Category: Healers

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Another Wave of COVID Grief Five Months In

Door open on mossy path
Door open on mossy path

In the last few weeks, my clients have started grieving COVID anew. Here in Philadelphia, we’re in a modified Green Phase, so we can eat outdoors at tables that stand six feet or more apart. In the city, we can theoretically do small outdoor gatherings of less than 50 people, but honestly, I’m not going anywhere near 50 people. Nor are my clients. We’re still pretty much in shut down mode. We shop for food every couple of weeks and that’s about it. We always wear masks outside the house, except inside our car. My clients report similar phenomena.

For my clients, acknowledging the pain and disappointment of the continuing precautions hurts. Whatever timelines we privately prepared for in March– this progress is slower and more ambiguous. In many ways, the reopening feels more painful and more complex than the closing, because everyone is navigating the new, looser rules with differing priorities, and differing assessments of acceptable risks. Now there is social stigma. We manage the emotional friction between those that continue to wear masks, per CDC guidelines, and those that don’t.

We grieve the understanding that this “Green Phase,” which feels far from normal, is the new “normal.” We’re still not seeing our friends and family with easy hearts. The calculus of who is at risk when we buy groceries endures. We’re still not engaging in the pleasures of travel and outings. Our innocence is stripped away. Seeing crowds on television shows brings out two feelings in me, “Oh my god, you lucky foods, you have no idea what’s coming. Your joy is such privilege” and “Dear lord that’s a superspreader event!” I feel like all my parts have battened down to endure this period of deprivation, of lack of community, of lack of human engagement. So now I ask, and I ask you to ask yourselves: Where is our joy?

Where can I find a sense that life is still a place of excitement and amazement? How do I connect with inner spaciousness? My connection to art and beauty, where has it gone?

It’s so easy to get swept up in my sense of duty and obligation, and to focus on the tasks, to focus on the work, instead of the human needs that have been shunted aside. So here are some considerations, as we hold another wave of grief and loss and the summer winds down:

Now that all plans are provisory, we still need to make plans to add lightness to our weeks. To comfort ourselves. What plans, what joys can we look forward to? My current plan in hatching is going to a drive-in cinema. My other plan in hatching is an evening run to the beach. What will your plan in hatching be?

I’ve switched from video calls (exhausting) to voice calls (intriguing) for keeping up with my friends. This also provides a nostalgia bonus–reminding me of hours wrapped along our long kitchen phone cord as a teenager. Community remains critical to our ability to feel engaged in our own lives and to reduce the isolation that comes with all the sacrifices we make during the COVID 19 pandemic. However you reinforce your sense of belonging, keep it up!

The most important change I’ve made is to check in with myself and consider my needs beyond my obligations. When I wake up in the morning, I ask myself, “What do I want to do for joy?” I then give myself an hour to write, or do whatever it is purely for my joy, my fun, my sense of an expansive self. My work self is critical but secondary.

Since I cannot go on vacation, I can save for vacation, and make a list of places to visit when I get the opportunity once again.

I’m no longer springing for gourmet take-out once a week, but I can enjoy mid-priced restaurants.

I’m eating more local produce and, in doing so, experiencing the seasons. I’m stocking my kitchen with the right tools for my frequent cooking efforts, and this improved kitchen environment lightens the load. My new cleaver can cut through anything, unapologetically.

My scope is shrinking, but in my better moments I like to think I am living more like a poet. Tuned into each moment, slow and aware, and full of gratitude.

I am in the process of completing Level 1 IFS Training and that has helped me reframe my experiences, to look at every moment through multiple eyes, multiple parts, and to realize no one part holds all the wisdom, life’s meaning lies in multiplicity. This means I am never all in despair and never all in hope. I lie in a grounded balance.

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How to Pick a Therapist

An acquaintance recently described a multi-year therapy relationship that she hadn’t enjoyed because she felt judged by her therapist. While therapists are supposed to provide empathy, a set of professional skills, questions that lead to reflection, and a kind support system on your life’s journey, judgment shouldn’t be in the room. I’m not going to claim that sessions are a totally judgment free zone, since therapists are people too, but (at least in my opinion) clients should experience thoughtful kindness 99% of the time.

If you consistently feel judged by your therapist, that person is probably not the right therapist for you.

So how do you go about picking a therapist? 

First, start by looking on Psychology Today (or another directory site) for a therapist in your area code who treats your concern. (Psychology Today is the yellow book of therapists, it has most everybody. There are other competing websites, and they have their own listings.) You’ll notice that many therapists do not take insurance, and you will need to use your out of network benefits if you have insurance, or pay out of pocket (depending on what fee you can afford). You might also want to google specific terms just to see what comes up.

Second, I recommend you contact at least five different therapists. (If the therapists have websites, take a look and see if you like their style and approach.) It’s likely that three of the therapists you reach out to will get back to you. Two will have openings at a time that works with your schedule and hopefully will have a fee that works with your budget.

Third, meet at least two therapists in person. There are a variety of treatment approaches and personal styles, and you will probably have a preference. Decide who is the right therapist for you.

Also, every therapist works better with certain people than others, and mismatches can be a little idiosyncratic. In my case, I’m not great at working with people who have long thoughtful pauses in their speech, though I hope I might get better at working with that population in the future.

If you do not have insurance, and are limited in your financial means, you have a few options. Remember that the major advantage of seeing someone in private practice and paying out of pocket is that they are a more stable provider: they are usually fully licensed and will not change employers. Paying out of pocket if you chose not to use your insurance will also give you more privacy: Just you and your therapist will know your diagnosis and no information about your treatment will be shared with your insurance.

Medicaid and No Insurance:
Medicaid is accepted at community mental health centers, and many centers take people with no insurance. This is a partial list. Community mental health includes: JFK Behavioral, NHS, NET, and COMHAR among others. To find out what Community Behavioral Health (CBH) centers are near you and accepting new clients, you can call the CBH member services number: 888-545-2600, open 24 hours a day.

Lower Sliding Scale Psychotherapy:
If you’re looking for a lower sliding scale psychotherapy than most private practitioners provide, you might consider contacting these providers: Therapy Center of Philadelphia, Council for Relationships, and Philadelphia Psychoanalytic Center. As this list is incomplete and could change, do your own research! (Also, feel free to contact me with updates.)

I’d be happy to hear any thoughts you might have on how you picked your therapist and why.

Disclaimer: This is intended as a set of suggestions. I trust in your ability to consider your needs and find the best solution for you.

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Article: Science and the Many Paths to Healing

I love good science. I particularly love science when it gives me language and a good theoretical framework to support understanding of observable phenomena–and offers new paths to understanding. I’m so pleased I live in an age where brain/mind science and nervous system functioning are being so thoughtfully studied. It’s starting to provide some empirical evidence for stuff that, in other decades, might have seemed witchy or intuitive or wacky. Science tends to take a while to catch up to certain kinds of pre-existing wisdom, and then takes the credit for inventing concepts that  were known within wisdoms outside of mainstream medicine/science. One quick example off the top of my head–Cognitive Behavior Therapy is just a fancy name for certain kinds of ancient Greek philosophy and Buddhist mindfulness practices.

All this to say that I’m increasingly trusting the heart, the soul and the body, as well as each person’s creativity, to assist in the mind’s healing process. And also, that while we like to call it psychotherapy and talk about the mind and the unconscious, maybe the mind and the unconscious are fancy constructs (or other types of symbolic language) for heart, soul and body striving together towards unity and self understanding.

Or as my partner would put it, based on a recent Radiolab, if we knew enough about individual biology, we would be able to anticipate 100% of what a person would do (and there is no free will). I see free will working daily in therapy: I think the process of making changes away from your baseline–which is the whole project of psychotherapy–is free will at work. In sciency words: the system trying to re-regulate.

I actually think the biology argument is a silly way of thinking because 1) it’s a tautology–of course everything is a biochemical process at a certain level and yes, the right number of identifiable variables would yield predictive modeling of all human behavior (thank you Asimov for calling that one ahead of time). 2) That’s just one language for describing phenomena. The same way that I prefer to think and speak of traumatized nervous systems that are highly reactive instead of labeling language like a possible diagnosis of “Borderline Personality Disorder.” Both describe similar observable behavioral and physical activation phenomena. However, I much prefer the nervous system science version because it starts to de-stigmatize the experience of those that struggle with their lived experience.

I know I’ve wandered a bit off the map, but I wanted to share what has been on my mind.  Here’s my point, or points.

There’s very strong evidence of a powerful placebo effect for therapies people believe in–regardless of the therapy–with patients being able to assess a reportable decrease in physical symptoms (with more complicated questions about the biochemical basis of these reported experiences of healing. Here’s a fun article about a researcher on placebos at Harvard). This means that for some people a Chakra healer, or a crystal energy healer, or a tribal healer will transform their lives.

This belief in a healing system also helps predict whether psychotherapy will be of assistance to our clients. On a certain level psychotherapists are asking clients, “do you want to believe that I can help you?” The answer should be “yes” and that will help shape what psychologists call “the therapeutic alliance” according to the American Psychological Association‘s Education Directorate (fun name, right?).

If you think Chakra work is going to be integral to your healing process, you better work with a therapist that agrees with you. <<[Also, here’s a book that you would like.] Also, I am a therapist that agrees with you.

I’m writing this in support of those who wish to find healing in other domains, or in addition to the experience of psychotherapy.  Humans are complex, and the healing experiences we will need to move beyond or integrate damaging life experiences will vary as our own understanding of how we function expands or alters. In my case, my belief system was challenged in a wonderful way by deep healing through craniosacral therapy and I wrote about it here. (Here’s an article about the benefits of the therapy while you receive the therapy.)

I’m becoming a nervous system/brain structure nerd.

Other fun texts:

  • Think religion should be in the mix? Here’s a fun article about “spiritual intelligence” helping Iranian teens deal with depression and anxiety.
  • Reiki? (Article from PsychCentral)
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Treating the Whole Person In Psychotherapy

I’ve been really happy with some of the work I’ve been doing with clients lately and the frameworks I’m using in psychotherapy. I’m realizing that I have a really nice toolbox to work with a variety of different aspects of the human experience. As someone who only feels comfortable when I feel I’ve reached a level of mastery, and someone interested in continuous learning and growth, I’m feeling very lucky about having become a psychotherapist at this particular time in the field.

We’re able to do a lot of really interesting connecting the dots between psychotherapy, the human experience and brain (and other) science–for example Siegel’s notion of interpersonal neurobiology (which makes intuitive and professional sense to me)  For example, we already knew that people who have experienced trauma have challenges relating to regulating their nervous systems, and the nervous system’s impacts on their experiences of their brains and bodies. But, more and more, we know why, and we also know ways of providing significant healing experiences at a client’s pace. I’m thinking primarily here of both Brainspotting and Somatic Experiencing, each of which offer approaches that don’t rely on a patient’s ability to communicate using words.

This is a relief for me as a therapist, because I believe that knowledge/feelings/memories are sometimes stored in the brain and body in ways we can’t access with language and conscious thought. We can now do work directly with the nervous system via the body, and with memories via the visual field and the brain/mind. I deeply believe (based on my own life experience, and my experience as a clinician of observing my clients’ bodies during therapy) that as we work to integrate all knowledge about self-regulation and reworking negative experiences, therapists will increasingly treat the whole person. Bringing the unconscious into light and discussing drives, motives and past experiences is necessary and important work, but only part of the puzzle.

I’m really happy to say that I feel increasingly comfortable working with the following different aspects of people’s human experience to help clients. In my case this includes using some of the following approaches/strategies to inform my work:

  • For concrete assistance with improving client behavioral strategies and negative thinking: CBT.
  • For reducing overall distress/anxiety: Deep breathing, relaxation methods like progressive muscle relaxation and mindfulness exercises.
  • For insight: Object relations theory, narrative therapy, relational therapy.
  • For traumatic memories: Brainspotting.
  • For difficult body sensations: Sensorimotor Experiencing.
  • For understanding motivation for changing challenging behaviors/managing ambivalence: Motivational Interviewing.

I’m also a feminist therapist, and I use critical race theory to understand the more damaging aspects of how power works and replicates itself in our society’s functioning. These are also tools for considering the language we use to discuss the “isms” that permeate our lives.

There’s more, but this is a good start. In short, I believe in treating the whole person and helping people develop better coping strategies, experience more positivity in their lives, gain greater peace with their thoughts and bodies, and (of course) gain insights around patterns in their lives and how those patterns were inspired by history and personality.

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Article: Recovering from being too sensitive

Have you ever been told “You’re too sensitive?” or maybe told that your emotional reactions were “too much?”.   According to Dr. Elaine Aron, this experience is fairly common for children and adults–about 20% of the population experiences life as a Highly Sensitive Person.  One of defining features of being “sensitive” is that you might have strong reactions to both sensory and social stimulation. You might need more rest or time to care for yourself. It might take you more time to make sense of your experiences. I find this theory fascinating, because it overlays nicely with the work being done through the Somatic Experiencing Trauma Institute.

There’s already some research confirming that Highly Sensitive People (HSPs) feel emotions more deeply–“that awareness and responsiveness are fundamental features of SPS”–meaning that HSPs will pick up more readily on emotional cues from others, and they will also respond to the emotions they pick up from others more intensely. My professional estimation, based on my clinical experience,  (I’m just starting to look into the research findings),  is that Highly Sensitive People have a more highly responsive nervous system overall. They take criticism and life experiences to heart, and experience emotion within their bodies much more readily than others. But if they can survive the experience of living in their responsive, compassionate minds and bodies, HSPs can do great things in the world. I particularly like this article from Entrepreneur Magazine.

Here’s another preliminary clinical formulation based on my client population, because they are so exquisitely attuned, unfortunately, HSPs often have challenging childhoods, and difficult teen years, which can impact their overall functioning by the time they are adults. The good news is that the world of psychology is increasingly finding great new strategies for helping those who are highly sensitive calm their nervous systems, through mindfulness strategies, and by incorporating knowledge gained through the polyvagal theory, for example.

So if you feel that your sensitivity has made life more challenging for you than for others, you’re on to something. And if you’re ready to get some support and find a more comfortable way of being in the world, please know that strategies do exist (I’m very interested both in Somatic Experiencing and in Brainspotting) and that I’m ready to do that work with you.

(One of the most exciting aspects of being a therapist is when different concepts come together and suddenly the puzzle pieces fall into place in a meaningful way and you find powerful new language–I’m so excited by this line of inquiry.)

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Defining Community Caregivers

When people hear the word “caregiver,” it can evoke quite a variety of different professions and identities. I’m thinking about, and using the word caregiver in a couple different ways. There are the family caregivers: parents and grandparents, family members, neighbors and friends who take care of children as they grow. Then there are the professional caregivers (and healers) who work in our community. They can be medical professionals or in the allied health fields (i.e., doctors, nurses, therapists, social workers, physical therapists, acupuncturists, chiropractors, personal aides, etc.) or they can provide personal services and body work (i.e., massage therapists, yoga instructors, Reiki practitioners,  stylists, and trainers, etc.) I also believe that healing/caregiving/social justice can be brought into our communities by artists, activists, community organizers, and those who work with nonprofits. I’m interested in working with a diverse set of clients, and want to help sustain the good work of healers and caregivers in my community.

My fundamental belief is that anyone who works with other people’s bodies and healing gives a great deal of themselves and needs their own support and care.

Also, as a psychotherapist and a social worker, I am interested in wellbeing and healthy function at the individual level, but also in the community setting and at the societal level. I think true healing happens when many simultaneous dimensions of a community are engaged and enlivened.  So that’s what I’m hoping for: Engagement, dialogue, self care, art and healing in my life and in the lives of those I work with as a psychotherapist.