The Way Forward

[Upbeat Guitar Music]

Mike: Welcome everybody. This is Avoiding the Addiction Affliction, brought to you by Westwords Consulting and the Kenosha County Substance Use Disorder Coalition. And by a grant from the state of Wisconsin's Dose of Reality: Real Talks reminding you that opioids are powerful drugs and that one pill can kill. I'm Mike McGowan.

Mike: Learning to deal with stress and anxiety that many of us experience is not easy. There are times where we all receive counterproductive messages from the people who genuinely care about us, and then there's stigma. We're gonna talk about what can work when it comes to our mental health, our relationships, and overcoming that stigma with our guest today, Kelli O'Rourke Wall.

Mike: Kelli is a California based licensed marriage and family therapist who works with individuals, couples, and families, empowering them through actionable healing strategies.

Mike: Welcome Kelli.

Kelli: Thank you. Thanks for having me. Glad to be here.

Mike: Yeah, Kelli's in the Napa Valley, so I told her before we started that I'm already jealous

Kelli: (laughs)

Mike: Such a beautiful part of our world, isn't it?

Kelli: Yeah, it is. I feel very fortunate to call it home.

Mike: Like a lot of professionals we've talked to on here, Kelli, you got into your profession having first been a client, right?

Kelli: Yes.

Mike: You experienced all this, right?

Kelli: Yeah, absolutely. I think a lot of us in the helping professions come to this work through our own lived experience of either our own mental health challenges for those of the people we love going through something.

Kelli: And so, yeah, I definitely came to this work through my own journey.

Mike: What caused your stress and anxiety back in the day that sought you to seek help?

Kelli: Well, I had gone through about nine years of infertility treatments.

Mike: Oh my gosh.

Kelli: So I'm kind of slow. Yeah. It was a long haul and I would take breaks because it was really a rollercoaster.

Kelli: Right. Just was hope, hope, and excitement. And then the drop when it wouldn't work. And so it was finally after my last failed IBF attempt. I think just something really broke inside me. I think I really just lost a lot of confidence in myself. I really struggled.

Kelli: I just remember getting that call from the clinic saying, sorry, it didn't take. And I was at work and I thought, oh my gosh, just how am I gonna get through the day? I was heartbroken. And I think I left that day and I actually didn't go back. I actually had to take a time out from my life.

Kelli: I was having a lot of panic attacks, a lot of anxiety. I had trouble leaving my home. I'd get in the car and I would just start crying or shaking or going into panic and I just really, yeah, I think it just broke my heart in such a way. I couldn't really function.

Mike: The word panic attack is used way too casually.

Mike: I've had three and the first time I had one Kelli, I thought I was having an asthma attack or a heart attack. I didn't know what the heck it was. So describe a little bit about what panic attacks entail.

Kelli: Yeah. Panic attacks are really your more severe anxiety, right? When you go into a panic attack, you're in such fight or flight mode that you kind of, it feels to me when I first had mine similar, I thought, okay, I'm dying.

Kelli: This is the end of the world. I felt so out of control. I didn't know what was happening to me. Took an actual journey to the ER to be like, what is happening to me? And yeah, they said, oh, that was a panic attack. So yeah, it was so intense that I thought, yeah, death was imminent.

Mike: Then there is medication for that. But I don't wanna always be on medication for a long time.

Kelli: Right, right, right. That's for sure. Yeah.

Mike: When you went through what you went through what were those people around you? What advice were you getting for people? Keep going with the fertility treatments or were you getting a lot of what Brené Brown would say. Fake empathy.

Kelli: Yeah, I think so. I got a lot of that. Well, I mean, I think first people generally around me, kind of my support people were, they were really sad with me. They kind of grieved a little bit, this loss. But that was kinda short-lived, right? Like then they were kind of expecting me to just get over it, go back to being myself you know, the strong, capable fixer person who was always there to support them.

Kelli: And when I was not in the position to support them anymore, I think people around me kind of struggled with that. They wanted me to just, yeah, get over it, like get in the car and get to the store. I like couldn't do those things, and it really started challenging some of my relationships and our dynamics.

Mike: How much grace period were you given?

Kelli: Maybe a few weeks.

Mike: Yeah. You know, come on!

Kelli: Yeah.

Mike: I had a young woman one time I was doing a presentation. She came up to me, she was 17. She said, my dad died last October, this was like May.

Mike: And my friends are all telling me, oh, get over it. It's been almost six months. She goes, should I be over it already? This is what people do, right? I think people who love you want you to just be over it. They want you to be okay. They don't know what to do.

Kelli: That's right. They don't know what to do.

Kelli: I didn't know what to do. I didn't know how to help myself. They didn't know how to help me and then deal with all the feelings they were having, you know, about their own lives impacted by what I was going through.

Mike: Yeah. So what do you tell people would be helpful? Like if I have a son, a daughter, a friend, going through depression, stress, anxiety, what is helpful?

Kelli: Well, that's a good question. And I think families are so important and your support system is so important. And some families can get into accommodating the depression and anxiety, and some people like, I think that would be one side, kind of of the spectrum. And then the other people are really push, push, push.

Kelli: And so I think it's really kind of something more in the middle, kind of really listening to your person, whoever's suffering and kind of seeing what they need. I think when we accommodate too much, I mean, definitely there was a lot of accommodation for me. I built a very small life for myself because of my, my panic disorder actually went into agoraphobia where I had trouble leaving the house and traveling and things.

Kelli: And so people accommodated that, because I just told 'em I just couldn't do it. Or I would have to start crying or have a panic attack and they were like backing off because they were unsure. But that wasn't super helpful because it kind of really helped me stay in the cycle that I was in. I had no real impotence to change because I was not self-motivated to face my, like panic and have panic again.

Kelli: But then if people pushed too hard, I would also kind of really shrink back and have difficulty with that too. So I really think it's kind of more in the middle.

Mike: What finally got you into therapy?

Kelli: I had struggled on my own for, gosh, close to 10 years this way.

Mike: Oh my goodness gracious.

Kelli: Yeah. Because I had a lot of pressure around me, because I always had the label be strong, you know, you can do it. I was constantly trying to be that person still, but like, just not able to. And so I was trying to do a lot of things in my own strength, reading a lot and doing things.

Kelli: But I was kind of just spinning my wheels. And so I actually found out that through my health plan, they were holding a class called Phobias. And it was by, you know, renowned Dr. Howard Lee Gold, just an anxiety specialist. And it was a 12 week program. And I was like, okay, I need help. I can't do this on my own.

Kelli: My people around me don't know how to help me. And so I went to my first class and it was just incredible. It was so overwhelming, but in such a great way. I think I cried maybe the whole entire first class because I was so, I felt like. Oh my gosh, these people know what I'm going through.

Mike: Mm-hmm.

Kelli: They know how to help me. and there was like 40, 50 other people in that class and I was like looking around and just heartbroken for them.

Kelli: Like, look at all of us. Just so broken. It really moved me, but I left feeling hopeful. I'm like, okay, there is, they know this, this is a thing and they know how to help me. And so I left with a lot of psychoeducation about what I was going through. 'Cause I didn't really understand, still panic attacks or what was happening.

Kelli: And I left with a framework on how to move through it and really overcome it. And so yeah, that was a really a powerful experience for me.

Mike: I bet you didn't wanna leave or wanted the next class to be the very next day.

Kelli: Yeah. I just couldn't get enough. I probably read through the whole book, you know, (laughs) when we were supposed to go one week at a time.

Mike: Yeah. To heck with that.

Kelli: Yeah. Super motivated. Yeah, so that was a pivotal moment for me.

Mike: So what finally worked for you to turn the corner?

Kelli: Well, I think, you know well this program, this framework of how to do it, the step by step kind of guide on what you do normalizing anxiety for me was super important. Like, these are normal bodily functions. This is your fight or flight system in action. All the sensations you're feeling are normal, effects of adrenaline. And what I kind of understand is like, oh, okay, this is normal. It's just happening at like not great times.

Kelli: But I think yeah, the psychoeducation really helped. And then the step-by-step process of really how to like desensitize to anxiety, to really kind of acclimate and become comfortable. And not be afraid of it.

Mike: Oh, that's great. How do you learn to desensitize or to relax?

Mike: Did you end up doing yoga, deep breathing? Like how did you learn to get control back over your bodily functions.

Kelli: Yeah. So that was a big part. 'Cause there was like head knowledge, right? But then there's also my body was just going through so much. So part of it was really understanding what anxiety looked like for me.

Kelli: So sweaty palms would start and then that increased heart rate. And then, so knowing my. How it manifested for me.

Kelli: And the earlier I could catch it, like the sooner I could use my tools to keep it down. So using like, we would use charts, scales, so subjective units of distress, and we would say, okay, where are you now on that scale? Right.

Kelli: So zero. I mean, you're probably asleep, 'cause no one's really at a zero. But like one is like, you're alert, you're functioning, you're doing well, you know, three, four, it's starting to get harder. Five, you're like, ooh, I wanna escape. I need to get outta here. Then boom, boom, boom, 10, you're at a full blown panic attack.

Kelli: And so really learning what that looked like for me, being able to use some tools when I started getting around a four. In four or five, you know, so that I could stay more grounded and kinda really. In whatever situation that I was in, instead of having to always have an escape plan and bolt out of there.

Mike: What did it feel like the first time you were able to employ some of these techniques and it worked. What did that feel like?

Kelli: Yeah. It was awesome because there are, it's important to have relaxation techniques, you know, things like, okay, I noticed my heart rate's starting to kind of go, okay, what are some tools I can use to relax that and see if I can stay in my feared situation.

Kelli: And just kind of acclimate and it was great. Now the other part of it is using a hierarchy approach. I mean, I definitely could not go over bridges for quite a while and yeah, I was very, very limited. And so like my goal was like, I'm getting to San Francisco. I went across the Bay Bridge.

Mike: Yeah. Really?

Kelli: So, yeah. So I had to kinda work my way up there. First I had to get in the car. So that was the first thing, sit in the car. So I could sit in the car and just sit there in my driveway and feel okay, like check. Okay. That's level one. Level two was getting in the car and like driving around the block.

Kelli: Can I do that with a safe person driving, I couldn't drive yet. So it was kind of these gradual layers of moving up the ladder, this hierarchy. So like till I got to 10. Getting on the freeway was another one I had to do. Being in traffic was a trigger for me because there was no escape.

Mike: Right.

Kelli: I felt locked in.

Kelli: And so I had to go get in traffic and just really use my tools and notice that I could handle that. 'Cause the brain learns by experience. We can have a lot of head knowledge, we can know all the things, but until we do it, our brain is still like, well. (shrugs shoulders)

Kelli: Now, I don't know Kelli, that might not be okay. You might get stuck. This might happen. Well, what if this? And so when we actually do the things we teach our brain, look, we're okay. We can handle this.

Mike: Awesome.

Kelli: And so it was really a step-by-step, gradual process of yeah, the freedom,

Mike: The first time you drove to the bridge.

Kelli: Yeah.

Mike: Were you alone? Did you have somebody with you?

Kelli: I did, the first time I actually had my husband was my driver because I was like, I can't drive yet.

Mike: Yeah, right. Makes sense.

Kelli: So I was like, well what if I have a panic attack on the bridge? Well, it's like, well, he's driving.

Kelli: I can have a panic attack. Like, we'll survive that. That's okay. Right? Because normal body function doesn't lead to death or disease. I'm not gonna die from this. So whatever happens, i'll use my tools, it'll be okay. So, yeah, but I was nervous, but I had a lot of tools, so it was just, oh, that tool's not working, another tool. So I'm definitely a fan of multiple techniques because in certain situations some are gonna be better than others, and you just keep going through your list until you find the one that works.

Mike: It's funny you should mention that because I've worked with a lot of people and I was actually a few years ago working with an NFL player.

Mike: So what does that mean? That means this person plays in TV, plays in front of thousands of people, it's a rough sport. And he had that exact, he could not go over a bridge. So he could drive and then when they got close to a bridge, he'd have to pull over and have his wife drive across while he battled more demons going across that bridge than he did being on TV in front of millions of people. The body's weird. The brain is weird, isn't it?

Kelli: Yes, it is. It is. It's weird.

Mike: That's not real scientific.

Kelli: But it is, it's like, why this thing and not that thing? Like why is this that kind of gets us this little glitch that we get hung up on? And yeah, I think it can be different for every person, like what that thing is. It is fascinating what can get us.

Mike: What's also cool about your story is that when you walk into that class and then you go get help.

Kelli: Yeah.

Mike: And you're obviously not in the same place. This stuff works.

Kelli: Yeah.

Mike: But there's two things I think that keep people from doing what you did. Stigma's one.

Kelli: Yeah.

Mike: Shame is the other.

Kelli: Yeah.

Mike: You talk about that on your website.

Mike: You experienced some shame regarding the infertility.

Kelli: Oh, for sure.

Mike: How did you overcome that?

Kelli: So that was kind of one of the last things that I overcame because I still had this belief through the infertility because it was my, it was female factor, so I wasn't able to carry a pregnancy, I thought, well, something's wrong with me. Like, I'm unworthy of this. You know, I must be a bad person that this isn't happening for me. And so yeah, I kinda really carried that around, and then when the anxiety happened, oh, that was like a double whammy of shame for me. Because, right, I'm always the strong one, the capable one, the one who does all the things, who's the fixer, the peacemaker, had all these labels and then anxiety made me feel really weak.

Kelli: As a person, like incapable, it really challenged my capability. I mean, like.

Kelli: Like, I used to go drive all over the place. Like, how come I can't get over a bridge? Like, what's wrong with me? I must be, you know, I'm broken. B ut I hid that from people. I would just be busy when people ask me to go into the city or like have to like travel somewhere.

Kelli: So I really kind of tried to hold up, this facade that I was still okay, even though I wasn't. And that was really my shame, not being able to share that with people. And so it was actually through a 12 step program that I got involved in that really helped me overcome that. Because shame was like telling me, keep this a secret, don't share this with anybody. What will people think of you? You know? And through the 12 step program, really like getting into the groups and the circles. You gotta share. And I remember almost having panic attacks in the seat, being like, oh my God, it's almost my turn. I actually held the bottom of my seat to be like, do not run!

Kelli: You are doing this. I just forced myself to stay there and open up about what I was struggling with. And with that just (sigh) like came just a release of that. It was out in the open. I wasn't hiding this secret anymore. And I think it drew vulnerability through really opening up and sharing that I was able to move through the shame.

Mike: And your faith played a large part of that too.

Kelli: Yeah, for sure. The 12 step program was actually a Christ Center 12 step program, was started through my church. And I think I was so grateful for that because I don't know that I would've gone to a 12 step program had it not been under the umbrella of my church.

Kelli: Because I think there's still a lot of stigma about 12 steps, like that's for those people. And I was like, no. Like they say this is for someone with a hurt, a habit, or a hangup, and yep, I like got all that. (laughs)

Kelli: Like, right, like, I'm gonna go do this. And so I think that really helped me kind of crossover, into the 12 step programs, which I think are huge.

Mike: Yeah. Kelli, I'm seeing so many people right now who are experiencing stress and daily anxiety and depression.

Kelli: Yeah.

Mike: The mental health in this country is not great. That's what all the studies tell us. What are you seeing in your practice, first of all, and what do you find works for people?

Kelli: Yeah. I think, I mean, I agree.

Kelli: I think especially coming out of the pandemic, I mean, and being in the pandemic, I mean, I could have worked 24/7.

Mike: Yeah.

Kelli: I was just getting calls after calls, people just needing support. And I think one of the good things that come out of that was there was some, you know, some of the barrier to mental health support.

Kelli: You know, it was kind of broken down. People were just in such crisis they needed to do it. So I still see quite a bit of people wanting access, you know, they're pursuing it. But yeah, I think there is still a lot of mentality, especially in certain cultures of, well, we don't share that, that's, you know, we keep all this stuff within the family and, you know, sometimes our families aren't the healthiest and that's not always the best place to get that kind of support.

Kelli: But yeah, I still, I see a lot of people with anxiety, depression, relationship issues.

Mike: Is there a technique that you like to use? Whenever I go on a therapist's website, you're all skilled in a variety of different techniques. Is there one that you, is there one that you, for instance, I have one of my my partners likes EMDR a lot and is amazed that it works.

Kelli: Yeah.

Mike: She says there's other techniques that you go, wow, that actually worked.

Kelli: Yeah. Yeah. So I am a little eclectic too. I like to do a lot of different things, but my primary, I think modality is cognitive behavioral therapy.

Mike: Mm-hmm. Mm-hmm.

Kelli: CBT. Because I, I think the framework just makes so much sense to me because it's, you know, what we think impacts how we feel.

Kelli: And what we do. And that is also I find, you know, as a person of faith, like it's a very biblical like framework. Because in the Bible we know it says like, as a man thinks, so is he.

Mike: Mm-hmm.

Kelli: Right? And so what's going on in our head is really important and it impacts us.

Kelli: So, you know, really looking at that. So that's more of like the top down kind of process where we're using our logic and reasoning to kind of manage other issues. And I find that that works. In some I think that's like the psychoeducation. It gives you an initial relief.

Kelli: But then there's the bottom up approach. Working with the body, working with our sensations. That's also really needed because, I mean, I could tell myself, you're calm, you're calm. Like, we're calm. And my body could be like feeling outta control. So how do I help connect those two. And so I like to really kind of marry those sort of by like a top and bottom approach to it.

Kelli: But I think with families I think really like emotional focus therapy is really great. Like really I think a lot of. Families talk, talk, talk at each other and not to each other. I think there's not a lot of listening going on. I think people wanna be right and they wanna be heard, but they find it hard to set themselves aside a little bit, to really listen and understand where someone else is coming from. And so I think that is a huge, huge thing because people, feelings, okay, we know feelings aren't facts, but feelings are really important. And, you know, people like to kind of argue a little bit more.

Kelli: It keeps them up here in (holds hands to head height), in logic and reasoning instead of feeling towards their compassion, empathy, connection. And so really kinda helping them switch that a little bit.

Mike: I think working with families and couples is always so interesting because no matter how close you are to somebody, we all come at the world from different places.

Mike: We all interpret the world from different places.

Kelli: Exactly.

Mike: I have three kids, they couldn't be more different. They're a lot alike, but they all solve problems in different ways.

Kelli: Yeah. I think there's a lot of assumptions that that go on, right? Like we think, we assume we know them, what they're thinking, what they're going through, you know, but it's, but we gotta check those, right?

Kelli: We've gotta like ask the questions. How are you doing? You know, we've gotta listen and hear what's really happening, 'cause we could be way off. We know someone really well.

Mike: Well, and what works for me might not work for you too.

Kelli: Yeah, that's very true.

Mike: And so on your website, I'll let you get out with this, as you say, there is a way forward.

Mike: I love that quote.

Kelli: Yeah.

Mike: Talk about the way forward.

Kelli: The way forward. I think it's, you know, it can be different for everyone depending on where you are. But I think it's really going back to the one day at a time, one step at a time. I think really sharing with a trusted person in your life, what's going on for you, really.

Kelli: You know, you can't heal a wound that you say, isn't there, right. If we're holding onto things and ignore, you know, like we've gotta share. And I think, you know, really opening up and telling someone you trust what's going on for you, I think is a big step. And you know, really just sharing with others, getting connected with support, because I really found, you know, a lot of my growth was in community.

Kelli: And so I couldn't do it on my, I tried for years to do it on my own, you know? But I think really we need help. We need the support of other people. And so I think one way forward is asking for support. Sharing what's going on.

Mike: I should have asked you this at the be at the beginning too. You obviously take people in person.

Mike: Do you also work virtually?

Kelli: I do. Yeah. Yeah. And I'm licensed in California so I can really meet with anyone in the state. And it's been interesting after the pandemic, a lot of people like virtual.

Mike: Yes.

Kelli: It's so easy to do it from the comfort of your home or some safe space.

Mike: Well, and in a lot of the places, especially people we've interviewed, there is nobody in their community, so.

Kelli: Right.

Mike: You know in much of the country, there isn't a professional who services that area, so you're lucky if you live in a populated area.

Kelli: Yeah. Yeah.

Mike: I mentioned that because for those of you who know, we're gonna put the links to Kelli's website on our podcast. Kelli, thanks a lot for sharing your experience, your work.

Kelli: Yeah.

Mike: For those of you listening, as always, we hope you find hope, courage, support, wherever you are. As always, thanks for listening. Be safe and may you find a way forward, because as Kelli probably knows, just over the bridge, there's stuff like Ghirardelli chocolate.

Kelli: (holds up fist) Yes! Good thing.