Episode 3: Mindfulness Matters

 *Opening Music*  

Listen up, animal care pros, compassion fatigue is real, and I'm here to help you address it. I'm Alissa Hebert-Wallace, an LCSW with over 20 years in the field, and this is Pawsitive Outlooks. On the show we'll take a look at various aspects of compassion fatigue and compassion satisfaction, including general information, mental health aspects, self-directed interventions, and a few guests along the way. 

I want to start by acknowledging that I live, practice, and learn in the traditional unceded homelands of the Acolapisa, Chakchiuma, Choctaw, Ofo, and Yazoo people, who continue to be stewards of this land. I also acknowledge the Houma people who were driven from this territory and on whose settled, unceded land I was raised. I mourn the loss of the individuals and tribes that did not survive the colonization, genocide, and warring of European countries. Finally, I acknowledge that this information regarding tribal lands was primarily taken from colonizers' records. 

*Musical Interlude* 

All right, so here it is—the episode you've all been waiting for.  This is when we start to talk about some of those self-directed interventions that can help you to reduce the signs and symptoms of compassion fatigue. 

In this episode, we'll talk about mindfulness and expressive writing. But before we start, I'd like for you to take notice of your surroundings, not just look at them, but really notice them.  What are five things that you see?  Try to come up with at least one adjective for the object. 1..2...3...4...5... Now what are four things you can touch?  Notice the texture or the temperature of each. 1...2...3...4... What are three things you hear?  Can you distinguish them from each other? 1...2...3... What are two things you can smell? Are these pleasant or unpleasant odors? 1...2... And finally, what is one thing you can taste?  Yes, you can taste something, even if it's the lingering toothpaste from this morning or those onions you had with lunch. 1... 

Congratulations, you've just completed your first exercise in mindfulness!  Wasn't that easy?  What we just did was a grounding exercise, and it can be useful for bringing you back to center and back to focusing on the present.  We'll get to why that's important in a minute.  But first I'd like to tell you a little about mindfulness. 

So what is mindfulness?  It is the act of consciously focusing your mind on the present, with no judgments and no attachments. When we think about the habits that we have that we just run through all the time without thinking, even though we're in the present, that's not mindfulness, because we're not focusing our mind.  However, we can mindfully practice some of those everyday tasks.  Also, some activities that we think about being mindful or that we use for mindfulness are not necessarily always mindful. 

Mindfulness is a practice that is focused on the present moment, but it is not attached to the present moment.  When practicing mindfulness, we want to just be in the moment.  We want to hear the sounds, notice the smells, and use all of our senses to be present.  We aren't attached to the present, so we aren't thinking about the present as if “If I just think hard enough, this moment will last forever.”  That's not mindfulness.  We want to be focused without being attached. 

Mindfulness is also not focusing so hard on the present moment that we block out any other thoughts that might come into our mind.  True mindfulness practice allows those thoughts to come in, recognizes them in a non-judgmental manner, and lets them move on as they came.  The key here is being non-judgmental.  So in your mindfulness practice you don't want to...if another thought comes in...get down on yourself or beat yourself up because other thoughts came into your mind besides what you were doing for your mindfulness practice.  You want to let it come in, acknowledge or observe it, and let it go out just in the same way.  You also don't want to be judgmental of your thoughts.  So if a thought comes in that might be something that's not so positive or comes with a heavy emotion, you don't want to say “Darn!  I shouldn't be thinking that right now.”  You want to say, "I recognize this thought, I acknowledge this thought," and then let it go.  That can be difficult at first, but with practice being non-judgmental toward yourself and your thoughts will become easier. 

Mindfulness practice is the repeated act of bringing yourself back to the moment in a non-judgmental, non-attached way, and you may need to use a specific task or exercise to do so.  Mindful living, in contrast, becomes a way of living every day in the moment with your eyes wide open and grounded in the present.  Either in a dedicated practice or in living, mindfulness is not a place to go.  Mindfulness happens when we are living in the moment wherever we are.  It is noticing just this one step or this one breath.  Things might come up that might be difficult, and they may take our focus out of the present, but if that happens, we can step away.  We can notice it and we can move on.  Life might be difficult again, and we'll need to step back and notice and let it pass again.  When our mindfulness practice does become too difficult, or the intrusive thoughts become too much for daily mindful living, we can just stop, take a step back, and come back to our practice again at a later time or on another day. 

So what about those thoughts that sneak in when we're being mindful either in practice or in life?  Some pitfalls along with those thoughts include holding on to those experiences or actively pushing them away.  Some thoughts might arise that we want to hold on to, such as when the smell of baking cookies reminds us of grandma, or when that perfect sky we're observing reminds us of picnicking in college.  As much as you want to remain in those thoughts, they are taking you out of the present.  They're taking you away from being mindful.  So observe those thoughts, acknowledge them, and let them go. 

Now, on the other hand, we may experience some fear or anxiety when we think about the coming week.  Observe those thoughts as well, and let those go.  So don't try to think of something else to take the place of that thought, because research tells us that actively trying to block out thoughts does the exact opposite.  It keeps those thoughts at the front of our mind, which is not what we're looking for during mindfulness practices, right?  At first, the process of observing and letting go will take focus and practice, but as you begin to practice mindfulness, it is common to need to observe your thoughts take a step back and restart the process several times. 

Now let's think back to those daily habits and mindful activities.  Think about your daily getting ready routine.  Many folks start their day completing the same tasks every day, showering, brushing their teeth, putting on jewelry, putting on deodorant and getting dressed, etc, without ever thinking about any of it.  Of course, your morning routine like that isn't very mindful.  However, these can become mindful practices.  When you're in the shower, you can notice the temperature of the water and the feel of the water on your skin.  You can listen to the sound of the water as it hits different places in your shower, or you can focus on the smell of your shampoo and soap.  While you're brushing your teeth you can focus on the taste of your toothpaste or how the bristles of your toothbrush feel in your mouth.  If you use an electronic toothbrush, you can notice how it sounds. 

What about so-called mindful activities?  For instance, some folks like to color or focus on creating mandalas or other artwork.  If you are focused on how each color looks on the page or the sound of the crayon or pencil as you color in the picture, these can be very mindful.  But if you're simply passing the time and thinking about when you spilled your coffee down your shirt yesterday, or all of the meetings you have in the coming week, you're not practicing mindfulness.  Remember, it is in the fact of focusing on what is happening in the moment that makes it mindful, not just the act or activity. 

Now keep in mind that observing is not always easy.  In fact, at times it can be very difficult, especially for people with trauma histories.  This includes folks who have experienced secondary traumatic stress.  And we all know that one of the components of compassion fatigue is secondary traumatic stress.  I mean, if you listened to the other podcasts, that is.  You may be worried that some of the thoughts that come in as you're practicing mindfulness will bring up some heavy emotions like sadness, anger, or helplessness.  However, research has shown that observing such thoughts during mindfulness practices and then letting them go, rather than focusing on them, will actually prevent the negative feelings from being reinforced with that thought. 

OK.  So after hearing all of this, you might be thinking that mindfulness sounds a little touchy feely or a little new age, or like some homework that a therapist might give you.  Okay, so you might be right about that last one, but it is so much more. Research actually tells us that mindfulness has been associated with increased emotional regulation and increased activity of the brain in regions that are associated with positive, as shown in MRIs.  Mindfulness also contributes to enhanced immune response, decreased depression and anxiety, and a reduction in physical pain symptoms.  The practice has also resulted in decreased psychological distress and an increased sense of well-being.  Studies also indicate that mindfulness can support medical improvement, as in one study that showed that psoriasis was healed because of mindfulness or another that showed improved functioning of the immune system in patients with HIV.  Not so touchy feely anymore, am I right? 

And what does this mean for you in relation to your levels of compassion fatigue?  As noted earlier, continued non-judgmental awareness of experiences of secondary traumatic stress will result in your ability to notice and think of these experiences with less intense or little negative emotions attached to them.  Additionally, research has shown that participating in mindfulness exercises reduces the overall levels of compassion fatigue.  In one study, nurses using mindful breathing.  While those who practiced at the prescribed rate did have the highest results, even the nurses who practiced only a few days a week showed improvement in their levels of compassion fatigue.  Another study indicated that after just five days of instruction on a mindfulness and meditative program, veterinarians and veterinary technicians showed a significant decrease in compassion fatigue. 

Now let's put some of this into practice.  Be aware that these are not one and done exercises.  These are exercises that you will be able to use again and again as part of your mindfulness practices, including the five senses grounding exercise from the beginning of the episode.  Some of them do have scripts, and some are done on your own from the beginning.  Although you may need to come back and listen to the scripts several times, all of them are such that you should be able to practice them on your own as you continue in your mindfulness practice. 

I hope that you take the time to practice these exercises today, but I know life is busy and you might be listening to this podcast while you're driving or while doing other things that you just can't stop.  If that's you right now, let's make a deal that you'll come back and practice, OK? 

Just a note about the five senses exercise, you don't have to go in the order that I did or use all five of your senses every time you do the exercise.  What is important is that you do take time to stop and observe your surroundings, and that you mindfully take notice of your senses, and that you observe and let go of any thoughts that come into your mind, non-judgmentally and without attachment.  The same is true for the rest of the mindfulness practices we discuss today or any others that you might take up. 

The following exercise comes to us from Doctor Marsha Linehan as part of her DBT practice.  This is an exercise on awareness, and it includes several pieces that can be used together or separately.  I will read through all of them and talk more about each piece when we're done.  Don't worry, nothing's wrong with your sound. I'm just going to be using my best guided mindfulness practice voice. 

All right. 

Sit in a comfortable but attentive position...Keeping your eyes open, find a good place to rest your eyes.  Looking down with only slightly open eyes or keeping your eyes more open...You might want to clear the space in front of you so as not to be too distracted....See if you can let your attention settle into your center at the bottom of your breath when you inhale just near your gut...That very centered point is wise mind...As you breathe in and out...keeping your attention there at your very center...In your gut...Now as you keep your center of attention in your gut, expand your awareness outside...Noticing in the periphery of your vision the colors of the walls, or floor, or table, objects in the room....people nearby...maintaining all the while awareness of your gut...your center point, your wise mind. 

Now stay focused on your breathing in and out for three breaths...And maintaining your awareness of your breath expand your awareness to your hands.  Just holding both in your awareness for three breaths...Now expand your awareness even further.  Maintaining your awareness of your breath and of your hands.  Include in your awareness sounds.  Staying aware of all three for three breaths...Letting go of perfection...If you lose awareness of one...And starting over again. 

Imagine you are sitting on a hill near train tracks watching train cars go by...Imagine that thoughts, images, sensations and feelings are cars on the train...Just watch the train cars go by...Don't jump on the train...Just watch the train cars go by...If you find yourself riding the train, jump off...And start observing again...Just noticing that you got on the train...Watching the train cars. 

Watching your mind again...Imagine that your mind is the sky...And that your thoughts, sensations and feelings are clouds...Gently notice each cloud as it drifts or scurries by. 

And we're back. 

The first two pieces, awareness of center and awareness of three breaths are useful for building focus during mindfulness practices.  Additionally, when you begin to notice sounds while you breathe, it is important to not label these sounds, but to simply observe them.  For example, that whirring sound is just that, a whirring sound, not the AC or the fridge running.  And those little peeps and chirps are just that, little peeps and chirps, not birds.  This is true in practicing any mindfulness practice.  For the section including observing train cars, those can be anything that pass you like cars or boats or even animals. 

The next exercise comes from the creators of mindfulness based cognitive therapy.  This is the same breathing exercise prescribed to the nurses in the previously mentioned study.  In this exercise, you will note your breathing and your thoughts for a total of 3 minutes.  During the first minute, simply observe your thoughts as if you were watching them on a screen, either at the movies or in your home.  In the second minute, you will leave this observation area and focus on your breathing and where you feel it in your own body, such as your nose or mouth, your throat, or your lungs.  Finally, in the third minute, you'll focus your awareness to sensations you feel throughout your body, such as your legs in the chair, your hands in your lap, or even that itch on your elbow.  In the beginning you might want to have a clock or a timer nearby so that you can see each minute without stopping the exercise.  As you continue this practice, you should be able to feel the approximate length of time, even if it's not exact.  I'll give you some time to practice this now. 

*Action Music* 

All right.  How was it?  The great thing about that breathing exercise is that you can do it anywhere, at any time.  Don't have 3 minutes?  I know sometimes life can be like that.  You won't even have 3 minutes.  Practice for 30 seconds each or take some time to do just one part.  Of course, the most benefit will come with the entire 3 minutes, but even a condensed version or one piece will help you to ground and refocus. 

In the final mindfulness exercise today, you're going to use your imagination and observation skills.  First, I want you to grab a healthy snack. I'll give you some time to get it so that we can go through the exercise together. 

*Action Music* 

All right, got one? Good. First, look at your snack as if you have never ever seen one of those before.  Notice the colors and the textures of your snack.  What happens if you squeeze or otherwise manipulate it with your hands?  Does it have a smell?  What about if you cut it open or break it open? Are the colors and textures and smell the same on the inside as the outside?  Now take a bite of your snack.  Is it soft or chewy or crunchy when you bite it?  How does it feel in your mouth?  Is it juicy or is it dry?  How does it taste?  Is there a sensation when you swallow it?   

This exercise can be done anytime you eat anything.  It will bring your focus into what you are eating rather than all of the stressors and other thoughts floating around in your head.  And as we talked about before, as thoughts come in and you feel yourself returning to mindless eating—which is what we do most of the time—you can let those thoughts pass and remind yourself to focus on what you're eating.  Mindful eating or other tangible tasks can sometimes be easier at the start of mindfulness practice, rather than focusing on breathing or on imaginary trains.  When you have something tangible, you can observe your thoughts and turn back to the task at hand, observing the experience of completing that task with each of your senses.  Also, you can practice just about any task mindfully.  Remember that mindful morning routine?  Try that the next time you're getting ready for work. 

So just to review, mindfulness is a practice in which you focus on the present in an unattached and non-judgmental way.  Also, any of the thoughts outside of the present moment that come in, you can simply observe those thoughts and let them move on just as they came in a non judgmental way. 

*Musical Interlude* 

Expressive writing was developed as a therapeutic technique by Doctor James Pennebaker of the University of Texas, although he notes that he is not a therapist but a researcher.  His first experiment took place in the mid 1980s after discovering the detrimental health effects of keeping traumatic events or other important issues, such as sexuality or gender identity, to oneself.  In the original study, participants were asked to either write about superficial topics or about traumatic experiences or major life stressors for 15 minutes a day on four consecutive days.  Although the experience of writing about personal, traumatic, or stressful events proved to be emotionally trying, the participants continued to return, many of them expressing how important the experience had been for them.  In the months following the experiment, those who participated in what we now know as expressive writing sought medical treatment at almost half the rate of those who wrote about superficial topics. 

Since that original experiment, hundreds of studies have been conducted on the benefits of expressive writing.  In addition to overall improved physical health, the practice has proven to be effective in several areas of both physical and mental health.  Physical effects include improved immune response, a decrease in chronic health symptoms in everything from irritable bowel syndrome to cancer, and a decrease in the physiological stress indicators such as muscle tension and blood pressure.  Although individuals may feel worse immediately after writing, this effect is normal, and long-term mood enhancement is a typical result.  Expressive writing has also shown behavioral improvements, such as improved working memory or enhanced social relationships, both of which can lead to improved social, educational, and employment functioning.  Concrete positive outcomes include students achieving better grades and unemployed persons securing jobs quicker. 

So what does this mean for you directly?  Well, research has also been conducted on the effects of expressive writing on euthanasia related stress, one of the components of veterinary compassion fatigue.  In one small scale illustrative study, animal shelter workers who were exposed to or participated in daily euthanasia were given writing prompts and time to write.  All but one of the participants reported a positive reaction to the experience.  The long-term effects of the exercise were not recorded, however, so it is unclear if this participant noted improved functioning despite their initial negative response.  On the other hand, this participant’s response may simply illustrate that expressive writing isn't for everyone. 

Research shows that certain methods of framing or technique may be more beneficial than others, while some don't affect the process at all.  While the thought of recording one's thoughts had little effect on the outcome of the exercise, the actual or potential sharing of the exercise—not the experience, but the exercise—heightened negative emotions rather than decreasing them.  Additionally, even proximity to professional helpers altered the effects of expressive writing.  Those who saw the most benefit completed writing exercises away from professional helpers rather than with them.  Finally, keeping the writings either in a journal or a computer file had no significant difference from writing and shredding, deleting, or otherwise erasing the entry.  And speaking of computer files, there has been little difference in the effects of typing or writing by hand. 

Researchers have also found that some methods of writing do have an effect on the potential benefit of expressive writing.  First, it is important that the writer acknowledges and labels the positive and negative feelings associated with the stressor or the trauma that is the subject of the writing. Ignoring the emotions associated with the event only provides a piece of the puzzle.  As Doctor Pennebaker states, “emotional experience is a part of trauma.”  Also, when writing, it is important to create a coherent story, often following a trauma or stressful life event, emotions and even recollection may seem disjointed or incomplete.  One of the benefits of expressive writing is in creating a complete story.  Some say that this is because our brains are hardwired to create narratives to help us make sense of our world.  Studies also indicate that attempting to view the narrative from another's perspective is beneficial, and that those who write in the third person have also shown positive effects.  Lastly, it is important to write in your own voice and to write openly and honestly.  Remember, there is no potential audience other than yourself.  You are not writing to impress as you would if writing for a publication or even a newspaper article. You are writing to reap the benefits of expressing trauma or life stressors. 

Before we go into some expressive writing exercises, it is important to note some concerns with expressive writing.  After all, this isn't a magic pill, right?  One minor concern is that one might lose control when writing about a particular subject.  Although there is little concrete evidence of this, remember this one rule.  If you think there is danger in losing control when writing about a particular topic, don't do it.  Maybe revisit it at another time.  If you do feel yourself entering crisis mode while writing, it's okay to stop.  If you need to talk with someone, please contact any of the supports listed at the end of the episode.  Another slight concern is over-analyzing or becoming obsessive with the topic you're writing about.  If you feel that you're not making progress after several sessions of writing about a particular topic, you may need to reframe or take a break.  A more moderate concern is the risk of someone else reading your writings and using them in a harmful way.  If you have any concerns that someone else may find your writings, delete or destroy them. Remember, people who did not keep their writings saw the same benefits as those who did.  Also, if you are using an electronic means of expression, be careful that your writings are not automatically shared or stored where there is shared access.  A final concern is the potential for life-changing effects.  Although participants credit writing with an overall positive change, the cost of these changes can be dramatic and may seem high at the outset, such as leaving a job or a relationship.  When inner conflict is addressed, the course of your life may change and have unintended effects on you and others in your life.  Again, if you feel you need to speak with a professional, I will provide some resources at the end of the episode. 

Now, are you ready to jump into writing?  Let's talk about a few more things first.  How often should you write?  Try for about 20 minutes at a time, but there is nothing set in stone that you need to write on consecutive days or for how many days at a time.  Some folks have written for four consecutive days on a certain subject, and some have undertaken longer stretches like six weeks. One study indicated that some benefits have been achieved with as little as two two-minute writing sessions.  Another way to think about it is like medicine.  There's no need to take aspirin when you don't have a headache, right?  There's no need to continue writing if you're feeling fine, but you might need a booster every now and then, or you may recognize another stressor that needs attention.  Also, you may be wondering if you should use a journal or not.  That is strictly up to you.  Remember, keeping the writings did not have a significant difference on the positive effects, and if there is a danger of someone else finding your journal, it may be best to destroy your writings after you've done them. 

Lastly, what should you write about?  You can write about the things that keep you up at night, or some experience you've had that are relevant to your present.  That said, you may find that it is too soon to write about a severe trauma that has recently occurred.  You may need time to be ready to deal with some of the deep emotions that come with addressing it.  Write about only stressors or traumas that are present in your mind, don't go searching for repressed memories here.  If something comes up during the process, then by all means write about it, but don't go searching.  Finally, trust yourself.  If you start out writing about the event that happened when you were a teenager and end up having written about something that happened last month, go with it.  It's all part of the process. 

In preparation for expressive writing, you'll want to ensure that you will have uninterrupted time for the exercise, and that you will have a period for reflection after each writing exercise.  Additionally, consider that you may be emotional or emotionally drained following the writing reflection, so consider what you have scheduled immediately after your planned time.  Similarly, you should consider the space in which you will write.  Ideally this will be a private relaxing space in which you are comfortable.  Also, use a method that is most comfortable to you.  It might be using different colored pens in a journal, using some electronic medium, or writing on loose paper then shredding it.  Wherever, whenever, and however you choose to write. Remember Dr. Pennebaker's quote "Flip Out Rule: If you feel that writing about a particular topic is too much for you to handle, then do not write about it.  If you know that you aren't ready to address a particularly painful topic, then write about something else.  When you are ready, then tackle the other topic.  If you feel that you will flip out by writing, don't write." 

Now I've pulled together a few writing prompts for you.  Feel free to try them all, or don't use any. Expressive writing is a personal exercise, not an assignment.  You don't even need to use proper grammar unless something that's important to you.  Unlike other interventions featured in the podcast, because of the nature of expressive writing and all of the things we just talked about, I am not asking you to engage in these exercises right now or at all, but I just want to give you a few prompts that may be helpful if you choose to participate in expressive writing.  Although some of these prompts may ask you to write about a specific topic, remember that's all part of the process.  You might find your mind moving to other life stressors or past traumas, and that's OK.  Thinking back to the mindfulness information, if you actively try to shut out thoughts, you may find yourself even more focused on them.  And that's not what we want from expressive writing. 

One more thing, these are personal writings for your eyes only.  Remember, we talked about destroying them if you need to.  They shouldn't be addressed to anyone else either.  If you do find yourself wanting to write a letter to someone, do so outside of your expressive writing time.  Maybe wait until after you're done having processed the experience. 

Now for the prompts. 

*Action Music* 

Writing prompt #1: This is directly from the case study conducted with the animal shelter workers.  For this exercise, you will write about work-related stressors over a period of two weeks.  While the participants focused on euthanasia, that may not be your focus.  Try to write for 15 minutes every three days, followed by a brief reflection period. During the two weeks, you should have five sessions. 

Writing prompt #2: This one is based on the original expressive writing study.  With this prompt you will write for 20 minutes a day for four consecutive days.  The topic for this prompt should be a traumatic event or a major life stressor, especially if it is something that you have been keeping to yourself.  Once you start writing, don't stop until your 20 minutes are up.  You may find that you write for more than 20 minutes, and that's great.  It doesn't take any time from the next day, though, we are aiming for 20 minutes over four days, not a total of 80 minutes.  The first day might be the most difficult and on the 4th day you should be able to tie things up.  If not, consider adding another day or two to the exercise. 

Writing prompt #3: This one goes way back, like to the beginning of modern psychology back.  William James, one of the founders of modern psychology, believed highly in stream of consciousness writing.  So that's what you'll try with this one.  Write for either 10 minutes or until you've filled about two pages.  For this prompt, you won't focus on a specific topic.  Just write about whatever comes to your mind for 10 minutes.  The idea here is that although your thoughts may appear to be random, they are indeed connected.  Also, we can only have one thought at a time.  Remember those mindfulness exercises? Going back over your stream of consciousness writing may reveal a pattern to you, and both what we think about and actively avoid thinking about are important.  This method may also be helpful if you find yourself having trouble writing or writing about a particular thing.  You might start out with “Today I'm going to write about blank.  Why am I having trouble writing about blank?” and see where that takes you. 

Writing prompt #4: This is another prompt that can be used alone or as part of a longer exercise.  You'll also be writing for about 10 minutes here, but this time you will actively be trying to use words that evoke a positive response, such as happy, strong, laughter, dignity, humor, inspiration, thankful, or satisfied.  You can also use any negative words that come to mind but try to use as many positive ones as you can.  You might find it helpful to have a list of positive thought-provoking words. 

*Action music* 

I'd like to leave you with some reflection prompts provided by Doctor Pennebaker.  These are helpful to measure any changes you note from completing individual expressive writing exercises.  So if you're writing for four days, do this every day.  If you're writing for 15 minutes over 2 weeks, again, do it every day.  And unlike your actual expressive writing, you can keep these notes without worry, as they won't include any personal information.  Now first rate the following questions from zero being not at all to 10 being the greatest effects.  How sad or upset do you feel right now?  How happy do you feel right now?  How valuable do you feel today's writing time was?  Did you express your deepest thoughts and emotions?  After you ask yourself those questions, describe how your writing went so that you can look back on your process and your progress. 

Trust the process and trust yourself.  Use what works and forget what doesn't. Write every day or write once a week. Write for 20 minutes or two minutes.  The most important thing to remember about expressive writing is that it is only helpful if you are moving to a better space. 

And that is for you to decide. 

*Musical Interlude*  

Compassion fatigue can have a detrimental effect on our mental health. If you need mental health assistance, please contact Not One More Vet at nomv.org. If you need to speak with someone right now or feel you are having a mental health crisis, please call the US National Crisis Line at 988 or visit nomv.org/crisis-numbers outside of the US. Please seek immediate assistance by calling 911 or your local emergency number if you feel unsafe. 

This has been Alissa Hebert-Wallace with Pawsitive Outlooks. If you enjoyed the show, hit that follow or subscribe button, tell a friend, and leave a review wherever you access podcasts. Also, your feedback is always welcome, just click that link in the description. 

Thanks for listening, and we'll see you next time. 

*Closing Music*