WMH 11: Mental Health and Hospitality in Las Vegas

This is a transcript of Watching Mental Health Episode 11 with Madison Hardy which you can watch and listen to here:

Katie Waechter: Hi everyone, and welcome to another episode of Watching Mental Health. Don't mind the angle today. I am operating off of a different technology for this particular interview, but that's okay because it's still going to be an outstanding interview and I am really excited today to welcome my guests because of her unique perspective and history here in Las Vegas. And so I'm going to tell you a little bit more about her and then we'll bring her right on. So Madison Hardy has a passion for the pursuit of knowledge, wisdom, and a deeper understanding of the human experience. She received her bachelor's degree in philosophy and master's in couples and family therapy and is currently a marriage and family therapist intern supporting individuals, couples, and families for the last three years. And on this episode, we are going to talk more about her work in therapy as well as her background in hospitality here in Las Vegas and get her thoughts on the mental health struggles that we have in southern Nevada and what makes us really unique here in southern Nevada when it comes to addressing our mental health. So again, I'm super excited to jump right in. So let's bring on Madison Hardy and welcome to the show.

Madison Hardy: Hi Katie. Super excited to be here. Thanks for having me.

Katie: Thank you so much for joining me. And I reached out, it was pretty random and so I just appreciate you going along this ride with me and I am just really grateful to have you here.

Madison: Yeah, thanks so much. Yeah, definitely couldn't pass up this opportunity.

Katie: Well, I appreciate it and I think that your perspective is going to be really great to bring to the table to this conversation that we're having around mental health and to really make a difference here in Nevada because we're starting off at the bottom, so there's really only one way to go. And so before we jump more into that, tell me a little bit more about who you are in your own words and what brought you to the field of mental health.

Madison: Sure. So I'm not sure if you mentioned, but I'm born and raised here in Las Vegas. Probably will never leave. I love it so much I haven't left. Got my bachelor's here, got my master's here. So it's really important to me to support the community I've grown up in and have grown to love. And like you mentioned, I have been industry worker in the hospitality industry for over a decade now at this point, operating on many different levels, many different positions from entertainment to serving, all of that kind of thing. So yeah, just true Las Vegas identity and obviously went to school, really enjoyed going to school and probably was there longer than I was supposed to be just because I was really into learning and I got my degree in philosophy and just wanted to take all of the classes. And naturally that led me to, I knew I wanted to go to grad school, but I wasn't quite sure for what. And randomly took a marriage and family therapy course, not really knowing what to expect and learned more about the field and realized it was truly a seamless transition from what I was learning in philosophy to a more practical application of what I was learning. And marriage and family therapy is actually almost like a criticism of your typical kind of psychodynamic psychological approach. So I really liked that aspect of it. So applied to the graduate program and haven't looked back since.

Katie: That's really interesting. I would love to learn more about that. Well that's awesome that you really found a class that took you and then kind of showed you a different way of supporting the community. And I too am a forever student and so I took quite a few philosophy classes. So yeah, there's so much in common between the two and to be able to apply, I think philosophy in a psychodynamic setting is really exciting and something that we need. So what have you seen here as far as what people are really needing in Las Vegas? Are you seeing struggles with people getting access or what are the kinds of things that you're seeing just from your experience in the field?

Madison: Yeah, definitely accessibility I would say is probably one of the main issues why we kind of struggle so much. It seems obviously being able to access services at an affordable cost. There's a shortage as you know of providers here in Las Vegas, which is why I really wanted to remain here to be able to do that work and provide that support. But as far as particular issues for Las Vegas, we are a very unique city, absolutely very service industry driven, tourism driven industry, which absolutely comes with its own set of issues I would say most definitely. But at the same time we are growing and there's been so many transplants as we've seen, we've been growing at an exponential rate here in Las Vegas. And so really you see everything you would see in any other big city. It's interesting, we have our own unique culture, but at the same time it's such a diverse population and so there's many challenges people are experiencing that, that are needing assistance.

Katie: And were you were working on the hospitality side, were you also seeing struggles and Oh yeah. What kind of made you want to not do hospitality anymore and really full focus into a different direction?

Madison: So I still am very much in the industry presently. It's been important to me to not make the full switch to full blown therapist. I like that. Yeah, I really always, like I said, I enjoyed it. It's always been a part of my identity to be working within the Las Vegas industry. I was a professional dancer for a really long time and loved that. And now I'm kind of more on the service end of things that I really enjoy and it definitely, it's an aspect of my identity and it's interesting because there's so many intersections of things. As many people know when you're a server you're very much taking care of people as a therapist, being able to see how those things intersect has been really interesting. But yes, at the same time I'm like, I don't want to do this forever. That's why school was always a really big thing for me because it was important to me to have a career. So yeah, definitely hospitality working within that industry has its own sets of concerns and issues. Yeah, absolutely.

Katie: Yeah, it does feel like that. And it is unique here. And so this actually transitions well to my next question and maybe you can talk more about what makes marriage and family, what makes that different, that it was really attractive to you and really it's about why is that method a little bit different and what does treatment really look like with marriage and family counseling versus other maybe forms of talk therapy?

Madison: Yeah, wow. I love this question because when I'm not going to lie, I had this almost aversion toward marriage and family therapy. It just sounded too constrained. But I took the class and it blew my mind and I realized it's not just about marriage and family therapy, it's about relationships. And that was something I always, always had a strong affinity for was this understanding that it's not just us, we're not just individuals, we're a part of a larger whole, right? This connection, the sense of connection we feel with our families, our communities. And so like I said, marriage and family therapy was born out of a critique of traditional psychodynamic perspective of psychology and counseling and it really took into account individuals in relationships and being told in my graduate program, you don't just have to treat couples and families, you can still treat individuals. But it's about that perspective of having that greater understanding of how we relate to ourselves, how we relate to our families, our loved ones, and how we relate to larger systems that are bigger than ourselves and those challenges that can arise from that perspective.

Katie:Wow, I love that. So it's really bringing in the perspective of relating to the whole community, and I've said this before on the podcast, but we are such social creatures that even when we're introverted, we still need need a village. We still need support from other people and to be able to provide that support in return. And so that's cool. That seems like that's what your focus is in how you approach things.

Madison: Yeah, exactly. And like I said, there is a strong philosophical foundation with marriage and family therapy. There's a lot of postmodern theories that are based on marriage and family therapy, like narrative therapy, solution focus therapy, collaborative language, which is the approach that I most use with my clients. So I really liked that it was kind of like this almost rock and roll spirit to therapy, which I loved. It just resonated with me so much.

Katie: That's so cool. I actually, I was really constrained in my thinking of it as well. So you really opened my eyes here. Wow. I think that's really, I never, I've taken that class. I have a BA in psychology, so it was the essentials, it was just the basics. It wasn't going into therapy. And so that's just so awesome to really hear that. So what does treatment then look like to you with your patients? Tell me more about how you approach treatment with them.

Madison: Sure. So of course every client is unique. Every client system is unique, whether it's an individual family or couple. So treatment of course is going to look different for everyone depending on what they're there for. My approach is very collaborative with my clients in that I only really want to work on what they want to work on. I'm not one of those therapists or those directive therapists, which is okay to be that kind of says, this is what you need to do, this is what I think you should do. Almost kind of like a coach kind of, which again, there's nothing wrong with, but the approach that I work from really believes that if you follow the client's lead, you're going to more likely get to where you need to go a lot quicker. So obviously a client that is motivated, that's important in terms of treatment if a client that's going to determine treatment outcomes if someone is motivated to receive treatment or not.

So I'm very collaborative in that way. I always ask my clients, how will you know will not need to come to session anymore? How will you know won't need to come to therapy anymore? And it's goal setting. So when I'm meeting my clients for the first time or we're in that assessment phase, it's very much about collaborating on goals and what they want to get out of treatment, what treatment looks like for them, how they know they will be in a healthier place or whatever it might be. I leave that to my client to be determined.

Katie: Yeah, that's really great. The collaboration I think is so key and just developing a good relationship with your therapist I think is key and not everybody is the right fit for everyone. And I find when I preach therapy to people who are maybe considering it for the first time, I find that I'm consistently telling them, it's okay if you don't like your first therapist, you have to keep trying, you have to keep going. That's sometimes the hardest part. What are your thoughts on that?

Madison: Yeah, same thing. I mean whenever I am helping people find referrals or whatever it might be, I always say therapy is dating. You have to just keep going through it until you find someone that fits because just like there's all different kinds of people, there's all different kinds of therapists and my might not work for everybody and that's totally okay. So finding the right fit is so, so important because something I also really hold true is the relationship itself between the client and a therapist is therapeutic in and of itself and just really holding true to my philosophy of therapeutic isn't something you do, it's something you are. So I really value the relationship with my clients and that's also really true of my approach as well. It's just really, really focusing on the relationship.

Katie: I really love that. Yeah, it's not something you do, it's something you are. And so as a therapist, what does self-care look like to you? It can be hard to I think spend all day digesting other people's traumas. And so how do you go home and apply that own therapeutic and self-care to you?

Madison: Yeah, absolutely. So my other job is my self-care, my weekend gigs. I get to just kind of disconnect and just really play with this other aspect of my identity and focus on that over the weekend. And then I come back on Monday and put my therapist hat back on and obviously show up there. But having something else I think is really important for my personal self-care. And then also just I tell all my clients having boundaries, knowing when to say no to things. I think we tend to spread ourselves so thin, especially in today's day and age where we want to do all the things and make all the money and protecting your mental health is so, so important. So knowing when to rest, taking a lot of rest, being able to identify when you need to take that rest and doing what feels good and just like I tell all of my clients, self-care is different for everyone. It's not going to be the same thing as it is for you as it is for me. So figuring that out is so, so important and knowing when to implement those self-care techniques.

Katie: Yeah, absolutely. I fully agree. And that's cool that you're able to, I think play with both identity, both aspects of your identity and to utilize self-care within that. Las Vegas is filled with so many opportunities to say yes, we keep growing and growing. I think that here, especially for us, we do have to be mindful to practice that self-care and to know when to say no and to not get that kind of fear of missing out syndrome. Do you think that's more common here in Las Vegas because of the kind of nightlife that fun that we are?

Madison: That's a good question. Probably. Yeah, I would imagine there's a lot of, it's almost like sensory overload here. Totally. Yeah. When I'm at my other weekend job and I'm talking with guests about their experiences and you get the sense that sometimes they're just overwhelmed by all of the things to do. And so yeah, I think you have to be careful in terms of how much of yourself you give and knowing when to say no and when enough is enough. Obviously there's a lot of, I guess vices in Vegas too, which is okay to engage in of course. But definitely knowing when to not partake and knowing your limits and how does it affect your mental health and that kind of thing I think is something people should definitely be aware of.

Katie: It does seem like here in particular, we have a few more struggles with addictions just because we're 24 hours and it's always there. You can always at any time on a Tuesday at three in the morning I can go and drink and gamble. And it seems like some people struggle with that when they come to Las Vegas, but I'm like you, I'm born and raised here and I'm probably going to die here. I love Las Vegas, I want it to be better. I want to see it improve, but it's like balance between fun and knowing when to stop.

Madison: Absolutely. Yeah, and I agree addiction is definitely something that is present here in Vegas maybe more. So that's an important thing to consider too, and knowing how your environment plays a role in that and relationship. Right,

Katie: Absolutely. So I think it segues well to this next question that I try to ask all my guests if I can. And it's do you believe that a mental health challenge or a diagnosis is something that somebody can overcome and heal, they can get better from it, like a physical condition or is it something that maybe they are going to have to battle with for the rest of their life, potentially taking treatment for the rest of their life or somewhere in the middle?

Madison: Yeah, I think definitely somewhere in the middle. Both things can be true, and I think it definitely depends on what it is exactly you're dealing with. I tend to, the approach that I work from, I'm really careful about the language that I use with my clients and I encourage the same for them, whether it's us talking in session or whether it's them talking with loved ones or just in general how they talk about their challenge or their problem. And so part of what I do with my clients in session is we co-construct new meanings together so we find discover new language to use that dissolves their problem or dissolves the problem system that they find themselves in. And so I really think it just comes down to how you relate, how you relate to your mental health challenges. I think you could consider it a challenge at one point and then maybe you overcome it or you construct new language or new meaning from that challenge, whether it's a diagnosis or relationship. So I really think it just we develop a new relationship with those diagnoses or those mental health challenges and eventually it just maybe doesn't become a challenge anymore or doesn't become a problem anymore or if it's still present, it's something that you've accepted or you're able to manage now at this point through the support of therapy or medication or whatever it might be.

Katie: So on medication, do you feel like there's a time and a place for medication or do you generally lean more anti-medication?

Madison: Definitely not all for if it works then do it. I think I definitely certain symptomologies certain diagnoses where if the symptoms are more severe at that point it's more I might not feel it's ethical for me to continue treatment if the symptomology is severe enough and I may need to refer in conjunction with to a psychiatrist or to a medical doctor. And that's just from an ethics perspective that we are trained in grad school to be able to present

Katie: For sure. I love that. I love learning that

Madison: And ethics is a big thing for me. I always want to make sure that I'm providing ethical care, and so part of that is knowing when something may be out of the scope of my practice, whether it's diagnoses or symptomology that's more severe that maybe needs to be referred and medication needs to be explored. So part of that assessment phase is assessing the frequency, duration and intensity of symptoms and if it is on the more acute or severe end, at that point it's ethical for me to offer the possibility of medication, not myself obviously, but for a psychologist or a doctor

Katie: For someone else to come in.

Madison: But if someone is not interested in medication, then obviously at that point, like I said, depending on the symptomology, they might need to be referred out because I always tell people too, that therapy by itself is awesome. Same with medication by itself is awesome, but when you use them in conjunction, you can really optimize your results.

Katie: Yeah, definitely. I think that if symptoms are severe enough, there's a time in place and I just appreciate that you have this kind of ethical foundation that you're really bringing to the table because sometimes, sometimes it feels like therapists can just treat everyone, but that's not really the case. And so what do you see most often and what do you feel that you're most skilled in treating?

Madison: Yeah, so definitely I would say relationships, relational issues, so couples families, however context that might exist, whether it's couples merged therapy or parent child dysfunction or conflict or even I have a lot of individuals who are just experiencing relational issues with whoever, and we just process how to better manage that relationship. Obviously anxiety, depression, stress management, that stuff is definitely in my wheelhouse. Same with trauma-informed therapy processing trauma. Okay, cool. Yeah, those are things I do a lot of and yeah, definitely. And

Katie: I love that. I think that doing that trauma-informed approach I think is trendy right now for lack of a better term. Yeah, definitely. Definitely. But I think that's kind of cool to focus more on healing some of those traumas that maybe we just kind of pile other feelings on.

Madison: Absolutely. Yeah, and you're right, trauma-informed is kind like this buzz word or buzz concept, but I really think it's just kind of a fancy name for, we talked about that therapeutic rapport, so so important when you're processing trauma because you want to be able to feel like you can trust your therapist, feel like you're really being validated and empathized with, like I said, that relationship alone can be therapeutic and really powerful, especially when it comes to processing trauma.

Katie: Yeah, no, I fully agree that trust and that's why the relationship is so important because people just aren't going to get deep unless they feel that they can have that. Yeah,

Madison: Exactly. Yeah,

Katie: That's awesome. Well, we only have a few minutes left, but I want to end on bringing it back to Las Vegas to southern Nevada and just your thoughts on maybe ways that we can improve our own mental health here in southern Nevada, perhaps as a community or individually or just what you've seen and what you're hoping for the future.

Madison: So we've been talking a lot about self-care and being able to recognize your own limits. And so obviously I'm a proponent of everyone should go to therapy at some point or another. That's also, I don't think I mentioned I go to therapy. That's a big part of my self-care too, especially with occupying all these different roles. And I think a lot of people in Las Vegas probably do or just in general. That's just the nature of our beings really. So I think it starts with you. I think it starts with yourself and your family and then that kind of disperses into the community and the city as a whole. So I think once you really focus on healing yourself, taking accountability for your own mental health, and then that trickles down into your relationships and then that trickles out into your workplace and then that trickles out into the community as a whole. So I think it really comes down to taking care of yourself first and foremost.

Katie: Yeah, no, I think you're right. We're such a gig economy and in some ways I've noticed a lot of industries are so siloed and really coming back and keeping yourself and your own relationships grounded and balanced and practicing that self-care and putting in place those boundaries. So Las Vegas doesn't get the best of you. Absolutely.

Think all of that's important.

Madison: Yeah, yeah, definitely. And yeah, like we said, we're all for having fun, but knowing your limits of course, and understanding when maybe chaotic relationships are beginning to form, whether with substances, other people or maybe a job, and so really being able to identify when you have to consider things a little bit more deeper and how they're affecting you.

Katie: Yeah, yeah, definitely. It can be so superficial, but we're all people underneath and there is a community here, and so it's a matter of finding. Yeah,

Madison: Yeah. I know that's a big critique and complaint is that Vegas is too superficial, too commercial. There's no community, and there definitely is. You just have to know where to find it. It takes little

Katie: Bit of work, but yeah, that's right. It takes a little bit of effort, but just like therapy, putting in that effort, I think that effort, it comes back tenfold. So I'm just like you, huge proponent of everyone should be in therapy at least once in their life to get through some stuff.

Madison: Yeah, absolutely. I think it's really valuable to just have that relationship and a different kind of conversation with someone.

Katie: Yeah, it is a different kind of conversation. It's not a conversation you could have with your loved ones, and it's wild to feel all that attention on yourself, which I think for some people is uncomfortable at first, but it's important to get that value. To get that attention.

Madison: Yeah. Because like you said, you're not going to have the same conversations you have with your therapist like you do your family or your loved ones or your friends. It's a very intentional conversation dedicated to opening up your perspective and better managing your needs and goals. So I really, really value being a part of that and being a facilitator in that way.

Katie: Oh, that's just so awesome. First off, we need more therapists and we need more good therapists, so I'm really glad that you put your hat in that you're a part of this community and I'm just really grateful for your time and to be here with me to kind of walk through your approach, which I just think is such a cool approach and so important for our city to have someone who knows and understands the city and the hospitality culture and to be able to bring that into therapy is just super cool to me.

Madison: Oh, thanks so much. That means a lot.

Katie: Well, I really appreciate your time again. So we're done. We are at time, so I'm going to wrap it up on this, but I'd love to have you back anytime. We are live every first and third Wednesday of the month, and then you can always see my episodes on my website@katierosewecter.com. So thank you again and we'll see everyone next time.

Madison: Thanks Katie.