COVID-19 & Anxiety

May 29, 2020

written by Tiffany Merchant, MS, LPC

The safer-at-home order has ended and many questions have begun to enter our mind and daily conversations. It seems that just as the world was beginning to settle into the “new normal” life is changing yet again. When the routines and rules that we live by  shift, there can be a significant sense of uncertainty and this uncertainty can lead to anxiety. 

Anxiety does not have a one size fits all definition. There are varying degrees of anxiety that present in significantly different ways. However, there are common threads that lead mental health professionals to a formal diagnosis including overthinking, excessive worry with the inability to stop the worry, and difficulty “turning off” the brain. It is also common for someone living with anxiety to experience physical symptoms such as increased heart rate, sweaty palms, shaking, and being restless. 

These thoughts and behaviors are connected to a well-known response called fight, flight, or freeze. This response serves an important purpose in self-preservation. When the brain detects a threat to its existence, the brain signals the body to either defend itself, run away, or be very still. For example, if you are camping and come upon a bear, you want your brain to feel like it is in grave danger! However, when a person is exposed to prolonged stress or trauma, the brain can interpret certain harmless stimuli as harmful and causes the body to respond as if it were in significant danger. 

This is especially relevant with prolonged exposure to the news or social media concerning COVID-19, as it could cause elevated stress levels over an extended period of time. Your brain could then interpret any exposure to information about COVID-19 as harmful, in turn, causing anxiety. 

Dr. Bruce Perry’s extensive research shows that one contributor to an increased stress level is “novelty” or anything new. With COVID-19, something changing everyday, so it is no surprise that more people are likely experiencing an increase in anxiety symptoms. If you have noticed that you are having difficulty “turning off your brain” or are restless, here are some practical suggestions that you might try: 

  • Meditation – There are numerous free apps that can be downloaded onto your phone as well as many YouTube videos that can guide you. Here is a link to a 5 minute meditation on YouTube. https://www.youtube.com/watch?v=inpok4MKVLM
  • Deep Breathing – Deep breathing helps to direct your focus on the present. Take a look at this article for step by step instructions on how to practice deep breathing. https://www.uofmhealth.org/health-library/uz2255
  • Exercise – Getting your body moving (taking a walk, using your home gym, hiking, or playing catch with your children) is one of the easiest ways to manage stress in your body. 
  • Daily Structure and Routine – Keeping our routines make things predictable, and safe for us. 

Some anxiety is necessary and helpful to protect us against danger. When it begins to interfere with a person’s daily functioning, it can be problematic. If you find yourself having difficulty performing daily tasks that were previously common and easy to perform or endless ruminating or catastrophic thinking (IE: thinking the worst frequently)it might be time to seek a therapist’s assistance. Stein Counseling is open and taking new clients and can help you process these thoughts and feelings, and assist you in coping more effectively with the changes we face everyday, or in times of stress. To schedule an appointment call 608-785-7000 x 221.

Updated: COVID-19 Precautions

May 28, 2020

The Stein Counseling Leadership Team is continuing to work hard to ensure the safety of our providers, office staff, and clients. As many of our providers return to the office this week for in-person appointments, we wanted to make sure we share our increased safety protocols to ensure a safe and smooth transition. Our safety procedures include:

  • We ask that you wash or sanitize your hands when you enter the waiting room. Hand sanitizer is provided in several locations throughout the waiting room.
  • We encourage all unscheduled guests (children, spouses, friends, etc.) to stay home during your appointment, or wait outside in the car.
  • Masks are recommended but not required. If you choose not to wear one, we will ask you to wait for your provider outside of the office either on the benches provided or in your vehicle. (You will be alerted when your provider is ready for you.) Disposable masks are also available for guests who do not have one.
  • Please bring minimal items with you into the office.
  • Traffic flow to-and-from provider’s offices will be one-way and you may be asked to schedule additional appointments with your provider in their office instead of returning to the front desk after your appointment.
  • We will continue to frequently disinfect our high traffic areas such as the check-in/check-out desks. Arm chairs, counter tops, and door handles in common areas will continue to be sanitized throughout the day, and at the end of each day.
  • Coffee, water, hot chocolate, and tea are unavailable until further notice.
  • Books, magazine, and children’s toys are also being removed from the waiting room.

We ask for your continued assistance as well by:

  • If you have been sick, or around someone that has been sick, we ask that you cancel your appointment.
  • Do not shake hands and avoid touching your face.
  • Cover your cough/sneeze with your sleeve or a tissue, not with your hand.
  • Be mindful of the space between you and others, and practice social distancing
  • Remember to also sanitize personal cell phones, desk phones, desk tops, pens, door handles, etc.

May is National Mental Health Month

May 13, 2020

May is #MentalHealthMonth! This year’s theme, #Tools2Thrive, explores practical tools that can everyone make small changes that have a big impact on their mental health, and increase resiliency regardless of the situations they are dealing with.

You can be supportive of those who are struggling with life’s challenges and their mental health. The Tools2Thrive toolkit created for #MentalHealthMonth includes practical tools that everyone can use. Download the toolkit at: mhanational.org/may. #mhm20 #mentalhealth

Recovery Resources

May 13, 2020

written by Tiffany Merchant, MS, NCC, LPC

During this difficult time of social distancing, many have reconnected with their immediate family, slowed down, and enjoyed the calm. For some, their mental health issues have increased. And for still others, their lives are physically on the line. While the front line “essential” workers are putting their lives at risk, there is another group of people whose danger is hidden in plain sight. Their fight is daily and takes courage, strength, and energy. They are mothers, fathers, sisters, brothers, sons, and daughters. They are professionals and workers of a trade. They are fun and full of life. They are grateful. And they must choose everyday to live life to its fullest. They are also in recovery from substance abuse. 

Recovery can include someone who has been sober for three months or thirty years. While there are multiple stages in the recovery process, there is one constant –  the need for support. This support is an essential part of relapse prevention. Famed researcher, journalist, and author, Johann Hari, has completed extensive research on addiction and one of his conclusions was that the opposite of addiction is not sobriety. The opposite of addiction is connection. The invisible ties between you and me, between each of us.

Please watch this brief video to understand more about the connection between recovery and relationships.

During the “Safer-at-Home” order, all of us have been cut off in some capacity from our clan, our tribe, our “persons” and are feeling it’s effects. Loneliness and isolation can settle in. Fear, anxiety and frustration overtakes us sometimes. Those in recovery may be feeling even more isolated than ever before. Without their support system they are at much more risk of relapse and falling into coping in an “old manner.” So, if you know and have a relationship/friendship with someone who is in recovery, reach out to them. Say “Hi” and see how they are doing. Drop a note in the mail to say hello and that you are thinking about them. Be still, be present and listen. Empathize and understand. The struggle is real. The battle is real. Victory is one day, one hour, and one minute at a time and when someone is in the trenches with us, we often feel comfort and not as alone. These small gifts can mean so much. 

Additionally, here are some online resources for those in recovery and loved ones of those in recovery. 

Alcoholics Anonymous (AA): https://aa-intergroup.org/ or https://www.aaonlinemeeting.net/

Al-Anon Family Groups https://al-anon.org/al-anon-meetings/electronic-meetings/

Cocaine Anonymous https://www.ca-online.org/

Co-Dependents Anonymous https://coda.org/find-a-meeting/online-meetings/

Face it Together https://www.wefaceittogether.org/pricing

Families Anonymous https://www.familiesanonymous.org/meetings/virtual-meetings/

LifeRing Secular Recovery https://www.lifering.org/online-meeting-schedule

Narcotics Anonymous (NA) https://virtual-na.org/

Parents of Addicted Loved Ones https://palgroup.org/find-a-meeting/pal-telephone-meetings/

Partnership for Drug-Free Kids   https://drugfree.org/article/online-support-community-for-parents-caregivers/

Recovery Dharma https://recoverydharma.online/

SMART Recovery https://www.smartrecovery.org/community/ or https://www.smartrecovery.org/community/calendar.php 

Young People in Recovery Chapters’ All Recovery Meetings http://youngpeopleinrecovery.org/virtual-event-schedule

Is Telehealth really effective?

May 4, 2020

written by Tiffany Merchant, MS, NCC, LPC

It started as something half a world away from the United States in December 2019. In January 2020 the World Health Organization (WHO) declared the novel coronavirus, COVID-19, a public health emergency of international concern. As the number of positive tests for COVID-19 grew exponentially in the United States the President of the United States declared a national emergency and Wisconsin Governor, Tony Evers, declared a public health emergency. On March 24, 2020 our definition of “normal” changed severely when Governor Evers enacted a Safer-At-Home order. 

This order has left many places of employment scrambling to understand what is considered “essential” and how they could continue to support their employees and customers. Doctors began cancelling “non-essential” appointments. Schools closed. Parents and guardians were now left questioning what they needed to do to educate their children and teachers began a journey of transforming the way they teach and inventing new ways of teaching. And many citizens were left with the question of how they would access the mental health services they have come to depend on. 

“Is it effective?”

Absolutely! Jonathan G. Perle and Barry Nierenberg completed a literature review (1) that found telehealth to be an effective mode of therapeutic treatment for people who are unable to access face-to-face mental health services. 

“Is it safe and secure?” “Will it be just us?”  

SCCS uses the safe and secure platform of Google Hangout Meet for telehealth ensuring HIPPA is followed even in these changing times.. Providers are diligent in protecting the rights of clients. Providers are alone in their office or home and use headphones if needed in order to ensure that client information is kept confidential.  

“Is it legal?”   

Telehealth is legal in the state of Wisconsin. Under the Emergency Order 16 and 2019 Act 185, mental health providers in the state of Wisconsin are authorized to provide telehealth services so long as the services provided are within the scope of practice of that provider, and the client is in the state of Wisconsin. Telehealth services were legal before COVID-19, however, under the Emergency Order 16 and 2019 Act 185 the provider does not need to be credentialed specifically for telehealth. There is no test to pass or further education required to obtain that credential. 

“What can you do with my elementary aged child on video?”  

SCCS providers that work with children are skilled in finding creative ways to connect with their younger clients. They will use numerous ways to connect including games, coloring, drawing, conversation about interests, and lego blocks.  

“There is no way that we can connect over video! I will feel so awkward!”

This is a common fear of telehealth. However, this fear should not keep you from seeking mental health care. In the times of COVID-19 and social distancing, it can become easier to connect in ways previously more difficult. SCCS providers will gauge the conversation and adjust as needed to find a way to connect with you. We are also continuing to provide counseling at the office in person.

“Will insurance cover it?”

Many insurance companies have shifted to cover telehealth, however it’s important to note, every insurance is different. If you are uncertain if your insurance will cover telehealth for mental health services, call the SCCS office and contact your insurance company to verify benefits. 

While transitions are difficult for many of us, most mental health clinics, including SCCS, have been providing telehealth options since the “Safer at Home” order. Hopefully, the answers above have helped you feel comfortable with the option of telehealth. SCCS providers and support staff are here to answer any other questions that you might have. And, again, we continue to provide services in person at both the Onalaska and Black River Falls locations.

To continue your mental health journey, or if you have discovered that you need someone to talk to and process just how upside down your world has turned in the last 6 weeks, call Stein Counseling at (608)-785-7000. We’re here to help!

(1) Jonathan G. Perle & Barry Nierenberg (2013) How Psychological Telehealth Can Alleviate Society’s Mental Health Burden: A Literature Review, Journal of Technology in Human Services, 31:1, 22-41, DOI: 10.1080/15228835.2012.760332

Trauma Informed Information

March 9, 2018

SMART Recovery Meetings

October 4, 2017

LaCrosse SMART Recovery Meeting Schedule

We have grown!

SMART Recovery is an abstinence based program

SMART = Self Management And Recovery Training

We offer Tools, Strategies and Exercises to help you in recovery

SMART is based on science and 4 principles:

1-  Building and maintaining motivation

2- Coping with urges

3- Managing Thoughts, Feelings and Behaviors

4- Living a Balanced Life

Mondays 5:30 – 7 pm       401 West Avenue

Unitarian Universalist Fellowship Building

Wednesdays 5:30-7 pm   921 West Avenue

Coulee Council on Addictions

Fridays 5:30-7 pm            921 West Avenue

Coulee Council on Addiction

Women’s SMART meeting

Saturdays 1:00-2:00 pm

Coulee Council on Addiction

Handling Conflict

June 14, 2017

Handling Conflict in Your Life


Let’s face it.  Conflict is going to happen in your life – possibly even daily.  It will occur at work, home, and in the community.  How you handle it will have a large impact on the quality of your life.

Some people thrive on conflict.  If it doesn’t exist, they will create it simply for the thrill of the drama.  They tend to be very loud and use explosive, if not obscene, language to draw attention to themselves.  They believe that the loudest person will win the argument.  And, as we become embarrassed by their display, they ramp up the volume.

Others find conflict so distasteful that they give in automatically to the person they are having a disagreement with.  They are even willing to give up their rights if they can avoid those ugly scenes.

An effective way to respond to conflict is to manage it. Here are a few steps to take to handle conflict without losing your cool or your rights:

  1. The first step is to speak with the person(s) you have a conflict with and state the truth:  “We don’t agree on this.”  Simply make clear what the issue is without assigning any blame.
  2. Make a statement about what you hope a conversation would lead to:  “I would like to talk about this with you and see if we can come up with a solution.  We work together every day and it would be nice if we could get along.”
  3. Now, the most difficult step.  Be quiet.  Listen without interrupting them.  And listen in order to get a complete understanding of where they are coming from.  Allow yourself to be influenced by what they say.  Do not listen just to debate.
  4. Next, prove to them that you listened with the honest intention of understanding.  Summarize what they have said back to them.  “So, you feel that I was putting you down when I said that.”  Or,  “You don’t like it when I do that because then you have to pick up the slack.”
  5. Now that you have invested the energy to understand their viewpoint, agree with whatever you can.  “Oh, I didn’t realize that you had to be the one who finished that up.  Now I see why you are frustrated with me.”
  6. And, now, the most important step.  Let what they said sit with you for a bit.  Does what you now understand change your opinion in anyway?   Those who take the time to give serious consideration to what the other person said are those most likely to come up with a solution or compromise.
  7. It is now your time to respond with your feelings and opinions.  Don’t use this time to jab back at some of the comments they may have made that you found offensive. Stick with the issue – even if they haven’t.   Talk about the problem – not them.
  8. Keep calm.  If they are fired up and you add fuel to that fire with your anger, it will only make things worse.  Nothing will get resolved.
  9. Regardless of the outcome, I suggest you end by shaking hands or at least making a statement of appreciation for their willingness to have an honest discussion with you.
  10. And, again, regardless of the outcome, do not ignore this person later or talk about them behind their back.  Treat them with the respect and courtesy you would like to receive from them.

Fix the problem, not the blame.

Karen Wrolson, MS, MEd

Stein Counseling and Consulting Services, Ltd.

Build Up Your Love Account

February 24, 2017

Build Up Your Love Account


Ahhh, February  – the month of love.  A good time to give attention to our relationships.

Like most things in life, relationships change.  As time goes by, they either grow healthier or become weaker.  Relationships need to be nurtured and attended to if they are to flourish.  Reflect back on when your relationship began and think about the attention and love that you gave so automatically.   Sadly, as time has gone by, many of us have changed the way we treat our partners.

Here are three easy steps to make some immediate improvement.  We are going to borrow the idea of the “Emotional Bank Account” from Dr. Steven Covey, world-renowned author and lecturer.

Consider a traditional bank account.  We make deposits and we make withdrawals.  Our deposits are made in the currency the bank accepts.  In America, for example, we typically make our deposits in US currency and not in Chinese Yuans or Russian Rubles.  Hopefully we make larger deposits and much smaller, and infrequent, withdrawals.  If our account has a low balance and we make a large withdrawal,  our account might get closed.

Now let’s think about Dr. Covey’s Emotional Bank Account.  Some couples have such a large emotional bank account that you can actually see it.  They hold hands wherever they go, their faces light up when the other approaches, and they always seem happy when together.  Here are a few simple steps you can take to work towards that kind of a relationship.

Step 1.  Determine the currency you need for your particular account

Use the knowledge you have of your partner to determine the currency you will use.  Think about what he/she values.  For example, if your husband enjoys car shows, go with him and listen to him as he tells you about the cars on display.   Does your wife feel overwhelmed at times?  Imagine her delight if she got in her car Monday morning and found out you had filled her gas tank.  On the other hand, using the wrong currency will not add to the balance and could even take away from it.  I remember one man who gave his wife a space heater for Christmas because she always said she was cold.  While this certainly was a practical gift, it wasn’t anything she wanted and, hence, was the wrong currency.  What a missed opportunity!

Step 2.  Begin making regular deposits to build up the balance

Couples with that special connection are those who take time daily to let their partner know they are loved.  It could be a gentle touch on the shoulder, shutting off the phone when they want to talk, or even a simple thank you to recognize the things you may have been taking for granted.  Note: the cost of this type of an investment is simply your time.  Such an easy and yet powerful way to demonstrate your love.  

Step 3.  Reduce your withdrawals

Withdrawals are times in which we hurt or disappoint our partners.  For example, forgetting an anniversary could be a withdrawal. Getting home too late to attend the children’s concert would be another withdrawal.   Naturally, withdrawals are going to happen from time to time.  However, they have much less of an impact if your balance is high because of your consistent deposits.  It is important to note that some withdrawals could bankrupt an account regardless of it’s balance.  For example, having an affair is an extremely large withdrawal that ends many relationships.  Account closed.

Let’s review.  Here are the steps you can take NOW to improve your relationship.

  1. Determine the currency you will use.  
  2. Begin making daily deposits.
  3. Cut back on your withdrawals.  

Love.  Something we all desire.  Something worth investing in.

Winter Blues or Depression?

February 24, 2017

Winter Blues or Depression?


Wisconsin is not the easiest place to live – especially in the winter.  Often stuck inside, people are missing the sunlight and fresh air they benefit from in other seasons.  Many socialize less, avoid outside activity, and may even put on a few extra pounds from those “comfort foods”.  Sleep can also be affected from these unhealthy habits.  All of this can lead to what is known as the “winter blues”.


The clinical name for the “winter blues” is Seasonal Affective Disorder, or SAD.  The most significant characteristic of SAD is that it is cyclical.  Most in this northern area begin to feel SAD in the fall, find that it worsens in the winter, and that it begins to recede in the spring.  There are many simple ways to work through SAD.  Get as much sunlight as you can, exercise every day, and keep yourself on a regular sleep schedule despite your desire to sleep more.  Another option is to purchase brighter light bulbs to simulate sunshine.


Why is it important to figure out if you have depression?  Simply put, it is to improve your quality of life.  If you are depressed, you are feeling weighed down and will continue to be sad until that depression is gone.  Spring and/or more light will not lift your depression.  And remember, depression doesn’t only affect you.  It impacts those you love, work, and socialize with.  Also important to know is that depressed people sometimes don’t think clearly and may make permanent decisions to try to escape the sadness: divorce, quitting their job, moving, etc.  Unfortunately, none of those major changes will take away the depression.

There are two main categories of depression: situational and clinical.  When something tragic happens, like the death of a loved one or receiving a diagnosis of a disease, we can develop situational depression.  This type of sadness will gradually diminish when we become adjusted to the new reality.  Clinical depression, however, is a more persistent feeling of sadness which can lead to physical and behavioral problems that last for years such as those as listed below:


  • Difficulty in making decisions
  • Hard to concentrate
  • Avoiding things that used to give you pleasure (including sex)
  • Spending less time with friends and family
  • Significant weight loss or gain
  • Changes in sleep pattern
  • Frequently feeling sad or irritable
  • Having pessimistic or hopeless thoughts
  • Suffering from aches and pains that won’t go away
  • Wondering if others would be better off without you – considering suicide


Should you seek help for your depression?  Yes, if it is negatively affecting your life.  Otherwise your depression can deepen and go on for years.  It could even become a threat to your life as one in 10 people with depression commit suicide.


Check with your doctor first to find out if what you are feeling is related to a medical condition.  If it is not, seek out a mental health professional.  You may find that counseling will make a great improvement in your life and the lives of those you love.  In addition, develop habits that will improve your mental outlook: physical activity, healthy eating, adequate sleep, socializing, and eliminating those things that cause you unnecessary stress.


Take care of yourself.  You are worth it.

Karen Wrolson MS, MEd

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