowl. Per the sound vibrations. Then, when it’s over, a few tears are pouring out. And the yoga instructor tells us it’s time to incorporate gentle movement back into our bodies. I do feel a release and a sense of relief. I am never quite sure why this is so effective but it is. I ask my instructor after my 4th class if this is normal. She starts to discuss the ‘Chakras’ and how our energy becomes compromised throughout our lives. With stressors and traumas. The sound vibrations serve as a sort of ‘release’.

I eventually notice that my mind was getting through the combat trauma processing. Why? Because eventually, my intrusive childhood trauma memories started to play out. Flashes of incidents that happened during the timeframe that my Bio Mom had custody of me and my brother. Flashes of different places we lived, different boyfriends she had. The unkind ones. Getting physically abused as a toddler. Getting abandoned. Seeing so many adults around me with scowls on their faces. Hunting for food with my brother and learning how to feed ourselves. Or worse, having no choice but to trust strangers to help us. Growing up feeling like a burden to everyone around me, as I was a very ‘unwanted child’ during the prevalent ‘first five years’. (Mental health professionals theorize that attachment disorders develop during the first five years of a childs life)

Then eventually, flashes of domestic violence from my ex fiance. How he shoved me to the ground when I was trying to leave our apartment right in front of his 3 year old toddler. All of the screaming and name calling he did. Tearing me down with his words and intentially destroying my almost non existent self esteem. Then, the horrific way in which my more recent relationship ended; my ex drug binging, taking off for long periods of time. Literally recreating my childhood right before my very eyes. Having to break up with someone that I still loved because I decided that respect is more important than love. Selling the first house I bought as it felt haunted with memories of us. Selling that house may as well have been me selling all of my dreams. I always wanted my own home and it was the most beautiful time of my life, until it wasn’t.

Lately, I have been having less intrusive trauma memories during my sound baths. Now it’s turning into pleasant fantasies and day dreams. I believe this may be a good sign. Also I have been experiencing more eye fluttering. “Energy release: Some believe that eye flutters during a sound bath represent the release of stored emotional energy, particularly related to the “third eye” chakra area on the forehead” (https://www.google.com/search?q=eye+flutters+during+sound+baths&sca_esv=1). So naturally, I wanted to know more about my ‘Third eye chakra”. The “Third Eye activation occurs when meditation techniques stimulate the Third Eye Chakra by sending energy and awareness to it. When you focus awareness and energy via meditation, the brain, nervous system, and all of your mental functions become relaxed, purified, enlivened, and strengthened” (https://www.bigshakti.com/third-eye-ajna-chakra-power-to-enlighten#What-is-third-eye). This is very good news as I have a tremendous amount of emotional turmoil stored up due to having PTSD and being a mental health professional where I still listen to trauma/ grief stories on a weekly basis.

To say that I recommend yoga and sounds baths would be an understatement! But, I do believe that people have to be ready and open to it. In my twenties, you would have never caught me in a yoga class. Because it didn’t seem ‘high intensity’ to me, I saw it as a waste of time. But now, I am doing yoga 1-2X a week, to balance out my brazilian jiu jitsu 1-2X a week. And it is quite interesting how these two sports oppose and balance each other out. In BJJ, focus is imperative. We need lazer focus to make sure we protect ourselves from people trying to hurt us. You have to get the techniques down perfectly. You have to become obsessed. In yoga, we let everything go. No more perfection, no more obsession, it’s the ultimate surrender.

Below is the attachment to the website for my Yoga studio for anyone that is local!

https://www.earthyogaandspa.com/