Tag Archives: management

SAMHSA’s 8 Dimensions of Wellness

20 Aug

From samhsa.gov:

A Holistic Guide to Whole-Person Wellness

For people with mental health and substance use conditions, wellness is not the absence of disease, illness or stress, but the presence of purpose in life, active involvement in satisfying work and play, joyful relationships, a healthy body and living environment, and happiness.

Wellness means overall well-being. It incorporates the mental, emotional, physical, occupational, intellectual, and spiritual aspects of a person’s life. Each aspect of wellness can affect overall quality of life, so it is important to consider all aspects of health. This is especially important for people with mental health and substance use conditions because wellness directly relates to the quality and longevity of your life.

That’s why SAMHSA’s Wellness Initiative encourages you to incorporate the Eight Dimensions of Wellness in your life:

Emotional—Coping effectively with life and creating satisfying relationships

Environmental—Good health by occupying pleasant, stimulating environments that support well-being

Financial–Satisfaction with current and future financial situations

Intellectual—Recognizing creative abilities and finding ways to expand knowledge and skills

Occupational—Personal satisfaction and enrichment from one’s work

Physical—Recognizing the need for physical activity, healthy foods and sleep

Social—Developing a sense of connection, belonging, and a well-developed support system

Spiritual—Expanding our sense of purpose and meaning in life

 

8dimensions2

 

 

“Top Ten Mental Health Apps” by Sandra Kiume

17 Aug

From Psych Central:

With so many apps on the market, it’s hard to know which are useful.

Many are designed by software developers instead of psychologists, without scientific testing. They range from beneficial, to harmless but useless, to bordering on fraudulent.

The apps selected for this list make no hucksterish claims and are based on established treatments. Progressive Muscle Relaxation, for example, has been used for a century and is likely just as effective in this new medium. Knowledge from Cognitive Behavioral Therapy and Dialectical Behavior Therapy enrich two apps on this list. Others mix solid information with ingenuity.

Don’t forget to download the free PsychCentral app to keep up with the latest mental health information.

1. BellyBio

Free app that teaches a deep breathing technique useful in fighting anxiety and stress. A simple interface uses biofeedback to monitor your breathing. Sounds cascade with the movements of your belly, in rhythms reminiscent of waves on a beach. Charts also let you know how you’re doing. A great tool when you need to slow down and breathe.

2. Operation Reach Out

Literally a lifesaving app, this free intervention tool helps people who are having suicidal thoughts to reassess their thinking and get help. Recommended by followers of @unsuicide, who report that this app has helped in suicidal crises. Developed by the military, but useful to all. Worth a download even if you’re not suicidal. You never know if you might need it.

3. eCBT Calm

Provides a set of tools to help you evaluate personal stress and anxiety, challenge distorted thoughts, and learn relaxation skills that have been scientifically validated in research on Cognitive Behavioral Therapy (CBT). Lots of background and useful information along with step-by-step guides.

4. Deep Sleep with Andrew Johnson

Getting enough sleep is one of the foundations of mental health. A personal favorite I listen to all the time, this straightforward app features a warm, gentle voice guiding listeners through a Progressive Muscle Relaxation (PMR) session and into sleep. Features long or short induction options, and an alarm.

5. WhatsMyM3

A three minute depression and anxiety screen. Validated questionnaires assess symptoms of depression, anxiety, bipolar disorder, and PTSD, and combine into a score that indicates whether or not your life is impacted significantly by a mood disorder, recommending a course of action. The app keeps a history of test results, to help you track your progress.

6. DBT Diary Card and Skills Coach

Based on Dialectical Behavior Therapy (DBT) developed by psychologist Marsha Linehan, this app is a rich resource of self-help skills, reminders of the therapy principles, and coaching tools for coping. Created by a therapist with years of experience in the practice, this app is not intended to replace a professional but helps people reinforce their treatment.

7. Optimism

Track your moods, keep a journal, and chart your recovery progress with this comprehensive tool for depression, bipolar disorder, and anxiety disorders. One of the most popular mood tracking apps available, with plenty of features. Free.

8. iSleepEasy

A calm female voice helps you quell anxieties and take the time to relax and sleep, in an array of guided meditations. Separately controlled voice and music tracks, flexible lengths, and an alarm. Includes a special wee hours rescue track, and tips for falling asleep. Developed by Meditation Oasis, who offer an great line of relaxation apps.

9. Magic Window – Living Pictures

Not technically a mental health app, it makes no miraculous claims about curbing anxiety. However, there is independent research indicating that taking breaks and getting exposure to nature, even in videos, can reduce stress. This app offers an assortment of peaceful, ambient nature scenes from beautiful spots around the world.

10. Relax Melodies

A popular free relaxation sound and music app. Mix and match nature sounds with new age music; it’s lovely to listen to birds in the rain while a piano softly plays.

 

http://psychcentral.com/blog/archives/2013/01/16/top-10-mental-health-apps/

Eleanor Longden: The Voices in My Head (TED Talk)

10 Aug


From an interview with Jon Ronson in The Guardian:

“Owing to a series of childhood traumas, I was a very anxious and unhappy teenager, and the voice’s methodical observations started to feel like a reminder that in the midst of crushing unhappiness and self-doubt, I was still carrying on with my life and responsibilities. I even wondered whether other people had similar commentaries but just never talked about it.”

“I…started making links between my emotions and the voice, and by putting this theory to the test, had achieved some positive results. In this instance, I’d stood up to another student in a particular seminar group who used to put me down a lot – usually, if I tolerated it, the voice would sound irritated, but when I was assertive and defended myself, it returned to its normal, calm tone.”

“[W]hat what research suggests is that voice-hearing (and other unusual experiences, including so-called delusional beliefs) are surprisingly common in the general population. This recognition has led to the popularity of ‘continuum models’ of mental health, which suggests different traits and experiences are all part of human variation – not strictly categorical in terms of ‘us and them,’ ‘sane and insane,’ ‘normal and abnormal.’ However, I do think life events play a vital role in determining who becomes distressed and overwhelmed and who doesn’t. This might include experiences of abuse, trauma, inequality, powerlessness and so on, but it can also include the immediate reactions of the people around you. If you don’t have people who will accommodate your experiences, support you, and help you make sense of what’s happening, then you’re probably much more likely to struggle.”

“For me personally, an analogy for all this is ‘a psychic civil war’. You start taking a blaming, negative stance towards your own mind. And the more I began to become fearful and resistant towards the voices (shouting at them, trying to drown them out, being abusive towards them) the more persistent, intrusive, and aggressive they became. I explore this concept in a lot more detail in the TED Book, but it has been neatly summarized by Marius Romme, co-founder of the Hearing Voices Movement: voices are messengers that carry important messages about genuine problems in the person’s life. Therefore it simply does not make sense to ‘shoot the messenger’ and deny the content of the message. My voices embodied all my (considerable) emotional problems.”

“Our society is given extraordinarily pessimistic messages about ‘schizophrenia’ (even though, as I discuss in my TED Book, the concept of schizophrenia as a valid entity is very problematic and contested) and in turn it can fill people with an overwhelming amount of hopelessness about themselves. Of course, everyone’s recovery story is unique and different, just as our experiences are. But I think a crucial part is providing hope, information, and choice. And being given opportunities to make sense of what’s happening to you, and what can be done about it: if passive drugging, sedation, and silencing is the cure response, then an active understanding, exploration, and integration of the emotional and social meaning of the person’s experience is the recovery response. But my own feeling is that things would never have got as bad as they did if I’d had someone available from the beginning to help de-escalate this crisis in a more positive way.”

“In my own case, I believe the reason I began hearing voices had to do with traumatic life events, and this was a separate issue that certainly needed to be dealt with. But what actually happened was that I ended up on the Schizophrenia Scrapheap – diagnosed, drugged, discarded, and with all the problems that had driven me mad in the first place still unprocessed and unresolved. Plus a whole burden of new difficulties, in terms of stigma, discrimination, medication side-effects, and a crippling sense of hopelessness, humiliation and despair about myself.”

“It was a complex process and happened gradually – and some voices took longer to change than others. But primarily it was when I stopped attacking and arguing with them, and began to try and understand them, and relate to them more peacefully. It was about putting an end to the internal civil war I mentioned earlier, because each of them was part of a whole – me! I would thank them for drawing my attention to conflicts I needed to deal with. I remember one very powerful moment, several years down the line, when I said something like, ‘You represent awful things that have happened to me, and have carried all the memories and emotion because I couldn’t bear to acknowledge them myself. All I’ve done in return is criticize and attack you. It must have been really hard to be so vilified and misunderstood.’ There was an immensely long pause before one of them finally responded: ‘Yes. Thank you.'”

http://www.theguardian.com/technology/2013/aug/08/ted-talk-eleanor-longden-schizophrenia

Things Not to Do When the Carnival Kicks in**

6 Aug

**See stand-up comic Doug Stanhope’s profanity-laden description of the carnival below.

1. Watch that macabre shit I usually love so very very much: The Killing, Twin Peaks, American Horror Story, and trashy, increasingly unwatchable True Blood. NO horror movies or psychological thrillers–they invariably include trauma and family dysfunction, and they sometimes make me speedy.

2. Participate in social media. Don’t broadcast the crazy. Also, online exchanges can provoke me.

(Case in point: last night’s horrifying parlay with random militant antipsychiatrist on Mad in America’s site. She kept putting quotation marks around  the words “mental illness” and “schizophrenia.” I feel like antipsychiatrists are the Tea Party of the mental health community: whatever valid arguments they have are vitiated by polarized thinking, a persecution complex, and snarky insistence that anyone with a different viewpoint is “drinking Kool-Aid.”)

3. Talk to people who can drain or trigger me.

4. Make irreversible decisions about anything long-term or important.

5. Tell my husband he’d be Better Off Without Me.

6. Drink caffeine (okay, one cup in the morning unless the anxiety’s really bad).

7. Watch or read the news.

8. Forget to eat.

9. Eat poorly, as in processed food, takeout food, high fructose etc.

10. Stay up too late.

11. Wake up too late.

12.  Fall down the rabbit hole of deconstruction.

13. Allow it to win.

“Mind over Mood: Recovery Refresher” by Stephen Propst

26 Jul

From BP Magazine:

 

Over the past five years, “Mind over Mood” has provided practical, recovery-oriented approaches to managing bipolar and maintaining balanced living. We’ve examined everything from sleep and self-esteem to wellness workouts and mental makeovers. Now, it’s time for a refresher. Here, from previous columns, are 20 of the most recurring themes and best strategies for keeping on course, when it comes to helping yourself or someone you love who’s on the road to recovery.

SELF-INVENTORY: Every now and then, it’s a good idea to take inventory of your thoughts, emotions, beliefs and behaviors, and ask yourself where there’s room for improvement. Doing so may provide some insight, which is crucial to recovery and a better quality of life.

THINKING: What you think and believe impacts your self-esteem, your well-being and your recovery. In the midst of mania, thinking you are indestructible can have devastating consequences. In the depths of depression, believing that your situation will never improve can put you into a deeper slump. When you have a twisted thought or backward belief, stop and restate the remark more realistically. Change “I’ll never get better” to a resounding “I can recover!”

PERSPECTIVE: Are you guilty of looking at the glass half empty, rather than half full? Do you find yourself thinking that you’ll never get better or never achieve your dreams? When you actively adopt a more positive outlook, that step alone brings wellness into closer reach. A change in perspective begins by focusing more on possibilities and less on problems.

IDENTITY: Having a mental illness is not easy, and it doesn’t help matters to define yourself as the illness. Identifying with your symptoms while ignoring everything else that makes you unique makes no sense. Don’t let bipolar become the sole focus of your life, because there’s so much more that’s singularly sensational about you.

SENSITIVITY: As someone with bipolar, it’s easy to let even the smallest things get to you. And wearing your emotions on your sleeve can thwart recovery as well as hurt your relationships. If you develop a Teflon-like outer shell that allows some of the small stuff to slide, you’ll eliminate a lot of stress and have fewer messes to clean up.

LAUGHTER: Laughter is an excellent prescription for better health. It reduces stress, wards off illness, and helps us manage pain. It also provides a feel-good outlet for pent-up emotions. Make a commitment to laugh out loud each and every day. I can always tickle my funny bone by spending time with friends who make me chuckle.

ANGER: Allowing your anger to get the best of you can lead to hostile, aggressive behavior with regrettable consequences. If you are having trouble controlling your anger, seek out help from your therapist or a professional who specializes in anger management.

SELF-ESTEEM: When bipolar disorder coexists with low self-esteem, a vicious cycle can occur. Poor self-esteem creates anxiety and stress, which negatively affects your stability. High self esteem gives you a more solid foundation from which to manage bipolar, work on your recovery, and move on with your life. Therapy can be invaluable in helping you accept yourself for who you are.

CHANGE: Even if you recognize that you need to take steps to improve your situation, you may become paralyzed out of fear that you might go too far down the wrong path. Once you know that you want to make the changes necessary to reach your full potential, trust yourself to take a step in a new direction.

STRESS: Use stress to your advantage. Instead of letting it wear you down, turn it into a catalyst for building strength, stability, stamina, and self-esteem. When you learn to control your reaction to the source of stress, you turn stressful situations into opportunities for growth.

SLEEP: Getting plenty of sound, restful sleep positively impacts the brain’s capacity to control emotions, handle decision making processes and govern social interactions. The better you manage your sleep, the better you’ll manage your mood.

MEDICATION: The right medication is an essential ingredient in recovery, but it’s not the only one. Drugs are no panacea. A prescription is not going to teach you effective behaviors or generate positive reinforcers. If you must, seek professional help to change false assumptions and beliefs or negative thinking.

SUPPORT: Support groups can be a safe harbor in the midst of a storm. They offer the opportunity for people with a common burden to provide mutually beneficial encouragement for one another. Explore support groups in your community, for a safe environment for sharing thoughts, gaining new insights and renewing hope.

MINDFULNESS: A total wellness workout means minding both mood and muscle. It means tackling triggers as well as working out with weights. And it means sleeping well and eating right. Only when you pay attention to both mind and body can you look and feel your best.

FEAR: There are times when fear may keep us from participating fully in life. Once we realize that fear is a state of mind, we can choose to face our fears, change our minds, and create the life we want to live. Start by separating what you desire from what you fear. For example, don’t let the fear of trying a new medication keep you from finding one that might have fewer side effects. Sort out your thinking, and stay focused on your goal.

PATIENCE: We all want immediate results, but with bipolar disorder there simply are no quick fixes. Counting on a miracle cure will only cause frustration. The road to recovery is not a straight shot; it’s a winding path with delays and detours. Progress can be made, but it takes time. So let patience be your guide. And here, some tips for loved ones and others who make up the important support networks for those with bipolar.

UNDERSTANDING: Educate yourself about the illness and try to understand its implications on your loved one’s life. Armed with knowledge, you’ll be better equipped to offer the kind of encouragement, motivation, and support that can make a world of difference.

COMMUNICATION: Before you “fire away,” take a moment to consider how what you say may have an effect on someone with bipolar. Choosing your words carefully can strengthen relationships, fuel recovery, and make for a better quality of life for everyone.

NURTURING: If you care for someone with bipolar, don’t forget to take care of yourself, as well. You won’t be of any service to anyone, if you get exhausted or sick. So, take a deep breath, be easy on yourself and don’t believe it’s solely your responsibility to turn things around and make everything right.

HOPE: If there is one piece of advice for anyone who cares for or about someone with bipolar disorder, it is this: keep the faith and never give up. Many times in my life I had nothing to fall back on but hope (and the fact that I am still writing this column is living proof that it kept me going). So, let your hope for a loved one spread—it’s contagious!

Remember, you don’t have to squash your appetite for a rich, satisfying life. Using the right recovery tools can help you function productively, cultivate meaningful relationships and feel better through and through.

 

http://www.bphope.com/Item.aspx/637/mind-over-mood-recovery-refresher#.UfINf83iz7Q.twitter

 

“The Role of the Family in the Course and Treatment of Bipolar Disorder” by David J. Miklowitz

22 Jul

Curr Dir Psychol Sci. 2007 August; 16(4): 192–196

 

Abstract:

Bipolar disorder is a highly recurrent and debilitating illness. Research has implicated the role of psychosocial stressors, including high expressed-emotion (EE) attitudes among family members, in the relapse–remission course of the disorder. This article explores the developmental pathways by which EE attitudes originate and predict relapses of bipolar disorder. Levels of EE are correlated with the illness attributions of caregivers and bidirectional patterns of interaction between caregivers and patients during the postepisode period. Although the primary treatments for bipolar disorder are pharmacological, adjunctive psychosocial interventions have additive effects in relapse prevention. Randomized controlled trials demonstrate that the combination of family-focused therapy (FFT) and pharmacotherapy delays relapses and reduces symptom severity among patients followed over the course of 1 to 2 years. The effectiveness of FFT in delaying recurrences among adolescents with bipolar disorder and in delaying the initial onset of the illness among at-risk children is currently being investigated.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2184903/?report=classic

 

 

Protecting Your Psychic Space

15 Jul

I have a very bad habit of letting negative people into my life and tolerating their toxicity. This is not good for anyone, but it is actually dangerous for those of us with mental health issues because such people throw us off balance and sap us of emotional energy that we need to take care of ourselves. They can also be triggering as hell.

One trait PTSD and mood disorders share is sensitivity. We are finely tuned to our emotional environment. There are potential benefits to this, such as empathy and strong communication skills. But if you don’t protect your psychic space, as certain as a shark loves blood, serial victims and emotional vampires will gravitate towards your openness and vulnerability. They will prey upon your empathy. They will suck you dry. And you can’t get and keep your shit together if you allow that to happen.

I’ve culled people who triggered breakdowns, who exploited everything they knew about my past and my symptoms to hurt and control me, and who caused me moral distress by expecting me to turn a blind eye to, if not actively enable, dysfunctional and abusive behaviors. I used to think that ridding my life of such individuals would be a finite process, but like most things relating to my mental health, I am discovering that it’s ongoing and requires a fundamental shift in my perspective and MO. Removing the toxic people I know is only the first step. I must also learn to identify and protect myself from the ones I encounter. Until I do that, all of my efforts towards recovery are futile.

If you have mental illness, especially PTSD or a mood disorder, clean your house, and keep it clean. You won’t be able to achieve anything close to stability otherwise.

Here is an overview of the usual suspects who crop up in my life. It’s not an exhaustive list and the categories are by no means mutually exclusive. Speaking from my own experience, beware the following:


The Bottomless Pit of Need

I have found this is the most common variety of toxic individual, and one to whom I easily fall prey because I feel loathe to judge. I too have been in crisis more times than I care to count. I too have felt that the whole world was against me and there was nothing I could do about it. I’d venture to say that everyone who grapples with mental illness can relate to this on some level. We all need help sometimes, and if someone is working towards addressing the problem, there is nothing wrong with giving them a hand.

But Bottomless Pits of Need do not address problems. They do not desire or seek agency. Instead, they embrace and wallow in their helplessness while harvesting as many resources (e.g. emotional support, favors, money) from you as they can.

Don’t Get Fooled: Occasionally, a Bottomless Pit of Need will seem to rally and try to cast off their self-forged shackles so that they can live a life of decency and self-respect. Once in a blue moon, this effort is genuine, and if the BPoN commits to change they may redeem themselves. Nine times out of ten, however, such essays are nothing but ephemeral, illusory attempts to keep you around so they can continue sucking you dry. Should you encounter a seemingly contrite BPoN, keep your distance until you are convinced beyond the shadow of a doubt that they are truly reformed. When in doubt, shut them out.


The Drama Magnet

There are two types of Drama Magnets. The most well known type is the person who endlessly pursues and manufactures crises, catastrophes, and interpersonal strife. Writer Suzan Bond refers to these individuals as Drama Creators. Many of them have been raised in chaos and now cling to it because it is familiar. They often do it to obfuscate the overarching issues that are fueling their behavior. It is also a handy method of control because the Drama Magnet’s crisis du jour will always take precedence over whatever else is going on.

Don’t Get Fooled: There is little hope for Drama Creators. As uncharitable as it sounds, the truth is that such behavior is usually pathological and unlikely to change. These people can ruin your life in a mind-boggling multitude of ways. Eliminate them. Extricate yourself. Run for the fucking HILLS.

Bond calls the second type Drama Allowers: people who let the Drama Creators in and don’t evict them from their lives. I am currently escaping from this category. We don’t seek out or actively cause drama, but we don’t take the necessary steps to protect ourselves from it, so it follows us wherever we go. Many of us have become so used to this state of affairs that we think it is simply our lot in life. A lot of us have savior and martyr complexes.

Don’t Get Fooled: Obviously, I believe that we Drama Allowers can be rehabilitated, but only if we realize that this is a pattern over which we have control and commit to actively interrupting it and enforcing our boundaries. If the Drama Allower will not do this, cut them loose, or at the very least distance yourself so you don’t get sucked into their vortex.

For more on Drama Magnets and other musings on self-determination, check out Suzan Bond’s excellent blog Word is Bond:

http://www.suzanbond.com/blog/


“It’s Not My Fault”

This is not uncommon to people with attachment issues and personality disorders, but PLENTY of “normies” are guilty of it, too. This is someone who endlessly recreates the same problems but devises a unique set of extenuating circumstances on which to blame each one as it individually occurs. In doing so, they completely escape accountability. They never learn from their mistakes or feel any need to change their ways. Their anger and defensiveness set up a positive feedback loop, and over time they become more stubbornly entrenched in their conviction that everything and everyone else is to blame for their woes.

People exhibiting the “It’s Not My Fault” mindset have a propensity for abrasiveness, manipulation, even emotional abuse. They tend to fight endlessly with everyone around them: family, friends, significant others, and professional colleagues.  A hallmark of these interpersonal conflicts is that such people rarely, if ever, offer sincere apologies. If pressed, they say that they’re sorry you took whatever unacceptable thing they said or did the wrong way, or that you deserved whatever they did to hurt you. Should you attempt to hold them accountable for their actions, they will denounce your instincts and observations and do everything they can to put you on the defensive, a charming technique known as “gaslighting.”

Don’t Get Fooled: These folks have an ever-increasing backlog of guilt and shame from which they are constantly fleeing, and many of them would rather eviscerate you than hear anything you have to say that threatens the reality they have constructed for themselves. Do not engage. Avoid at all costs.



 

The Willful Martyr

The Willful Martyr is a close friend, family member, or romantic partner of another toxic person.  The Martyr normalizes and accepts their toxic counterpart’s behavior and, to at least some extent, expects everyone around them to do likewise. Their full-time job is caring for their toxic counterpart and “saving” them from the big bad world. They are constantly putting out fires, convoluting excuses, and compensating for their counterpart’s dreadfulness. Willful Martyrs must work very hard to maintain the cognitive dissonance necessary to do all of this. As their sense of reality erodes, they become blind to their counterpart’s destructive qualities and behaviors, and may even come to emulate them.

Identifying Willful Martyrs can be tricky because many seem like nice people. Often, their toxicity becomes apparent only when viewed in the context of their counterpart. But rest assured, anyone who seems fine on their own but is in a close relationship with a toxic person is a Willful Martyr, and must be shunned lest their counterpart’s nonsense seep into your life.

“But he seems so nice!” “She’s just a regular person!” Do not fall into this trap. Willful Martyrs are enablers, however harmless and well intentioned they might seem. Let them in and you open yourself up to the counterpart’s poisonous nature and all it engenders. Worse yet, you may become complicit in the Martyr’s enabling campaigns.

Don’t Get Fooled: Even if the Willful Martyr shuffles off their toxic counterpart, they are likely to take up with another one. A Martyr between toxic counterparts is still bad news and should be kept at arm’s length until they demonstrate that they have changed their ways.


Now, if you’ll excuse me, I have some housecleaning to do.

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