women's health – FilipinaYEG

By: Giselle General

Therapy, the mental health kind, is something that I have been doing on and off since 2017. It’s remarkable how much time has passed since I first experienced going to a centre with a business-and-clinic vibe waiting room, and sitting in a cozy office with a couch-like chair and chatting with a professional with a clipboard.

Due to the pandemic, I had my first opportunity to do a few virtual therapy sessions with someone I’ve met in person a few times. It worked out well because I’ve met her in-person many times before, so there is a rapport and a baseline of trust.

Now, I’ve been having appointments on a regular basis with my latest therapist for the past two and a half years now. This doctor, I’ve never met in person at all! The primary format of their mental health service is telephone appointments, so video meetings were not even an option. When I asked my family doctor’s clinic to be referred to this service though, I know I needed regular and ongoing mental health support without worrying about whether I’ll ran out of appointments.

Here’s an overview of my top three tips on how to make telephone therapy appointments as successful as possible.

First: Mindset and Expectations

Telephone therapy appointments, in terms of actual logistics, is different in many ways compared to virtual or in-person therapy.

The lack of opportunity to see facial expressions or nonverbal cues is a disadvantage. They will have a difficult or impossible time telling whether you are lying or withholding information. So in my opinion, this is most suitable for someone willing and able to be more forthcoming with their struggles. I think that telephone therapy can help a lot with issues that are not an escalated crisis.

For those that might have trouble being too vulnerable in a closed off space like an office, or might even have trouble with being honest when someone is watching their face, then telephone appointments can be advantageous. It can help someone be more up front because they don’t have to be afraid of seeing their doctor’s facial reactions immediately upon hearing their comments or stories.

Second: Preparation

It’s best to establish a physical space where you would speak to the therapist in private. Tidying or re-organizing the space, whether it is the desk and chair, a bed, living room, dining room can help you focus on the important and vulnerable conversations that is coming up.

Charge your phone and ensure it is 100% and ensure your headphones, if you’re using one, are nearby. I personally prefer having headphones because it keeps my hands free to do other tasks.

Now here’s where telephone appointments have advantages. If you think you would need to fidget, you can do so – just have your fidget items right next to you. I tend to write notes and the doctor’s advice during the appointment, something I haven’t done in in-person appointments since it just feels so awkward to me. You can have a drink of choice instead of just water if you want, like tea of coffee or smoothie. Although for myself, water has always worked.

I highly suggest preparing the topics you would like to talk about. During the initial appointment, when the therapist asks the awkward and important question “what brings you in today?” be prepared to say the difficulty you are having and a short summary of the backstory. So for me, for one of the things I need help with I said “I am running for elected office next year and will be starting a lot of work in a few months, so I am asking for help on an ongoing basis to deal with stress during this period of time and managing my real fears from being an immigrant, minority woman who might be attacked and hurt”.

If it is a follow-up appointment, the first two will likely be follow-ups or updates on previously discussed issues, and if there are any, one to two new things you’d like to talk about. I usually write this on a notepad, with space in between the points I wanted to talk about, to write any insights, advice or next steps most relevant to the topic.

Third: Appointment Day

It’s appointment day! Your supplies are ready, phone is charged and you are on your way to the private quiet space you picked for the phone call. I treat it as seriously as going out to an actual appointment, so I feed myself a good meal, wear ‘going out’ clothes but more comfortable versions (like a nice swater and slacks) but I skip the shoes.

I also give myself a small window of time to be the commute or the waiting room time, just about five minutes. My husband has been understanding about this, so he leaves our bedroom, I lock the door and he goes way to the other end of the house, like the living room, to be out of earshot.

Another benefit of telephone appointments is because no one will see you, you can be as visually expressive as you need to be. You can flail your hands while explaining something that’s upsetting. You can roll your eyes when the doctor says something that makes you react “duh, why didn’t I think of it that ways before?!” You can switch what your hands are doing between fidgeting, typing notes, or wiping tears and snot off your face. I typically write down a few bullet points for each of my concern that I can categorize as follows: insights, counter-points, action items.

One thing I strongly advice against is multi-tasking. No social media or emails or chores during the appointment. Since it is likely that the impact of a telephone appointment is slightly diminished from not interacting face to face, multi-tasking and getting distracted makes it worse.

Finally, after the appointment, give yourself at least five minutes to take a breath and process. Those few minutes right after an in-person appointment, when you walk out of the lobby out of the office to start traveling home, are helpful for a reason. Especially if it is an emotionally heavy conversation, it helps your mind settle a bit before you resume with the rest of your day.

A woman with a short haircut and brown and white sweater, on a phone call with her cellphone and writing on a notepad on her desk.

After each appointment, same principles apply to in-person or virtual appointments. If there is homework or readings or activities that were asked of you to do before your next appointment, do them as diligently as if they told you in person.

Just like any other way of getting support for one’s struggles, therapy will likely not be enough to help solve one’s trauma and past hurts, so I suggest thinking of the methods of therapy the same way. It’s okay to patiently put up with the realities of telephone therapy and then switch to your preferred methods at the first opportunity. But who knows, maybe the conveniences of telephone therapy can help you access it on a more frequent basis so that it can help with your self-improvement goals.

In honour of the soon-to-end International Women’s Month, and in appreciation of the recent Disney Pixar movie Turning Red, I’d like to share the memorable and also a bit scary experience I had when I got my first period.

By the way, I got mine when I was in Grade 5, at 10 years old. So for those who argue that getting periods is not a topic for children, this is something that kids experience all the time!

As a storekeeper of a sari-sari store, I’m familiar with menstrual projects, which we nickname “napkins” in the Philippines. I noticed though that when kids come to our store to buy them, they always asked that it be wrapped in newspaper, or in an opaque plastic bag that conceals what is inside. When I ran out of newspaper, I’d use the cardboard from a 10-pack of cigarettes, or a bag from a wholesale pack of candy or bubble gum – those things are thick and brightly colored. During the movie, when Mei’s mother was putting different types of pads on the bathroom counter while describing them “regular, overnight, scented, wings…” it make me chuckle.

Just like most of my weekends, I was left alone watching over our little store in the mining village where I used to live at the time. Grandma (Lola Aleg) left for the day, to go to the city to get products for the store. Or is it for a while weekend or week? She’s gone so often I can’t keep track.

It was early in the weekend, when my mischievous self was tempted to sneak a chip bag from the store inventory as a snack for myself. It was 10 AM so the electricity for the whole village was shut off for a few hours already, an austerity measure that the mining company introduced a year ago. If I needed to go to the bathroom which is in the basement of our little store, I have to very carefully head down the ladder and do my business in a tiny room that is almost pitch black.

I went to the bathroom and in the faint light coming from the window, I saw something very wrong in my panties. I thought to myself, OMG! I can’t believed I pooped my pants without even knowing! This is what I get from sneaking too many snacks from the store display. It was sticky and brown, but surprisingly not as smelly as poop normally would. I hurriedly changed into clean underwear, fumbling in the dark where my underwear bag would be, worried that a customer would be calling from the storefront upstairs.

Then 4 PM comes around and electricity is back in the village. I went to the bathroom again to checked if there’s anything unusual in my underwear. This time around, there’s no mistaking it. It’s liquid, it’s sticky, it’s red – it’s a period! I hurried to try to wash both panties with water and bath soap, as I didn’t know how to clean blood off of fabric then. We learned that later in the school year.

I honestly can’t remember whether I told my grandma that weekend or sometime later. It wasn’t until six months later that I had my second menstrual cycle. This I wasn’t surprised about, as we learned about this in health class earlier in the school year. We also had a school assembly shortly before my first period, from one of the multinational companies that sell household items, including menstrual products.

What I do remember thought is that once I started having acne, lola told me many times on how I missed out on one of the most effective ways to combat acne. She said, I could have used the underwear when I had my first period, lightly wash off the blood but not completely clean if off with laundry soap, and with the part of the panty that had some light menstruation blood residue, to dab it off my face where pimples are popping up. The things was, she said, is that it needed to be from my first menstrual cycle. Looking back now, it sounds kinda nasty, but I understand that she grew up in a rural area in the 1930’s – 50’s. My brother and I weren’t spared from other old-fashioned methods to address various illnesses growing up.

Thinking back now, there were so many things that I wish I learned about how menstruation works. Dealing with cramps every month was a common experience, but I learned later on about how it can be debilitating for other people – as in blacking out or being nauseated in pain. I wished I learned earlier on how having sexual intercourse works during someone’s menstrual cycle. Turns out, it is messy, but doable and pretty satisfying – as long as you and your partner have prepared to clean up afterwards. I wished I got adequate information when I was exploring birth control methods, so I can better differentiate what is “expected spotting”, “usual menstrual cycle discharge” or “excessive bleeding” when I adjusted to having an IUD implanted in my uterus. It took one year for my frequent bleeding to stop and I’ve had an IUD in me for 11 years, that I might have a learning curve on how to put on pads again. Maybe I’ll just skip those altogether and go with a Diva Cup or those fancy new period panties.

Compared to years past, I think that available information about puberty life and other life milestones is getting better now, thanks to access to online information, being referenced in mainstream media, and professional content creators. I hope that for kids, teens and their families, that such experiences are something that is anticipated and informed about ahead of time.