Feb 27th

Quiet Agony: Chronic Pain & Mental Health

By Cathy Malmon, LMFT, LICSW

Quiet Agony: Chronic Pain & Mental Health - Calli Institute

Remember some physical pain you have had in the past. Hitting your funny bone, a sprain, headache, stomachache, or even a broken bone. There might have been some initial intense pain; choice swear words, a certain amount of time to heal, possibly some accommodation as a bandage, sling, limited driving, food restrictions, or movement restrictions etc. Except for the obvious bandage etc, there is no clear visual that you have been hurt. You recover from that experience, and your life resumes.

Imagine this.

Now imagine that the previous pain experience doesn’t lessen or go away, but lasts for weeks, maybe months, or longer. Consider how the length of time would add to the experience and how it would impact your life. There might be some discomfort, some difficulty in completing things you could normally do easily. There might be certain activities you are not able to do at all for some time. You might have to alter your physical or social activity.

Imagine this.

Chronic pain is described as any pain lasting more than three months. The pain can progress to the point that the pain persists long after the original injuries heal.

According to the 2012 Survey National Health Interview Survey, 25.3 million adults in the United States have suffered some from pain that lasted over three months. The study found that 17.6 percent of American adults suffer from severe levels of pain. That translates to millions of adults who are dealing with chronic pain.

Chronic pain doesn’t exist without some collateral damage and other co-occurring issues. Those suffering from chronic pain usually report depression and anxiety.

Psychiatry Investigation 2015 Jan; Pain and Depression: A Neurobiological Perspective of Their Relationship explores the neurobiological relationship between chronic pain and depression, as well as explaining the neurological factors with both pain and depression.

Clinical symptoms that often appear with chronic pain are changes in sleep, appetite, mood, and energy. Sleep deprivation and inadequate nutrition over time will have long-term effects that can be an additional source of medical and clinical attention.

The Institute for Chronic Pain (ICP) wrote an article that was within a series on chronic pain. It described the interaction between chronic pain and anxiety. Understanding Chronic Pain: Complications and Anxiety Complications (Understanding-chronic-pain/complications)

Anxiety is an adaptive response that alerts our system of possible danger. Pain is also a warning sign that signals the need to protect and guard against further injury. The flight, fight, or avoidance responses can then become chronic themselves. Pain becomes a focus of attention and decisions are then based on how much pain a person feels. The cost to self-esteem, personal and work relationships can be huge.

Pain management programs usually include cognitive behavioral therapy, antidepressant medications, relaxation exercises, and some form of mild physical exercise. I want awareness for the person behind chronic pain.

I had hip surgery over three years ago. I don’t remember the pain connected with it and had resumed my life. I am now dealing with rotator cuff surgery and am reminded of the lessons I learned then. Daily activities like dressing, bathing, planning for groceries, taking care of my dog, and transportation are tasks I did not have to think about before. My sleep is compromised, and my attention is more often on the pain in my arm. I have to ask for help, which is difficult for me.

I am lucky; for there will be an end to this chapter, and I will resume most normal activities. I respect the daily struggle of those who will have to manage their pain long after mine has subsided.

I am now a regular Lyft passenger, because I am not driving. One of my drivers and I were talking about the issue of chronic pain as his wife struggles with long-term pain connected with a driving accident. He talked about what he witnesses with her struggle to dress, bathe, and get out of the house. “I see her quiet agony.”

For all those struggling with quiet agony, we need to see you more.


Feb 20th

The Reverse Bucket List

By Tessa Gittleman, LAMFT

Calli Institute - The Reverse Bucket ListDerived from the phrase, “to kick the bucket,” bucket lists are essentially a compilation of things to do, try, or see before you die. If you have never made one before, imagine creating a list of New Year’s resolutions that you try to hold yourself to accomplishing over a lifetime. If you love animals, maybe you want to ride an elephant? If you are a traveler, maybe you want to take your motorcycle across the country, or sail around the world? The list can be as long or feasible as you want, which is perhaps why so many people find bucket lists problematic.

Like New Year’s resolutions, my bucket list is intended for my ideal or best self. When I feel good, capable, and have the resources, it inspires me to take initiative to do things I otherwise can’t or won’t do for myself. When I am my every-day self or feeling even slightly below average, the list becomes more evidence of what I “should’ve” or “could’ve” done, and a glaring reminder of how much I have left to do. It becomes a pressure or burden in my life instead of a reminder of good things to come.

If you read parenting websites, Fast Company, or lifestyle blogs, you might have seen a new way of bucket-listing become increasingly popular over the last few years—The Reverse Bucket List.  What’s the difference? Instead of writing down a list of things you hope to one day achieve, you write down a list of things you have already accomplished. The exercise forces us to revisit positive, meaningful, and proud moments from the past, reminds us of the progress we have already made, and gives us a gentle reminder of what we are capable of.

When I first tried it, I could feel myself resisting the experience. It felt unnatural to be both humble and bragging at the same time. With every positive memory came a reminder of what I had yet to do, or something I had lost along the way. I realized coming up with as many positive memories as I had bucket list goals was going to be impossible. I had been building one list all of my life, and the other for about two months.

With a little more practice, I found a system that worked better for me. I set a specific amount of time aside each month, and I shoot for 5-10 items list-worthy in that time. I include moments that are big, such as graduating or a first job, and moments that are small, such as bringing an extra coffee to someone having a bad week. I have found that I have more gratitude, positivity, and patience for myself.

If you’re still skeptical, you don’t have to take my word for it. In a 2015 study from The Journal of Positive Psychology, researchers verified that “grateful recounting,” or the practice of remembering good things from one’s life, make positive memories easier for us to access. Over time, the continued practice is shown to enhance well-being and promote satisfaction. With results like those, you can think of your reverse bucket list as an investment in accomplishing your actual bucket list!


Feb 8th

Many Families

By Tessa Gittleman, LAMFT

Calli Institute Family of the YearAnd the award for family of the year goes to…

Football season has been the prime time focus for many Minnesotans, regardless of their interest in sports, thanks to this year’s Super Bowl. So much so, in fact, that many have forgotten we are in the middle of another big season for TV consumption, and I am not referring to winter…

Awards season kicked off with the Golden Globes, most recently celebrated the SAG awards, and will end in March with the Academy Awards. While I have historically not had much interest in either football or awards season, for me, 2018 was more personal. With football, the investment is perhaps more obvious. I wanted to cheer on the home team that could go down in history books as the first to have home-field advantage in a Super Bowl.

With the awards shows, I wasn’t necessarily pulled in because of the #metoo movement, or because of the first all-female presenters night (though both are historically significant in their own right). Instead, I found myself invested in the stories being awarded, and what these stories have meant to the individuals and families I see or talk to every day. Don’t get me wrong, I have always enjoyed movies and TV shows. As a child roughly thirty years ago, “Growing Pains” or “Family Ties” helped shape my ideas of family, or at least what family was supposed to be.

Even though my family never fit the script exactly, it made me feel better to watch shows as I got older that reflected more complicated family dynamics. When my parent’s divorced in the nineties, I had “Mrs. Doubtfire” and “The First Wives Club” to watch. As I went to high school, “The L Word” and “Queer as Folk” depicted families I had never seen… When I went away to college, people gathered together to watch “Modern Family” and “Parenthood,” processing similar experiences we had in our own lives.

Today, I can watch any show and see families where disabilities, chronic health, and socioeconomic status are as multifaceted as orientation, color, and gender identity. I can watch families brought together by choice (“Transparent”), necessity (Marvel’s “Runaways”), and accident (“Catastrophe”). These shows are winning awards, becoming lenses through which to see the world and references for pop culture.

As parents, most of us grew up in an environment where it was easier to talk about anyone else’s family besides our own. We never learned to talk openly about mental health, LGBTQIA, or non-traditional families. Our kids, however, have grown up in a different world, where traditional models of family, love, or communication are not standard, and entertainment can only bridge the gap so much.

Have young kids and want to get a jump-start on the hard talks? Scroll down to some reading suggestions at the bottom of this blog. Need a bit more support? Through individual and/or family therapy, our team acts as a translator, mediator, and mirror between family members. We help you to bridge gaps between family members, align expectations, and establish what the right kind of normal is for your family.

Reading list:

– “And Tango Makes Three” by Justin Richardson, Peter Parnell
– “Heather has Two Mommies” by Leslea Newman
– “King and King” by Linda de Haan, Stern Nijland
– “Who Are You?: The Kid’s Guide to Gender Identity” by Brook Pessin-Whedbee
– “My Princess Boy” by Cheryl Kilodavis

– “The Day We Met You” by Phoebe Koehler
– “Tell Me Again About the Night I Was Born” by Jamie Lee Curtis
– “I Love You All The Same” by Donna Keith, Allson Edgson
– “Over The Moon: An Adoption Tale” by Karen Katz

– “Why Do Families Change?: Our First Talk About Separation and Divorce” by Jillian Roberts
– “Two Homes” by Claire Masurel
– “Daddy’s Getting Married” by Jennifer Moore-Mallinos
– “My Mom’s Wedding” by Eve Bunting
– “Dinosaurs Divorce” by Marc Brown, Laurene Krasny Brown

Modern Families
– “Who’s in a Family?” by Robert Skutch
– “Love Is a Family” by Roma Downey
– “All Families are Special” by Norma Simon
– “The Family with Many Colors” by Emma Louise, William Thomas
– “Who’s in My Family?: All about Our Families” by Robie H. Harris
– “My Rainbow Family” by K. R. Vance
– “All Kinds of Families!” by Mary Ann Hoberman
– “A Family Is a Family Is a Family” by Sara O’Leary


Jan 16th

Are you SAD?

By The Calli Institute

SAD Seasonal Affective Disorder by Calli Institute Been thinking about warmer climates lately? Planning a trip to the beach for spring break? You’re not alone. Minnesota is known for its harsh winters and this one has been especially hard. One of the reasons for your desire to head south may have to do with the body’s natural yearning for daylight to brighten your mood.

Seasonal Affective Disorder (SAD), sometimes referred to as the “winter blues,” is a type of depression that occurs at the same time every year and usually resolves with the next change of season. SAD is seen more often in northern latitudes and occurs more frequently in women than in men. The exact cause of SAD is not known, but it has been linked to genetics, age, and your body’s natural chemical makeup. The most common factors associated with SAD include:

Your biological clock or circadian rhythm: As the days get shorter in the fall and winter, exposure to sunlight is reduced and may disrupt your internal clock
Melatonin levels: The change in season can disrupt natural levels of this hormone which can lead to changes in sleep patterns and mood.
Serotonin levels: Serotonin is another chemical in the brain that affects mood. Decreased sunlight can cause serotonin levels to drop leading to the experience of SAD.

Common Symptoms Include:

• Depressed mood
• Anxiety
• Loss of energy
• Social withdrawal
• Oversleeping
• Loss of interest in usual activities
• Increased cravings for carbohydrates
• Weight gain
• Difficulty concentrating

Treatment for SAD ranges from natural remedies to prescription medication and psychotherapy. Light therapy or phototherapy is one natural option. Light therapy involves the use of a light box which produces a high-intensity light that mimics outdoor light and appears to change melatonin and serotonin levels in the brain. Use of a light box needs to be individually tailored depending on the severity of one’s symptoms and other factors that should be addressed with your healthcare provider before starting this treatment. Although light therapy is generally considered safe, it can pose dangers for those with retinal disorders or in those taking medications that can cause sensitivity to light.

Other natural therapies include the use of certain herbal supplements. Although you do not need a prescription for these substances, it is still important to consult your healthcare provider before using them, especially if you are already taking other medications. In some cases, you and your healthcare provider may decide to use an antidepressant. Psychotherapy is also an effective treatment option. Although SAD is thought to be related to biochemical changes, your thoughts, feelings, and behaviors affect your mood. Psychotherapy can help you identify and change negative thoughts and behaviors and significantly improve your overall state of health.

Conquering the “Winter Blues”

Make your environment sunnier and brighter. Open your blinds, add skylights, sit closer to bright windows in your home and office.
Get outside. Take a long walk or simply sit on a bench and soak up the sun, even on cold or cloudy days, outdoor light can help.
Exercise regularly. Physical activity helps relieve stress and anxiety which can increase your symptoms of SAD. Being more fit also improves self-esteem which can boost your mood.
Socialize. Make time to connect with people you enjoy being around. They can offer support and a shoulder to cry on or a joke to laugh at.
Take a trip. If possible, take a vacation in a warm sunny location.

Dec 28th

A Better Recipe for a Better Year

By Tessa Gittleman, LAMFT

Recipe for a better youI don’t know about you, but in my experience with cooking, I’ve historically found that the seemingly easiest recipes are the ones easiest to mess up. Having grown up in the restaurant industry, I learned that this experience was not unique to me, or industry specific. Go to any part of the world, meet with all the best culinary minds, and you will undoubtedly find a chef who practiced making the most basic of dishes (ie: scrambled eggs, pasta, rice) for months before their instructor let them move on, and who still employs the same tactics with their students.

So, a few years back when I stumbled upon a recipe for the Quintessential Recipe of A Year, listed at the bottom of this post, and saw that it was for beginners, I decided to give it a test run. I thought, “I know these ingredients” and “I can do this!” Fast forward roughly 30 attempts, and it turns out, no matter how much practice one has, a year is still a pretty easy thing to mess up. It can be almost like a holiday cookie you’ve made a million times, but still doesn’t look as good as your mom’s, or never turns out how you expected it to.

When I consider that the recipe calls for miscellaneous ingredients to essentially be stewed over a 12-month period, attempting to control for unknown variables, and then physically watch over it the whole time, I realized it was an impossible task. I felt defeated each year, like Sisyphus, unable to distinguish between progress and perfection. Hind-site is always 20/20, after all, and now I am just grateful I didn’t burn down anything letting so much simmer for so long.

The thing that the Quintessential Recipe of a Year has helped me to digest is that: there is no one perfect way for a year to turn out. There are just common elements or ingredients, organized in similar and different ways, we can tailor until it suits us best. For example, while you might prefer ginger-molasses cookies over sugar cookies, both require flour, butter, sugar, and eggs. If someone hadn’t taken the time to master a sugar cookie, or had stopped innovating cookies altogether, a ginger-molasses cookie might never have come along. For 2018, what I hope this recipe gives you is the knowledge that: regardless of your ingredients or the instructions listed on the sheet, there is no one-way to have a great year. You get to keep changing the recipe for success until it fits the way you want it to, for as long as you want it to.

Quintessential Recipe of a Year

Author Unknown
Take 12 whole months.
Clean them thoroughly of all bitterness, hate, and jealousy.
Make them just as fresh and clean as possible.
Cut each month into 28, 30 or 31 different parts,
but don’t make up the whole batch at once.

Prepare one day at a time with these ingredients:
Mix well into each day one part each of faith, patience, courage, and work.
Also add to each day one part of hope, faithfulness, generosity, and kindness.
Blend with one part prayer, one part meditation, and one good deed.
Season the whole with a dash of good spirits, a sprinkle of fun,
a pinch of play and a cupful of good humor.

Pour all of this into a vessel of love.
Cook thoroughly over radiant joy, garnish with a smile and serve with quietness, unselfishness, and cheerfulness. You’re bound to have a happy new year.

Dec 22nd

Happy Holidays!

By The Calli Institute

May your holidays be filled with love, happiness, and peace.

Calli Institute-Wishing You a Happy Holidays

Dec 12th

Five Tips to Keep the Sparkle in your Holiday.

By Kari Lyn S. Wampler, MA, LMFT

Holiday Tips

For many of us, this is the time of year that we look forward to the most. In the midst of our daily routine and monotony we dream of snowflakes, glitter, familiar tunes, red suits and twinkle lights. The season, for us, is loaded with celebration, family, delectable food, and a sense of wonder. Oh how we yearn for the festivities of the holiday season throughout the year.

But in the midst of this splendor, the enormity of the season can take us over. There are so many lists to make, presents to buy, so much money to spend, and gatherings to attend that the sparkle of the holiday season can quickly lose its luster. So, we are faced with the dichotomy of the season, the love of the spirit and the drudgery of the “to do” list. As we strive to strike a balance, here are a few suggestions to help keep the sparkle from fading.

Create a holiday budget.

One of the greatest stressors around this time of year is often money. To help alleviate this stress look realistically at your finances and determine what amount you can allocate to holiday spending. Once you have a dollar amount, figure out what you need to spend money on and allocate amounts for each. For instance, you may decide to spend $75 on new holiday decorations, $30 per gift for friends, $100 per child, etc. Most importantly, stick to the budget you plan. Hold yourself accountable by adding receipts and deducting from a ledger.

Implement Family Ritual.

Much of our holiday joy comes from the traditions we remember implementing year after year. Unfortunately, the busier we are the more likely we are to cut out those traditions. As a family, pick one or two things you want to do every year. Some suggestions could be cutting down a tree, making holiday cookies, caroling or family devotions. Keeping family rituals alive helps us to feel like we are amidst the holiday season, even if we feel busy.

Make a list of what you need to get done and accomplish a few tasks each day.

One of the biggest contributors to holiday stress is the list of things we have to do. To help manage this stress, write something down on a “To Do” list once you think of it. This accomplishes two things: you won’t forget about it, and it gets the ideas out of your head so you won’t think about the same thing over and over again. By assembling a list and getting things down on paper our thoughts are more organized and less stressful to us.

Choose one fun holiday activity to do with family or friends.

There are a million offerings to help us celebrate the season. There are parades, plays, parties, exhibits, concerts, etc. We are bombarded with fabulous things to do and see, making it impossible to partake in every offering. However, if we miss all the opportunities we can be left feeling cheated out of the festivities. Each holiday season, choose a new activity that you want to participate in. Over the course of a few years, you will experience nearly all the season has to offer.

Do something for someone less fortunate.

Finally, give of yourself each holiday season. Maybe that means working at a shelter or helping an elderly neighbor with holiday tasks. It could also mean participating in a gift or food drive with your children or delivering a plate of cookies to someone who is unable to leave their home. Giving back at the time of year when abundance is all around will increase the spirit of the holiday season, bringing to the forefront the blessings we have been given and blessing someone else in return.

The holiday season has arrived. Make the most out of the season and enjoy every possible sparkle. Happy Holidays!



Nov 28th

Chasing Happiness

By Cathy Malmon, LMFT, LICSW

Chasing HappinessI originally planned on writing a lofty blog piece using quotes by Aristotle, Thomas Jefferson, and Abraham Lincoln (though I still might use some.) After all, isn’t happiness a serious topic? I could cite the World Happiness Report included in the November 2017 issue of National Geographic. I have included it in the references in case you want to wade through it. Oprah has probably written on happiness, and it would be easier to read than the World Happiness Report.

I stumbled on some books that take the seriousness out of the pursuit of happiness, (borrowing from The Declaration of Independence.) The Subtle Art OF Not Giving A Fu*ck, by Mark Manson was shown to me by one of my clients. I like this client (not because of some mutually salty language), and I liked the premise of the book. We are encouraged to embrace our limitations, accept our imperfections, and grow from solving problems. This book is sprinkled liberally with the F__ bomb, but there is a point. Doesn’t a good swear word now and then make us happy?

Manson writes that “Happiness comes from solving problems…  to be happy we need something to solve. Happiness is, therefore, an action; it’s an activity, not something that is passively bestowed on you.”

Here comes Aristotle.

He wrote that our supreme good, or happiness, is to lead a life that embraces our ability to reason and that good or bad fortune can play a part in determining our happiness. If we live life to the full, we are bound to be happy. For Aristotle, happiness is a question of behavior and habit, rather than luck. It is an ACTIVITY.

The Happiness Project Or, Why I spent a Year Trying to Sing in the Morning, Clean My Closets, Fight Right, Read Aristotle, and Generally Have More Fun” by Gretchen Rubin is a funny though well-researched book. Rubin did what I had no interest in doing. She tackled the subject of happiness through a wide lens: religion, philosophy, literature, psychology science, and popular culture. Even a fortune cookie-  “Look for happiness under your own roof.” She developed a set of commandments she chose to live by:


1. Be _____________(fill in your own name).
2. Let it go.
3. Act the way you want to feel.
4. Do it now.
5. Be polite and be fair.
6. Enjoy the process.
7. Spend out.
8. Identify the problem.
9. Lighten up.
10. Do what ought to be done.
11. No calculation.
12. There is only love.

Then there is Dennis Prager, a nationally syndicated radio host who is known for his conservative, political, and social views. He was asked to provide a talk to a college audience and thought he would be speaking about religion. Instead, he was asked to talk about happiness, which threw him into a ten-year journey of reading, writing, and lecturing about the topic. His book, Happiness Is a Serious Problem: A Human Nature Repair Manual was published in 1998.

He asserts that the human desire for happiness is as universal as the obstacles…  According to Prager, happiness is a moral obligation, but “does not mean acting unreal…or refraining from honest and intimate expressions of our feelings to those closest to us.” It means to “work on our happiness”.  Happiness is a continuing process of celebrating connections, doing good, counting your blessings, and not taking yourself too seriously. Prager encourages the actions of finding and making friends, not seeing yourself as a victim, and finding meaningful work (paid or non-paid.)

What factors into happiness?

Being active, physically, emotionally and spiritually.
Meaningful work or life purpose.
Friendships and community engagement.
Being self-compassionate and learning from life’s challenges, not being victimized by them.
Chocolate. (OK I added that one)


Folks are usually as happy as they decide to be.” – Abraham Lincoln

The Search For Happiness
, National Geographic November 2017
The Happiness Project, Gretchen Rubin
Happiness Is a Serious Problem: A Human Nature Repair Manual, Dennis Prager
Happiness Is, from You’re A Good Man Charlie Brown


Nov 23rd

Happy Thanksgiving!

By The Calli Institute

Gratitude unlocks the fullness of life. Happy Thanksgiving from the team at Calli Institute!

Happy Thanksgiving

Nov 14th

Self-injury: Cutting, Self-Harm or Self-Mutilation

By Wendy Walker, MS, LP

Calli-Institute-Self-Harm-Wordcloud-BlogSelf-injury, also known as cutting, self-harm, or self-mutilation, occurs when someone intentionally and repeatedly harms herself/himself in a way that is impulsive and not intended to be lethal. It can be frightening for a parent to discover that their son or daughter is engaging in this behavior.

Self-harm is rarely a problem that occurs in isolation. It is often a way to manage conflict or distress and a tool to manage emotions that feel unmanageable to an individual. The person may have a difficult time regulating, expressing or understanding their emotions. Adolescents often say they feel empty inside, lonely and unable to express strong emotion.

Self-harm is often hard to detect because it is secretive. Researchers at Cornell University suggest that several signs may indicate self-harm behavior. These include unexplained burns or a cluster of scars or cuts, difficulty handling feelings, relationship problems or avoidance of relationships and poor functioning at work and or school.

Common areas for self-harm are the wrists, fists, and forearms, however any area of the body is possible. Those engaging in such behavior may wear clothing that is inappropriate for the season as they try and conceal the scarring. Also, using heavy wrist bands, bandages or other coverings is common as one tries to conceal their wounds.

The following are some forms of self-injury:


  • Cutting
  • Scratching
  • Burns (using matches, cigarettes or hot sharp objects such as knives)
  • Carving words
  • Hitting or punching
  • Piercing the skin with sharp objects
  • Pulling out hair
  • Persistent picking designed to interfere with wound healing
  • Breaking bones
  • Drinking something harmful

Persons who engage in self-harm are more likely to be highly self-critical and poor problem solvers. Age is one of the biggest risk factors for self-injury, with teens and young adults being at a greater risk. According to Mental Health America, research indicates that self-injury occurs in approximately 4% of adults in the United States and 15% of teens with an even higher risk existing for college age students. Other risk factors include; friends who self-harm, being neglected or abused (sexually, physically or emotionally) and persons who question their personal identity or sexuality.

There is no sure way to prevent a loved one from self-injury. Reducing the risk involves individuals and communities including parents, schools, medical professionals, co-workers and coaches working together and communicating openly about what they are seeing.

  • Offer help. Those at risk can be taught alternative coping skills and to rely on their own strength and resilience.
  • Encourage expansion of social networks. Many people who engage in self-harm often express feeling lonely and disconnected. Forming connections and improving relationships can help decrease the disconnection.
  • Raise Awareness. Adults, especially those that work with children, should be educated about the warning signs. Group discussions and educational programs can be helpful in raising awareness.

If someone you know is engaging in self-injury consult a mental health professional that has expertise in this area to obtain an evaluation or assessment, followed by a recommended course of treatment to prevent the cycle from continuing.

S.A.F.E. Alternatives (Self-Abuse Finally Ends)
Information Line: 1-800-DONT CUT or 1-800-366-8288


11334 86th Ave North Maple Grove, MN 55369

Ph: 763.255.2125 | Fax: 763.255.2126