Monthly Archives: May 2006

horticultural therapy

7 am today, when i was watering my garden, my bare feet tickled by the morning dew, i thought, why not do a quick write-up about horticultural therapy?

so i googled the term and on the first site that came up, i clicked on “what is horticultural therapy?”, this is what i found:

“There are four elements that are essential for an activity to qualify as horticultural therapy if it is to be considered a profession eligible for the same status as other caring professions.

  • a defined treatment procedure that focuses on horticultural or gardening activities
  • a client with a diagnosed problem who is in treatment for that problem
  • a treatment goal that can be measured and evaluated
  • a qualified professional to deliver the treatment”
    doesn’t that sound … errr … exciting?

    no?

    it doesn’t really tell me what horticultural therapy is. it focuses completely on the profession (another term that i think of is “priesthood”) of horticultural therapy. apparently, these pries … i mean therapists are just like “other caring professions”.

    so what do they care about? defined treatment procedures. aaah, there’s someone who needs to be treated! who might that be? a client with a diagnosed problem. right. if you have priests, you need sheeple. and these sheeple need problems – not just any problem, mind you: it needs to be diagnosed. with the bibl … i mean, with the DSM IV, presumably. next we care about treatment goals, and not just any treatment goal – it needs to be measured! no treatment goals, no therapy. and get out your measuring tapes, guys! and for heaven’s sake, if the prie … i mean the therapist who administers the treatment isn’t qualified – just imagine the jungle of a mess that would create! i also wonder, is it considered beneficial to administer fertilizers and psychiatric medication at the same time?

    oh, and did you notice the word “status” in there?

    there’s probably a lot of wonderful, truly caring horticutural therapists out there, and i am sorry if i offended them. it’s just when i read something like the above description (which doesn’t even answer the question), my bile rises. it brings up so much of what’s wrong with mental health professions.

    what does this say about me? am i getting a kick out of criticizing some of my colleagues? where do i commit the same errors as they do?

    i’ll reflect on this next time i dig around in my garden. the one that i call my “nature overcomes civilization project”.

    isabella mori
    counselling in vancouver
    www.moritherapy.com

gratitude – even when i’m tired

after an 18-hour day, i am incredibly tired. but i can still find a few minutes to express gratitude for the good things in my life.

the great weather we’ve been having lately.
our lovely gray cat, rum, who has such an easy-going personality.
that my blisters never popped!
the willingness to exercise most days.
that my friends feel comfortable giving me feedback.
the deep conversations i had today.
my “practice angels” (people who refer clients to me).
easy conversations with god.
oh, and the ivy that’s really starting to grow around my window …

isabella mori
counselling in vancouver
www.moritherapy.com

increasing psychotherapy effectiveness

research has shown that when clients are directly involved with charting the course of therapy, therapy tends to be much more effective. because of that, i use two very simple tools in my sessions that help to ensure client involvement. the one i am reprinting here is the one i give at the beginning of the session. it is useful in many ways – one of them is to chart improvement over time. if there is little improvement, the client and i can discuss what changes we need to make; and if there is improvement, we can figure out how that improvement happened, and how the improvement can be strengthened even more and firmly anchored into the client’s life.

here then is the outcome rating scale:

Looking back over the last week, including today, help us understand how you have been doing in the following areas of your life, where marks to the left represent low levels and marks to the right indicate high levels.

Individually:
(Personal well-being)
I———————————————————————-I

Interpersonally:
(Family, close relationships)
I———————————————————————-I

Socially:
(Work, School, Friendships)
I———————————————————————-I

Overall:
(General sense of well-being)
I———————————————————————-I

© 2000, Scott D. Miller and Barry L. Duncan

the second tool i use is the session rating scale, which is given at the end of the session. this little questionnaire ensures that the client gets what they need out of the session – for example, that she or he feels heard, and that we talked about the things she or he wanted to talk about. when there is dissatisfaction, we talk about it to make sure that next time, the session works better for the client. an example of the session rating scale can be found at the end of this article.

isabella mori
counselling in vancouver
www.moritherapy.com

mental illness, mental health, mental wellness

the public health agency of canada has a site on mental health – or mental illness, if you prefer that term. the definition is:

Mental illnesses are characterized by alterations in thinking, mood or behaviour (or some combination thereof) associated with significant distress and impaired functioning over an extended period of time. The symptoms of mental illness vary from mild to severe, depending on the type of mental illness, the individual, the family and the socio-economic environment.

this is an ok definition as it goes but i ask myself right away – if there is an alteration, a change, then what has it changed from? has it changed from ease (as opposed to distress) and skilful (as opposed to impaired) functioning? or maybe just from distress (as opposed to significant distress) and acceptable (as opposed to impaired) functioning?

so let’s say that when one is not mentally ill, then one varies somewhere between ease and distress and between skilful and acceptable functioning.

this is again ok but just not very exciting, is it?

what’s mental wellness, then?

fortunately, the public health agency has something to say about this, too. in fact, it is the UN definition of wellness:

Wellness is not only the absence of illness but also the sense of total physical and mental well-being.

this sounds fabulous! it sounds as great as the definition of non-illness sounds unexciting.

unfortunately, it also sounds pretty unrealistic.

i think that’s partly because of the dualism involved in illness vs. wellness. when you take these definitions, someone with a chronic condition could never have well-being. the diabetic who lies totally content on the deck of a cruise ship during her honeymoon – sorry, no wellness. on the other hand, a physically healthy psychopath with not a care in the world would enjoy all-round well-being.

obviously, there is something wrong with this picture.

i certainly have no easy answer to this. i guess my point is that mental health, mental illness and mental wellbeing are difficult concepts to pin down. in the end, i think every person needs to define these terms for themselves.

isabella mori
counselling in vancouver
www.moritherapy.com

chronic pain – hard to understand

many years ago, when i was still in the early phases of studying, i had a telephone conversation with a friend of mine, who at that point had lived for many years with chronic back pain. inexperienced and naive, and influenced by reading louise hay, i suggested to my friend that at some level she wanted the pain.

she was livid. why would anyone want something so horrible and crippling? how could i be her friend and say something like that? she hung up on me, angry, anxious, bothered.

that night i went to bed in a state of bewilderment. i clearly remember lying there, staring up at the ceiling, praying for insight.

and then it came to me. obviously, i did not have idea one about chronic pain. since i was not suffering from chronic pain myself, how could i? i decided there and then to become a student of people with chronic pain, to ask them to teach me.

i am grateful for the experience. being a student of chronic pain sufferers has taught me so much that is directly related to pain – about pain medication, the connection between chronic pain and depression, how doctors and the rest of society relates to people with chronic pain – the list goes on and on. but i’ve learned so much more. for example, about what it’s like to have a disability – visible and invisible; what it means to live a “normal” life; and the superstitions we harbour towards people who are “different”.

isabella mori
counselling in vancouver
www.moritherapy.com

suicide by a friend. or was it a stranger?

last week, a young man in his 20s, let’s call him john, ended his life. he had struggled with depression for quite a while and just couldn’t take the pain of his life anymore. he swallowed the pills he had hoarded over a few months, and then he left us.

there was a memorial service. they talked about how much he had loved his cat; how close he had been to his friend, mark; how much his job had meant to him; and joked that he’s probably in heaven now, playing cards with st. peter.

the problem —

john liked his cat, but he adored his two horses, which were never mentioned. he had stopped talking to mark a year ago. he hated his job. he had turned his back to the church, and he was passionately opposed to gambling, which is why he never played cards. nobody talked about the fact that he was a talented, aspiring artist.

what had happened?

did the people who organized his memorial service really know john?

what would it have been like for john to truly be known by more than just a handful of friends? would it have made a difference?

i honestly don’t know.

but i ask: who do we have in our lives? do we know who they truly are? do we care? do we show we care?

isabella mori
counselling in vancouver
www.moritherapy.com

getting sick

i feel a cold coming on.

i could ignore it.

i could go to bed.

i could get all panicky.

i could have a hot bath.

i could listen to my body.

i could feel guilty about getting sick.

i could be afraid that i’ve infected my friend who is weak from chemotherapy.

i could realize that it’s normal to get sick once in a while.

i could accept my present reality.

i could worry that it might turn into one of those long-lasting flus.

all these options.

i think i’ll accept that i’m not feeling well, listen to my body, have a hot bath, and then go to bed early. without feeling guilty, worried, afraid, or ignoring my present reality.

thank you, everyone who has helped me get to this point of agreeing to be friends with my body. it still doesn’t come automatically, i still see feeling guilty, worried, and all those other feelings about getting sick as options – but i don’t exercise those options anymore.

thank you.

isabella mori
counselling in vancouver

hopelessness?

“research convincingly shows that people come to therapy not because they have problems but because they have become demoralized about their chances of resolving particular challenges.”

this is something i brought up in one of my earliest blog entries. there, i talked about how we face problems all the time, and how the “size” of a problem seems more to be related to our personal attitudes to them than to “what” the problem actually is.

today, rereading these words, i got stopped short by this sentence again. people become demoralized about their chances of resolving particular challenges.

in other words, they become hopeless.

“they” become hopeless.

never mind “they”: i, too, have moments of being hopeless. i wouldn’t even call it that (my ego doesn’t like it when i call myself hopeless; it is convinced that it has a reputation to uphold) but still, that’s what it is, essentially. for example, when i find it difficult Continue reading