Treating the Whole Person

This article was the feature article in the NAMI Advocate Winter 2018 edition: Putting the Pieces Together on Integrated Care.

“She’s just anxious, Allison,” said my mother’s physician.

Nathalie White

I had called in desperation to report Mom’s intensifying symptoms: cold sweats, difficulty breathing, low-grade fever, no appetite. In return, I was dismissed. I reported her labored breathing and her inability to force herself to eat—how she wrinkled her nose to once-favorite foods, how sweat rolled down her face, even when our car’s air conditioning was turned up too high. Despite her physician’s lack of concern for all this, Dad rushed Mom to the ER one day anyway, where her excessive coughing delayed a necessary lung biopsy.

The next day, Mom’s physician (now involved in her care) met me outside her hospital room and quietly said, “I’m sorry, Allison. Your mom has lung cancer.” I slowly entered her room and sat down. The words continued: “Late stage … little hope … chemo immediately.”

Devastation. Anger. Disbelief. The physician left me with nothing to hang onto. As Mom gasped for breath, her anxiety showed; she finally knew what was growing inside her, what she tried to treat with antibiotics and antihistamines. It was like being trapped in a nightmare. Mom was only 45 years old, was never sick, had never smoked, never even had allergies—and she loved life.

When I returned the next day, I walked into an empty room. I ran to the nurse’s station. “We’re sorry… Your mom had a stroke and is unresponsive. She’s been taken to the ICU.” Within hours, my family gathered to make “the decision.” I watched as my dad struggled to make the final call. I was numb. I watched the doctor’s lips move, but I didn’t understand. We gathered around her bed as Mom took her last breath. It had only been two weeks since my phone call asking the doctor for help. Now she was gone.

I later found in Mom’s datebook that she tracked her temperature for months and scheduled appointments with specialists who gave her various medical diagnoses and prescriptions. However, the elephant in the room was always her diagnoses of depression and anxiety. Her mental health diagnoses somehow managed to overshadow the underlying cancer that had been quickly invading her body. “She’s just anxious, Allison.” No… my mother was simply never heard.

I was 23 when my mother died. I’ve never really gotten over her death, but over time, I’ve learned to move through grief and turn it into something else. At the time, I’d been unsure of my career path. But after her death, everything became crystal clear.

Stigma cost my mother her life. I never wanted to see that happen to anyone again.

So, I obtained my master’s degree in social work and swore that I would always listen to my clients. I worked with people who had mental illness and often observed their physical symptoms being neglected due to their predominant mental health diagnoses. They would frequently call their doctors with symptoms that could be related to anxiety or depression and would have their psychiatric medications increased before having possible physical conditions evaluated.

People coming in for mental health services often lack a proper education about how their physical conditions impacted their psychiatric symptoms. For instance, I once met with someone before she met with her psychiatrist. She stated she was going to request an increase in her antidepressants since she was experiencing low mood and decreased energy. But I observed that she was drinking a regular soda and eating chips. Knowing she was diabetic, I talked with her about the importance of letting her psychiatrist know about her eating habits and blood sugar levels before defaulting to an increase in antidepressants. She had no idea that her food choices might be impacting her mood and energy and her psychiatrist had never mentioned it, either. As a clinician, it was frustrating to see.

That’s why I was excited when the organization where I had been working for years decided to become part of Missouri’s Healthcare Home pilot program. This program spearheaded the path to integrated care for our most vulnerable populations: people diagnosed with mental illness and major physical health issues. Research from the program showed that people with mental health diagnoses die, on average, 25 years earlier than people without mental illness—due to things like lack of health care integration, health literacy, poor nutrition and other social factors that impact overall health and wellness. When this program was initiated, I worked on its treatment team and referred many clients to the program, so they could have the medical oversight needed as part of their overall care.

When practicing integrated health care, an ongoing challenge is to coordinate care across all providers to ensure treatment plans are focused on health, wellness and preventive care. There are many barriers, which often keep doctors treating patients in a silo-approach (focused on our own areas of expertise). But the benefits of integrated care are innumerable—including decreased trips to the emergency department, decreased hospitalizations and reduced cost of health care thanks to preventative care. Having a whole team of professionals across various disciplines improves outcomes through early detection, monitoring and care coordination.

Programs like Healthcare Home show these effective interdisciplinary teams in action. Doctors, nurses, dieticians, occupational therapists, therapists, social workers, etc. meet to consult with each other and coordinate care using knowledge from each area of specialization. That way, when someone with physical health symptoms and a history of mental illness or substance abuse is being treated, they are heard—without stigma or judgment.

In the 32 years since my mother’s passing, progress in medicine and psychiatry have drastically and positively influenced health care. Thankfully, advances have also been made in integrated care, but we have a lot of work to do. We must break down the silos that separate physical and mental health because everything is connected: Physical symptoms affect a person’s mental health and a mental health diagnosis may increase the risk for physical health-related issues. Listening to a patient’s every symptom will lead to proper treatment and better quality of life.

As doctors and mental health professionals, it’s our job to dig deeper, peel the layers of the onion and address the core issues that keep people from living life to their fullest. Whether that’s uncovering childhood trauma that hasn’t been addressed or substance abuse that helps numb overwhelming symptoms or pushing past a mental health diagnosis to see a possible physical health diagnosis, addressing “one side” of a person’s care is just the tip of the iceberg.

If my mom’s cancer had been caught earlier, she may have been cured, but just as important, she would have been heard. It was only when my mother was diagnosed with cancer that her health care professionals gathered to formulate an integrated treatment plan. But by that time, it was too late.

I will never forget those words: “She’s just anxious, Allison.” Losing my mother changed my life, but it also inspired me to make changes in health care, so everyone—regardless of mental health diagnosis—gets the whole-person, integrated care they deserve.


Allison White, ACSW, LCSW, CCDP-D is a licensed clinical social worker with over 25 years in the field. She works in a community mental health integrated health care program. An important part of her work is recognizing and addressing all aspects of a person’s life and working with other health care professionals to integrate and coordinate their care. Visit her website at

The Art of Mindfulness

It’s becoming more challenging trying to live a balanced life when there are so many obligations and so little time to get them all done. We plan for the future, while ruminating about the past. It’s easy to allow things to spiral out of control as we get caught up in the business of everyday life. But there is hope.

When thinking about my vision of calm within the storm, I remember the movie “A River Runs Through It,” which shows how the art of fly-fishing demands stillness, creativity, concentration and balance for one to be successful at it. A main character in the movie often struggled to control his emotions, except when he was practicing his skills at fly-fishing. He found solitude on the river, where he learned to regulate and calm himself through what we refer to as “mindfulness practice.” Through the rhythmic, intentional casting of the line, he retained balance while standing on the rocks in the midst of the raging river. The fishing line flew with wild abandon above the water, but the fisherman maintained control as he stood solidly on the ground, keeping his focus.
This is the extent of my fly-fishing knowledge, having never experienced it, but the movie left an impact on me because it mirrors what we experience in daily life. We allow our thoughts and emotions to lead us, like the fishing line whipping wildly above the current – up, down, sideways, back, forth – with nothing to guide them in the right direction. Our thoughts can hijack our ability to think clearly and with purpose. No guide, no focus leads to feeling out of control, and increases stress, anxiety and depression, making it difficult to enjoy life.
It’s easy to get trapped in the chaos – the raging river – which can easily sweep us downstream. I’ve experienced the drifting; it leads me further from my goal, while zapping my energy as I fight to regain control. I’ve also had to tread water while searching, sometimes blindly, for that rock to hang on to in the current. It’s during those times that I force myself to focus: There are ways to catch myself before being swept away.
I learned the power of finding balance while practicing mindfulness. Just as in fly-fishing, it takes skill, practice and patience. When our thoughts leap around aimlessly – media blasts, cell phone calls, to-do lists – just like the fisherman, we must remain still, notice where our thoughts are leading us, then gently guide them back to stable ground. Breathe deeply; then reel them back to center.
Mindfulness is the practice of paying attention to the moment, without judgment. It seems so easy until the first wave of emotion hits. This is why it’s called “practice.” When life happens, we react, turmoil ensues – and the cycle continues. Mindfulness is the stabilizing force to help guide us back to stable ground.
Distractions – “I should have …” “If only I had …” or “What if …” – keep us stuck, unable to move, frozen in time, stagnant. They set us up for anxiety and depression, and quickly deplete our energy. So, you ask: How do I stop being hijacked by my thoughts and emotions? The first step is to notice the signs of tension or stress in your body. Whether you feel tightness in your shoulders, body fatigue or headaches, your body stores your emotions before you attach meaning to them or are able to name what you’re feeling. Notice changes in sleep patterns, which are clues to your need for mindfulness. Listening to your body’s needs creates the base necessary for overall well-being. Then, you can work on mental health to maintain balance.
Practice mindfulness every day, until it becomes a habit. Focus on your five senses, breathe deeply, listen to music, play with your pets, guide your mind’s imagery, mindfully eat healthy food – all ways to refocus on the things that matter and the moments you can experience right now. These are things you can control that will help regulate your moods.
Your mind and body are interconnected, so caring for your body is essential for good mental health. During times of low mood, increased stress or anxiety, reflect on how your body is feeling, and listen to what it’s telling you through symptoms such as headaches, muscle aches, tension, fatigue. The easiest place to start when you’re struggling is to focus on just breathing; that will ground you while your next steps become clearer. This is practicing mindfulness. Through this practice will come peace, and with this peace comes the ability to handle anything that threatens to knock you off your feet. If you do get knocked down – and you will – return to the practice. Breathe deeply again. Focus again. Stay grounded, and ride out the storm. The storm will pass – again – and in its place will come renewed strength and a sense of mastery over life’s obstacles.
We don’t get stronger by avoiding our obstacles. We learn from our failures and our weaknesses, and we gain strength through our ability to overcome them. It’s only then that we are able to live life to its fullest and enjoy what it has to offer.

Allison White, ACSW, LCSW, CCDP-D
Wellness Alley, LLC

Through My Dog’s Eyes

I’ve always been a pet lover. I remember when I was 7, my great-uncle Benji said to my parents, “Allison needs a dog.” It was at that time, my life changed. I was a very quiet, reserved kid, but dogs brought me out of my shell and taught me lessons as my life began to unfold. They were with me during good times, painful times and major life events, and loved me no matter how I reacted to these situations. They remained stable forces in my life, even during the darkest turmoil. For example, my dog Charity stayed with me during the final days of my grandmother’s life. Charity was a healthy dog, but as I sat by my grandmother’s bed, she became sick, which forced me out of my immediate pain and suffering to divert attention to taking care of her. She suddenly became “well” after my grandmother passed away. She seemed to know how I was feeling, even when I had trouble expressing it myself. Charity stayed by my side, giving love and attention that dogs are so good at providing.

I often ask myself whether I’m treating others and living my own life as my dogs do. Am I loving without conditions, judgments or expectations? Am I living in the moment, or do I let the past cast shadows on the present? Do I worry about future issues that may or may not happen? Living life through the eyes of a dog is a challenge, but trying to do so is slowly changing my life. When I find myself defaulting to old habits and patterns, I try to recognize them, which makes them easier to deal with. It brings an almost immediate sense of calm and appreciation that would have gotten lost in the turbulent thoughts that used to take me off course. I’m able to stay on my path without so many diversions. And I use the same skills from my toolbox to teach others who also want to gain more joy in their lives.

I saw amazing results when I took my two certified therapy dogs on visits to a children’s home. Charity seemed to use her sixth sense to identify which child needed extra attention. I watched as she “worked” the room, going to the child who was quiet and reserved, but who lit up when she sank her head into the child’s hands. I started becoming more aware of how she interacted with these kids, using an unassuming presence without expectation or reward. She just sat by them, until finally, their hands reached out to touch her. She let them initiate the first step before moving closer. Then, beside even the most resistant child, she would roll over to get her belly rubbed, to the glee of the child. She loved her visits with “her” kids and knew whenever it was time to visit, waiting patiently by the back door as I prepared her therapy vest and tags. The uniform turned her into a dog on a mission, and she took her job very seriously.

Chip, my golden retriever, takes his job very seriously too. He patiently watches leaves and twigs fall, then runs around gathering them into piles that he quickly shreds into small pieces. He spends a long time on this task, stopping only when I call him inside. He loves his sticks and could be satisfied spending every waking hour gathering them and shredding them. The day in the life of a dog … it doesn’t get any better!

I practiced enjoying the moment as I watched Chip sleep peacefully in a chair on this lazy Sunday morning. A ray of sunlight beamed onto his head as he snored. I stopped writing my grocery list to capture the feeling of serenity and happiness, while watching his legs move as he dreamed. How I love this dog. His mission in life is to bring me dirty socks, towels and sticks, and to roll in anything muddy. Oh, and to bring me his beloved tennis balls!

I finished my “to do” list with a different appreciation for the day and what was really important for me to accomplish. All is well for me … in this moment.

I work with clients who have chronic issues such as depression, anxiety and addictions, and they don’t always feel like there is hope. It’s hard for them to see there is light on the other side of the darkness, and peace seems so far away. As I use my dogs during pet therapy visits, I see that spending time with animals brightens up a person’s mood and brings joy, even if it’s for a short time. That moment allows a small trickle of light into that person’s heart, which may not have been there before. During one session, a client asked if she could get on the floor because she wanted to talk to my therapy dog about something “very important.” She buried her head into my dog’s fur and told her about the horrible week she had endured. As she stroked my dog’s fur, I could see a sense of calm overtake my client in a way I could not have accomplished by merely talking with her. No judgments, no expectations – just a furry hug.

When we’re facing despair, loneliness, chronic health issues, depression, addictions, or anything beyond our ability to cope, a pet may help ease the pain. He or she can give us a reason to get out of ourselves and our thoughts to focus on a sense of purpose, meaning. Even pictures of pets can warm our hearts and make us laugh. I keep cute animal pictures readily available for a quick pick-me-up. The relationship we have with our pets is real and symbiotic. What I give to my pets comes back to me in ways that can’t be measured. If you’re not able to own a pet, there are many ways to reap the benefits of a pet relationship. Volunteering at a local shelter or helping rescue groups or therapy dog organizations are ways to save pets’ lives, and possibly your own.

Wildlife photographer, author and television personality Roger Caras said it best when he stated, “Dogs are not our whole lives, but they make our lives whole.” Now, go enjoy a pet, and allow yourself to reap the benefits he or she will so generously give back to you.

Allison White, ACSW, LCSW, CCDP-D

Wellness Alley, LLC


Preholiday Survival Plan

I love the change in seasons, but with it comes the busy holidays and the desire to gorge myself with artery-clogging treats. I can feel my body drifting into hibernation mode, enjoying the fire pit, roasted marshmallows and lazy evenings at home. It gets harder and harder to make it to spin class. Interaction with friends and family often involves food, which offers gratification – until I step on the scale the next morning. Succumbed to temptation, yet again! But why?

For many reasons, we disregard rational thought for that heavenly slice of cheesecake. Habits, patterns, cravings and pleasure all play major parts in the cycle that takes us away from our wellness goals. It’s challenging to change old habits, and it seems to take forever to develop new routines. We have cravings, are tempted and seek relief to satisfy our bodies and minds. It’s a vicious cycle. But how satisfying is succumbing to immediate gratification? What do we say to ourselves to justify this behavior? These questions play a part in the creation of habits.

You’ve likely heard that almost anything in moderation is okay, but that’s not true for everyone. Understanding what impacts craving, motivation and behavior – and setting goals – will help you break bad habits and make positive changes in your life. The effort requires making incremental changes, while learning why changing the behaviors is hard, and why it’s important to practice self-compassion during the process. Be as kind to yourself as you would a friend who needs support during a challenging situation. In her book on self-compassion, Kristin Neff, Ph.D., author and associate professor of Human Development at the University of Texas in Austin, states that when we try to “beat ourselves into shape,” we become overly emotional, anxious, depressed and impulsive in our behaviors. We react, rather than respond rationally. She states that self-compassion changes our way of dealing with situations and can counteract the stress.

Many experts discuss motivation, change and habits – it’s important to find the message that resonates for you. Kelly McGonigal, Ph.D., health psychologist and lecturer at Stanford University, offers many YouTube videos on “willpower,” motivation and the neuroscience of change. Deepak Chopra, in his book What Are You Hungry For? discusses how underlying emotions lead to unhealthy eating. This expert in mind-body healing says that understanding why we reach for food helps us deal with the underlying issues directly. Dr. Wayne Scott Andersen, in Discover Your Optimal Health, states that setting primary goals and developing strategies to resist temptation are important. You have a choice to eat that piece of cheesecake, but that decision should be intentional, not impulsive. Keep your eye on your main goal (losing weight, feeling healthy). The question “Why?” will help guide your behavior: Why do you want what you want – be it good for you or bad for you?

Reporter for The New York Times, Charles Duhigg talks in his book, The Power of Habit, about the “habit loop” – consisting of cue, routine and reward. Once you recognize a habit loop, and the reward (pleasure) you seek, you can work backward to identify how it contributes to the unhealthy patterns – you can change the loop. For example, if you crave soda, what pleasure do you derive from it? Is there a substitute for that pleasure? By analyzing the reward (sugar, energy boost, stress reduction) that’s driving the behavior, you can create substitutes that will give you that boost without the undesired consequences. Then, work backward to change your routine to fill that need, which will lead to a different, healthier reward. Duhigg states: “If you identify the cues and rewards, you can change the routine.” It’s actually a very simple concept when broken down and analyzed.

It’s also important to identify what needs changing in your life and the obstacles to that end. How can you support yourself when making the change? For example, if you know that you eat poorly when you are stressed, take a route that avoids your favorite fast-food restaurant after a hard day. Try to identify the stress leading to the craving, and deal with that stress. It doesn’t have to be complicated.

By identifying the underlying trigger (stress) and the familiar behavior (eating fast food for relief), then practicing stress-reduction techniques while supporting yourself (taking a different route to avoid temptation), you will feel a sense of accomplishment. When you succeed even once, you will realize you are stronger than your urges. It’s all about choice in the moment, and identifying your triggers. Then, if you choose to eat that cheesecake knowing it’s not because of negative emotions, you can enjoy it. You regain control by making conscious choices, rather than reacting based on emotion. This power will lead to more positive changes in other areas of your life!

(published in 12/2015 Spirit Seeker Magazine)


Step Out of Your Box

Has the phrase “you have to step out of your box,” ever sent your cortisol levels skyrocketing into fight or flight mode?  “Expanding your box” sounds more palatable, less intimidating.  Dorie Clark talks about (in her book, Reinventing Yourself) the need to constantly re-evaluate who you are, what you’re doing and how it’s working for you.

The constantly changing world demands resilience in order to keep things flowing. Balance is the prerequisite since all dimensions of life (emotional, physical, spiritual, financial, intellectual, educational, social, and occupational) are interconnected.  Weakness and lack of homeostasis in any dimension creates stress, resulting in the seesaw effect as we strive for equilibrium.  It’s important to identify when the seesaw begins to tip and make corrections before experiencing consequences such as excessive tiredness, irritability, excessive eating, reduced productivity, illness, job dissatisfaction, etc.

Reinventing yourself begins by reviewing your strengths and areas of potential growth.  You can then develop a plan to enhance strengths and shore up your potential growths-expand your box- and open up more exciting opportunities.  Although uncomfortable at first, by taking small steps to build confidence and having a mentor for support, you can override your fear. By becoming aware of obstacles and developing a plan to remove them (or make them less obtrusive), they soon became past hurdles that you’ve successfully conquered.  Growth doesn’t occur by staying in your comfort zone.  Strength is derived from overcoming challenges.  What a self-esteem boost!

It’s sometimes difficult to recognize change, which may lead to relapse into old, familiar patterns of behaviors. As you gain confidence in new abilities (it takes time and repetition to develop and reinforce new habits), this becomes easier.  Act confident and others will begin to reinforce your positive changes. Eventually, new patterns will be formed.  Align yourself with supports who will acknowledge your strengths. They will validate your new path and the momentum will lead to other areas of growth.  How exciting!

Who you are today doesn’t need to be who you are tomorrow!


Favorite Quotes

Dante Alighieri: “In the middle of the journey of our life, I found myself within a dark woods where the straight way was lost.”

Dr. Wayne Anderson: “Optimal health is a journey taken one step, one habit and one day at a time.”

Buddhist Sutra: “Unceasing change turns the wheel of life and so reality is shown in all its many forms. Dwell peacefully as change itself liberates all suffering sentient beings and brings them great joy. Dwell peacefully with al of these patterns of change, and to have faith that the unceasing turning of the wheel is spinning us all toward greater wisdom and joy.

Jimmy Carter: “The awareness that health is dependent upon habits that we control makes us the first generation in history that to a large extent determined by its own destiny.”

Deepak Chopra: “We limit ourselves by defining ourselves and giving labels that limits ourselves.”

Stephen Covey: “Motivation is a fire from within. If someone else tries to light the fire under you, chances are it will burn very briefly.”

Dalai Lama: “The tendency to avoid problems and the emotional suffering inherent in them is the primary basis of all human mental illness.”

Einstein: “No problem can be solved from the same consciousness that created it.”

Victor Frankl: “The last of the human freedoms is to choose one’s attitude in any given set of circumstances.”

Robert Fuller: “Good habits once established, are just as hard to break as bad habits.”

Jesus: “If you bring forth what is within you, what you bring forth will save you. If you do not bring forth what is within you, what you do not bring forth will destroy you.”

Jung: “One does not become enlightened by imagining figures of light but by making the darkness conscious. The latter procedure, however, is disagreeable and therefore not popular.”

Jung: “What is not brought to consciousness, comes to us as fate.”

Kurdish saying: “The root of all health is in the brain. The trunk of it is in the emotion. The branches and leaves are the body. The flower of health blooms when all parts work together.”

Stephen Levine: “The beginning of the path of healing is the end of life unlived.”

Mizuta Mosalinda (17th century Japanese poet): “Barns burnt down, now I can see the moon.”

Dolly Parton: “Find out who you are and then do it on purpose.”

Rumi: “Let yourself be silently drawn, by the stronger pull of what you really love.”

Rumi: “Learn the alchemy true human beings know. The moment you accept what troubles you’ve been given, the door will open.”

Jim Ryun: “Motivation is what gets you started. Habit is what keeps you going.”

Thoreau: “Be resolutely and faithfully what you are, not who you think you should be.”

Chinese Sage Seng Ts’An: “Don’t keep searching for the truth; just let go of your opinions, loosen grip of judgments-give truth chance to reveal itself.”

Mark Twain: “The trouble with the worlds is not that people know too little, but that they know so many things that ain’t so.”

Unknown: “Man sacrifices his health in order to make money. Then, he sacrifices money to recuperate his health. He lives as if he is never going to die and then dies having never really lived.”

Lee Ann Womack: “When you get the choice to sit it out or dance, I hope you dance.”


Journey of a Rescue Dog: Baptism By Fire

My phone rang one early morning; the caller was very anxious: “He may have to go back!” Elizabeth was tired, frustrated and at her wits’ end. “I’ve never given a pet back before, but I don’t know what else to do!” Following Austin’s adoption, she had taken the week off to bond, establish a routine and spend time with her new baby. She had created the perfect beginning: new toys, leash, puppy collar, kennel for his safety while she was gone, safe dog bones, etc. – all of the new-puppy essentials. Since I knew this 5-month-old pup was very active and not the perfect candidate for apartment living, I introduced Elizabeth to a professional obedience trainer, so they could get off on the right foot/paw. But, plenty of activities occurred prior to that appointment with the trainer.

Austin’s introduction to his new home involved his racing from room to room, barking and ripping his new toys into shreds. Elizabeth tried to pry those very expensive, “indestructible” toys from his grasp, to no avail. With no “Let go” command in his repertoire, he clung to each broken piece with the jaws of life. Teaching him to release would be a priority for a future obedience lesson.

Walking on a leash was also a challenge. Every rabbit and squirrel beckoned a chase by taunting him with its tail. With Austin gagging and pulling, Elizabeth fought to control this headstrong, energized 28-lb. dog. Leash-walking was also bumped to the top of the obedience training list. Then there was his incessant barking in the apartment, which could easily result in eviction. It was hard to choose which behavior to address first without overwhelming owner or pup.

“I wonder what kind of dog he is?” Elizabeth mused. Beagle? Jack Russell? Foxhound? American bulldog? He possessed a strong prey drive and jaws of steel, and bayed like a hound. His black, tan and white markings resembled those of a beagle, and his ability to jump 5 feet from a standing position screamed Jack Russell terrier. This dog has to have a job, and quickly! To reduce Austin’s often-frenzied behavior, Elizabeth began a walking routine, accompanied by a lot of frustration training him to walk on a leash. The walks started at 3 miles in the morning, 2½ miles in the late afternoon and 2 to 3 miles before bedtime! Apartment-style ball throwing and broken-toy mouth retrieval came in between. “What am I going to do when I return to work?” asked Elizabeth. Austin barked loudly at noises heard from inside the apartment building, jumped on the windowsill to bark at neighbors, and barked when put in his kennel. Elizabeth was feeling like a prisoner in her own home. The frustrations were quickly replacing the joys of new-puppy ownership. She had seven days to control this new puppy or return him to his former foster mom. Her head said to return him, but her heart couldn’t let him go. She enjoyed challenges and was already becoming very attached to this dog.   Austin playing with toy

The next initiation that’s imperative when acquiring a new pet is the first visit to the veterinarian. Establishing a positive working relationship is important, since the doctor will help guide care and treatment of this important member of your family. Austin made his presence known in the vet’s office by barking at the other dogs, pulling on the leash to the point of making a loud gagging sound, then screaming while throwing his body into gyrations before the vet could even examine him. She was patient and was finally able to finish the examination, but everyone in the room was exhausted from the struggle. He left with a clean bill of health. Now he could officially be registered for obedience class.

Due to timing and availability, the appointment for his one-hour private obedience lesson came just a few hours after his veterinarian appointment. We arrived for the lesson, but Austin was not himself. Tired from the struggle at the vet’s office and possibly the vaccine boosters given, he did not demonstrate any of the unruly behaviors that Elizabeth needed to have addressed. In hindsight, this worked out for the best. Having a calm dog allowed the obedience instructor to work with Elizabeth on basic skills and how to apply them while developing a new routine. She left the lesson with a plan and felt optimistic that everything would work out.

I received a text, then a call when I didn’t answer the text immediately. A panicked voice said, “I can’t take it anymore!” Austin quickly bounced back from the aftereffects of the booster shots and became a terror in the apartment. He barked constantly, jumped onto the couch and the windowsills, and demolished every toy that had “for extreme chewers” written on the packaging. This voracious chewer was eating himself through the apartment. In response, Elizabeth and Austin continued walking and walking and walking. They were up to 6 miles a day, which barely took the edge off his insatiable appetite for activity and destruction. I began asking friends and dog experts for advice and helped Elizabeth whittle down her list of options. She still had a few days left in her agreement, so he could be returned to his former foster mother if this became even more unbearable.

One thing she noticed is Austin rubbed his skin everywhere, including in the grass. Maybe his behavior was due to itchy skin? He had red bumps on his belly, which led to another veterinarian visit. Elizabeth changed Austin’s diet and gave him medications, but those took awhile to work. There were so many pieces to this puzzle, and nothing was a quick fix.

That first week in the life of Elizabeth and Austin was jam-packed with learning. Looking back through the texts and phone calls I received while trying to help my friend navigate through these obstacles was daunting. We watched Cesar Millan shows, and although not all techniques should be used in all situations, the shows taught Elizabeth the importance of being a pack leader, being consistent and being tenacious – if she could stick with it, she may see results.

Here are some of the training techniques used that first week:
• Walking – Cesar Millan-style – with Austin by her side wearing a training collar, and walking in the opposite direction when he tugged at the leash.
• Teaching him to “Wait” at all street corners – since he tried to pull her into traffic.
• Extending the walked distance – once Austin was able to walk on a leash without lunging for every squirrel that taunted him.
• Using a doggy backpack – laden with a water bottle on each side to wear him out faster during walks. The obstacles: He didn’t want to walk with it on, and then he didn’t know how to navigate through the door with extra padding on his body.  Austin with backpack
• Teaching basic obedience skills – like “Sit,” “Down,” “Kennel” and “Quiet.”
• Using a water squirt bottle for dire emergencies – when he was zooming around the apartment, while biting everything he passed.
• Toenail trimming – the attempt at which was a full-contact sport! At first, Elizabeth held him in her lap on my ottoman, while I approached with the Dremel. Austin shot his body backwards, which caused Elizabeth to fall off the ottoman, almost hitting her head on my tile floor. We switched, and I held Austin in a stronghold, while Elizabeth used the grinder. I had scratches and bruises on my arms and legs from the event, and no nail was ever touched. This would be a challenge for another day.

Everything became a routine. He wasn’t given any treat, food or toy without being asked to perform an obedience behavior. Elizabeth slowly became the pack leader, and by anticipating any bad behaviors Austin may have, she was able to head them off, often avoiding potential disasters.

Now, why was Elizabeth continuing to give Austin a second, third, fourth chance? Amid the challenges, there were many easy-to-forget positives. Austin is adorable, funny and mischievous in a Dennis the Menace kind of way. He makes her smile, and believe it or not, he enjoys snuggle time. Yes, there are times when, like an overactive toddler, he collapses after moments of high energy, and the innocence he portrays as he sleeps erases the moments when she feels like pulling her hair out. Austin is quite the snuggler and snorer, as well. He has a way of using his eyes to draw you in, and his antics can be quite hysterical.

Elizabeth has become attached to both Austin and the challenge. She can see small progress, which is often followed by regression, but she is learning how to teach Austin to learn. She is molding his behavior into something she can live with. Her biggest regret is the money spent on too many toys, which were quickly destroyed. They overstimulated, sending Austin into a frenzy.

The next step in the training process is formal obedience class. There are many fears, mainly not knowing how he’ll react around other dogs. Will he become over-the-top crazy when toys are used? Elizabeth’s biggest fear: Will they pass the class, or be told to take Novice again? We talked about how there is no shame in repeating that class, since sometimes those basic skills take time to learn. That will be a story for another day.

The biggest news is that I got a call from Elizabeth on the seventh day of having Austin, to say she could not give him back. It was a very long week, but she saw results. Austin had already been in four foster homes before she brought him to her own, so she knew it would take more time for him to adjust. He had experienced a lot in his five months of life, and knowing he was already in the “teenage” stage gave her hope. She made the long-term commitment of a life together, and Austin finally got his forever home. But, there is so much more … Stay tuned for the saga of this rescue dog, as both Elizabeth and Austin face more life challenges together, which in turn, changes both of their lives.

Austin and Elizabeth on Couch


Journey of a Rescue Dog

“What kind of dog should I get? Maltese? Chihuahua? a small one that will snuggle with me?” my friend had been asking almost continuously lately. I knew the time was nearing when she’d find the “perfect” fur kid because her persistence with wanting a dog had been intensifying. As we walked around another adoption event with all the sad eyes peering through the cages, all seeming to be pleading “Please take me home with you,” I could hardly stand it anymore. If I had room for them at home, they’d all be mine.

My friend coaxed me to accompany her to yet another event on another weekend, where we passed several cages of very small dogs. And, then, there he was – fixed stare, adorable face, floppy ears, one white with speckles on it. His gaze followed us as we petted the smaller pups. My friend turned to the rescue group staff and said, “I’d like to play with him,” as she pointed to that floppy-eared, 6- month-old, 28-lb. beagle-terrier mix. My mouth flew open in disbelief since this wasn’t what I envisioned for a suitable apartment companion.

We took him for a walk, played with him in the enclosed area, then handed his leash back to the foster mother with whom he had been living. “I’ll think about it,” my friend said. But as other potential adopters looked at that pup in the cage, my friend knew she didn’t want him going to live with anyone else.

Fast forward … The pup soon had a new home in an apartment with my friend, the new-doggy mom, who had fallen instantly in love with him. His name was Austin, which fit him perfectly. Yes, there would be behavior issues to resolve, but this would happen one step at a time. I said I’d help with training and problem-solving, which, I have to admit, made me run to some professional dog trainers for assistance.

The first task was to create structure and to set boundaries for what was acceptable behavior in an apartment setting. Then, establish a routine, get Austin checked by the veterinarian, find a kennel for safety when unattended, then sign up for obedience training. She focused on not projecting upon him her trepidations about his past life and what may have happened to him as a rescue dog. The lesson learned was that humans may live and think in the past, but dogs live in the moment. They may react from how they were treated in the past, but our job is to help them work through those obstacles without giving in to the “poor baby” mentality. It’s important to reinforce the behavior we want to continue. Coddling an undesirable behavior, such as fear, will only intensify it.

My friend has done all the right things and has a thirst for knowledge that stems from her love and immediate bonding with Austin. Trying times are ahead, especially with Austin’s need for constant attention and exercise, but so far, my friend has been able to offset the negatives with the realization that they have come a long way together in a very short time.

I will continue reporting on this journey, which is just beginning for Austin and his new mom.


Allison White
Wellness Alley, LLC



Reevaluating Our Pet’s Goals

Have you ever wanted a goal so badly that you’re driven out of  your comfort zone to achieve it? Have you almost reached that goal only to have the bottom drop out, forcing you to rapidly change course? It is hard to stop midstream to reevaluate and change your path, especially if you have a lot of emotion and time invested in achieving whatever needed to reach your goal.

I’ve raised puppies with a specific goal in mind, whether it’s that they become therapy dogs, earn advanced obedience or agility titles or become conformation champions. Once my dogs enter my household, they rarely leave, so it’s difficult when my high hopes that they’ll fulfill certain goals don’t work out. I’ve had dogs who had to retire from performance events because of sports-related injuries, had to end conformation careers because of genetic conditions that shouldn’t be passed to offspring, and had to retire from obedience competition because they didn’t enjoy it. One dog was trained to advanced obedience titles when he shut down in the competition ring. Could I have spent time working through his fears? Maybe. When I released my expectation and found an activity he enjoyed, his true nature and joy of life emerged. He never did achieve advanced obedience titles, but he loved agility and quickly attained advanced agility awards.

I’ve enjoyed doing therapy dog work but faced some of the same issues. What do you do when you want a goal more than your dog does? It takes some soul-searching, and it can be a personal loss to overcome. I’ve seen trained therapy dogs who didn’t seem to have fun anymore. Maybe they visited too often or didn’t take a break, which is essential for their emotional well-being. Therapy work is both emotionally and physically draining for pets. That one hour visiting a hospital or nursing home, where people’s needs and emotional situations are displaced onto the therapy dogs, can be draining. My own therapy dog will sleep all the way home after a visit. They may not be aware cognitively of what people are saying to them, but they feel the emotional intensity of the various situations. Therapy and service dogs need regular vacations or time-outs to play and just be dogs. They benefit from exercise to release pent-up energy, so they can return to work refreshed.

How will you know when it’s time to retire your dog from his chosen profession or performance event/career? Here are some of the more common indicators that maybe it’s time to find another activity for your dog:

  • The enthusiasm to run out the door with you for a visit is gone or starts to dwindle.
  • Your goal or desire for success or achievement is higher than the dog’s ability to achieve it.
  • The dog is either suffering from an injury or chronic condition, which may postpone competing in dog shows or events. Returning to shows early may be tempting, but rehab is slow, and the risk of reinjury may end a performance career if the dog is not completely healed.
  • Look into your dog’s eyes during training and evaluate whether you’re still working as a team, or has something changed? Who wants this more, you or your dog?

This topic evokes a lot of emotion in me since I’ve experienced many scenarios leading to potentially career-ending decisions. I didn’t make all the right decisions all the time, but I learned from them, which changed my outlook over time. There were many sleepless nights trying to decide whether I made the right decision. I found that if I looked into my dog’s eyes and pushed away my ego and my need to earn a ribbon or award, I came to the often painful truth, the right decision, and I was able to sleep soundly again, knowing my dog’s happiness was placed higher than my own needs or desires.

What are the consequences of these decisions?

  • My dog is less stressed and has a higher quality of life.
  • I may be removed from friends with whom I used to share experiences and travel to shows.
  • My dog and I will have to focus on different goals, while saying goodbye to sometimes years of training.
  • I may lose my identity and have to change my preestablished course. For example, someone once said, “Allison, you usually have an obedience, conformation and agility title on your dogs by now,” after I took a break and changed my normal path. It wasn’t easy to accept, and I felt like a failure.

I have utmost respect for people in the dog community who value the human-animal bond and who make their pets a part of their lifestyles. This increases quality of life for everyone, and at its best moments, life doesn’t get any better. But things can change, even subtly, and it’s important to look for the signs that goals may need to be reevaluated. Circumstances change, and we may need to choose a different path. What doesn’t need to change is our relationships with our pets, who are important members of the family and who just want to please us no matter what we do together. After all, it’s the connection we have with our pets that we remember far after the memories of the ribbons or titles fade.

Allison White

Lessons Our Pets Teach Us

This week I faced the fear that many pet lovers experience…the realization that my beloved pet was getting older. I found myself watching every move to “catch” any indication of declining health. My 14-year old dog suddenly became ill and it wasn’t resolving quickly. He had moments of energy followed by sluggishness when I wondered whether a trip to the veterinarian was needed. In the past, many hours have been spent in emergency rooms only to be told everything was fine. Should I risk waiting this time? No, so away we went to the urgent care facility. Waiting for “the news” seemed to take hours. Diagnostics were completed then the veterinarian entered the room smiling as she announced everything appeared normal. I could have given her a hug! I had more time with him. My heart went out to everyone in the waiting room and I hoped they would also receive good news.

As I nursed my dog back to health, I reflected on the short time we have with our pets. Watching mine brought up many questions. Have I given him a good life…, an excellent life filled with love and joy? As he slept peacefully on his bed, he looked like he could not be happier. He has never had high expectations except to be fed, walked and to greet me when I come home. He gives unconditionally with little expectation in return. On his 14th birthday, I gave him an overly stuffed dog bed, which was placed at his favorite spot by my chair. He sniffed it, turned away, and jumped onto my chair instead. I moved the new bed on top of my chair so now he had a truly overly stuffed dog bed. What’s wrong with this picture? Nothing. It’s what we do for our furry kids and it makes us happy. It’s the least I can do while sharing my life with a dog who loves me unconditionally, who sees me without makeup (and doesn’t run screaming), who smiles at me as I leave for the day and jumps up to greet me after a long day of work or gone for 5 minutes to take out the trash.

Sharing our lives with pets can be hard. We lose them far too quickly, grieve their loss, then somehow, realize that life isn’t the same without so get another. It is the cycle of life, part of love and sharing. The loss after they go is still worth the time they spent with us. It’s hard to explain their impact on us but we know how empty it feels when they’re gone. Dr. Temple Grandin stated in her book, “Animals Make Us Human” that they teach us life lessons. I have tried to adopt this realization in my daily life. Pets practice mindfulness skills by living in the here and now, which I am reminded of when my Golden Retriever stops to watch a butterfly. How many times have I missed these amazing gifts of nature? Our pets have a keen awareness of their surroundings, maybe because they depend on others to fulfill basic needs.

In Dr. Marty Becker’s book, “The Healing Power of Pets,” he talks of how our pets share life lessons if we would only open our eyes to learn from them. It took my dog’s illness to clarify both my fear of losing him and the joy he continues to bring every day. My pets teach me not to be judgmental, to be compassionate, joyful and appreciative of the love I receive and the love I give. They help us become children again – if only for a moment – letting us play, laugh, run and enjoy the silliness of the simplest experiences. Look at the videos shared on Facebook and YouTube. They brighten our days. My cell phone has my favorite dog photos to look at when I need a pick-me-up. Our pets remind us of what’s important in our lives…..the bonds, the special connections we share. It’s what truly makes us human.  It’s also what causes grief and despair when faced with their loss.

Pet lovers realize that loving also means someday saying goodbye to a beloved pet. As our pets age, the realization often brings fear of the inevitable loss. We are never ready for that moment, which means losing a friend, family member, confidante and someone who has loved you unconditionally without judgment. When this time comes, it’s important to reach out for support, whether it’s a friend, family member, counselor or support group.  Don’t struggle alone. Pet lovers may hear others make light of their loss, so it’s important to find empathetic people who will listen without judgment. Acknowledge your feelings and don’t deny the impact your pet’s loss is having on your life. Take care of yourself!  Make sure you get enough sleep, eat and take extra time just for yourself. Many people feel that they must “get over it” quickly without facing the true depth of the grieving process. Our situations are unique so there is no standard time in which to “get over” the loss. There are many pet lovers willing to provide support so reach out and ask for what you need.

The human-animal connection is powerful and the joy, love, companionship, fear, loss and the whole emotional connection adds another dimension to life that’s difficult to replicate. Our pets teach us lessons if we take time to listen. Pay attention to what they’re telling you in subtle ways as you share your life with a pet who loves you the way you are. As we honor their lives, we also honor their memories. When it comes time to say goodbye, you will have received the greatest gift …the deep love and affection of a faithful companion. Those memories will stay with you forever.

Allison White, ACSW, LCSW, CCDP-D

This article was published in MetroPet’s June 2015