RAYS Director of Strategic Relationships
I remember having to hide my money in my room when I was a kid. I was so young I was keeping my life savings in a piggy bank. If I didn’t hide it my sister would come in my room and take it. When I complained to my parents they reminded me that I knew she did this so why didn’t I hide it?
I didn’t realize that this was strange until I was an adult and was able to look back on a lifetime of “odd” behaviors within my family to cope with my sister’s undiagnosed mental illness.
My sister was a surprise baby after my parents were told they couldn’t have kids and so had adopted me as an infant 5 years earlier. It was a difficult birth but then pretty normal infancy. There were a few developmental signs such as Tracy didn’t talk until she was 2. She understood everything that was going on, she just didn’t verbalize about it. Once she started talking, it was in full sentences and advanced.
We grew up in a small Midwest farming community where people were hard working and scrappy. If someone was a little different, they were cared for by their family and people didn’t talk about their problems. We didn’t talk about Tracy’s stealing or her lying. She would lie about anything. Most kids go through a lying phase to get out of punishment, but her phase never ended. As an adult she would lie about being married, about having a job, and about being pregnant. What I came to believe later is that she actually believed her lies to be the truth and she was often able to convince me to believe her too.
Looking back, we might have managed to get her help for some of these issues if we hadn’t had the life altering experience of our mom dying when Tracy was 13 and I was 18. That was a trauma our family would not recover from and sent Tracy into a downward spiral of unhealthy behaviors. At that point we did get her into counseling. It seemed to help for a while, but she didn’t stay with it and the therapist wasn’t working with a physician to discuss the combination of physical and emotional issues going on. From working at RAYS, I have a better understanding of the importance of integrated health care and how this can impact successful treatment plans for patients.
From working at RAYS, I have a better understanding of the importance of integrated health care and how this can impact successful treatment plans for patients.
I had always wanted to have a good relationship with my sister. The kind I saw in other families where siblings loved each other, had fun together and supported each other. I envied that, especially after we lost our mom. It would have been so wonderful to have a close friend in the family – someone who shared all the same memories and could share the responsibility of caring for dad. It wasn’t possible.
Why am I writing about this now – years after Tracy has passed away from health complications? I’m writing this because I know it’s hard for people to talk about the times in their life that they didn’t how to help someone they loved. I think about my sister more often since I started working at RAYS, especially when I hear my colleagues talk about how they are working with a client to overcome a particular challenge. Or when I hear kiddos walk down the hall past my office to pick a game to play with their therapist. I know they are going to be in a safe space to talk about whatever is bothering them. The recent experience of a 15 year old losing his mom and learning breathing exercises to cope with his deep grief really hit home. Our therapists are teaching kids and families tangible skills that are going to help them cope with the challenges life throws at them.
I’m writing this because I know it’s hard for people to talk about the times in their life that they didn’t how to help someone they loved.
I was a child during much of the time I lived with my sister and I didn’t have the skills to help her. The best I could do was survive. It makes me sad to think that maybe if we had had a place like RAYS when I was growing up, and if others around us had helped remove the stigma against mental health, maybe my sister could have had a better life. Maybe we all would have.
I am proud and grateful to be part of RAYS. I get to work with caring and passionate individuals who are committed to helping children, youth and families lead their best life. My role is to connect people who want to help with the people who need our help and I love making those connections.
Almost everyone has a family member who has struggled with their emotional and mental health and we need caring experts to help us when we are at our most vulnerable. It is too late to help Tracy and to re-do my childhood, but it’s not too late for the kiddos who find their way to my amazing colleagues at RAYS. We can all play a role in their success.
Thank you to our RAYS clinicians, interns, and program staff. You save lives every day.
For our second installment of the RAYS Staff Spotlight, we are highlighting Heather Fisher. I sat down with the Lego-loving, mental/medical heath integration specialist to ask her a bit about herself and her work. Heather does a lot for us at the agency so she had a lot to say. It was wonderful to visit with her and hear her story.
First, we’d like to know a little bit about you. Could you tell us a bit about yourself?
Heather Fisher: Sure. Well, I went to SPU in my Masters in Family Therapy and they have the only medical family therapy certificate program on the west coast. So I was drawn to that program in the first place because I had an interest in trying to figure out how to do counseling with people who have medical issues. I, myself, have had a host of medical issues and have chronic illness. I was hoping to help families in a way that the physical and medical community was not able to do. My interest was in bridging those two worlds [medical/mental health] for each individual client in order to be able to help them understand better and benefit their entire self.
“I would encourage others to have conversations about the mind-body connection so that they can learn to advocate for themselves within the different programs.”
When I’m not working I enjoy doing lots of creative things – arts and crafts and painting and those types of things – and definitely getting together with friends, having good conversations is one of my favorite things to do. And it’s great living in the Pacific Northwest because I love to be outside and on the water, kayaking and that kind of stuff – just as a grounding activity to kind of re-center myself when I get the chance.
So are you from this area originally?
H: I was born in California and I was a Navy kid, so I lived in different places, but I’ve lived in Snohomish since I was about 10. Now, I live in Ballard.
What work do you do here at RAYS?
H: At RAYS I definitely do a couple of things. I’m at one of the middle schools for one of my sites and, currently, I’m also at one of our co-located medical sites which is UW Valley Medical Children’s Therapy. I’m helping with Medical Integration. We’re evaluating the needs and doing assessments now too as we are getting ready to open some new clinics in the future as well.
Can you tell us about Medical Integration piece? It’s a new avenue that most mental health agencies are headed towards now, correct?
H: It’s definitely new for agencies. So basically the goal is to integrate and learn how to collaborate with medical physicians to help the whole person with their medical and mental health needs. I think primary care offices and hospitals have been trying to figure out how to meet this new mandate of integrating mental health/behavioral health into their physical health.
At RAYS, there’s a couple things – we’re moving towards including more medical check-ins with our clients and incorporating those pieces into our treatment plans. We’re also beginning to evaluate our clients for those medical concerns – in order to assess for what we may need to work in collaboration with primary care doctors. And then there is the piece where we are arranging collaborations with other organizations such as Health Point and UW Valley Medical. Like I mentioned, we are co-located at UW Valley Medical Children’s Therapy – we just finished our pilot year there. We’re currently there two days a week. We also received some grant money through Best Starts for Kids to open a teen clinic with Health Point at Renton High and also a clinic at our Cynthia Green Family Center in Skyway.
“We’re moving towards including more medical check-ins with our clients and incorporating those pieces into our treatment plans.”
So there are several things going on here! [Laughs] We are looking at what matches philosophically with what we are already doing and what we’d like to add in.
It sounds like there is a lot going on in many different areas! So why were you drawn to the medical integration model and counseling? What about your work and your philosophy led you to this?
H: I worked in childcare either as an educator, a facilitator, or as a parent educator for about 13 years. I was fortunate to work in a childcare center for about 5 years that was a really progressive, social justice minded place. There were some really amazing families, some of whose children had medical illness and needed accommodations at the school and I was doing a lot of parent education.
I started realizing how much I enjoyed staying late with parents, talking with them about what was going on at home and the social emotional issues. And I realized the community that I was working in was a more privileged middle class community and started thinking about how I could use those skills I was learning with underserved populations to help them access those types of early education and parenting services.
It felt like a really good fit ever since I started doing the counseling work, and when I went to the grad program I suddenly felt like, “Oh these people get me – they’re like me and they see the world the way I see the world” for the most part. So I was just discovering throughout the program what felt like a good fit.
Why do you feel this type of integration is important?
H: I feel like this type of work is important because as a culture I think we often underestimate the mind-body connection. We underestimate the effect and impact that trauma has on our physical health. I think we tend to see physical health and mental health as two separate things and they very rarely are – every couple months there is new research out showing that people with higher Adverse Childhood Experience scores tend to develop “X, Y, Z” illnesses – higher rates of heart disease, diabetes, chronic illnesses, fibromyalgia, things like that.
Those connections can’t be denied – that research is strong. It’s been done by outside sources. You know, the more that I have spent time here at RAYS and really dealt with children and families who have had generational trauma, the more I have seen those connections. So there is that piece but there is also these underprivileged families tend to not know what those resources are or understand the importance of preventative medicine because it hasn’t been modeled for them before. So this is really our opportunity to combine those two things and help people understand how they’re feeling physically and how they are feeling emotionally have a direct correlation to one another, and working towards changing either one of those things can have a great impact.
You do some other work here as well, correct? The work you do individually with clients is interesting too.
H: The work I do with individual clients is sometimes at a local middle school and sometimes here at the agency. I work with ages 3-14 at the moment. I tend towards narrative therapy – which is, in the simplest form, that our lives are a series of stories linked to one another. Some of those stories are authored by us and some are authored by other people for us. Narrative therapy takes a look at the stories and finds out what fits and what was maybe a bad fit for the person and what their preferred story going forward would be. The main thing I really like about narrative therapy is that it is all co-created.
It assumes the client is the expert on their life and they are deconstructing and re-authoring stories in a way that I am working as an assistant, kind of reframing and asking questions to help them get an understanding of what’s going on.
And with young kids, what I have found works really well is to do this with Legos. So I come from a long-line of Lego people in my family [laughs]. I definitely grew up with Legos. I find that therapy with Legos combined with narrative for kids has worked really, really well to help them visually construct what an emotion or feeling might feel like or what family dynamics might feel like using Lego people. So it really is as boundary-less as possible for their imaginations in order to help them understand what’s going on with them.
And so they are actually creating whatever they need to talk about?
H: Very much so. In narrative therapy one of the things that we work with is externalization, which is taking a feeling or something that you’ve internalized as a truth and taking it so it’s outside of your body so we can look at it a little more clearly and examine it. So it doesn’t feel like we are picking apart a person, it feels like we are taking apart an issue. Legos are a good way for kids to say “this is what this looks like” versus a blank piece of paper. For a four year old kid, if I say “draw that thing” they might feel overwhelmed by just a blank piece of paper. Legos, though, are like a box full of ideas so it tends to be a better place to start.
So last question, as a wrap up, if there was one thing that you would tell others – about you or about the work, Legos, medical model – what would that be?
H: I would encourage others to have conversations about the mind-body connection so that they can learn to advocate for themselves within the different programs. And if they don’t know how to do that, which most people don’t, I would say checking in with your doctor, your nurse, or your mental health counselor is a really good place to start learning how to advocate for yourself.
It’s been exciting working with other agencies and seeing how they all work. Yeah, I’m happy to be here and to use my expertise. Working with people who find medical integration valuable, that’s pretty tremendous. We definitely have that here at RAYS.
Well, thank you for giving us some of your time today.