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Working with Dissociation in Trauma Therapy

The cover is getting tattered and I’m STILL not fully through it, but READ THIS BOOK! I cannot emphasize enough how critical it is, particularly in trauma work, to be able to identify dissociation in our clients. We ALL dissociate to some degree – daydreams, spacing out, finding ourselves thinking one thing but instead saying the thing we KNOW will cause trouble. (Been there, done that.)

Dissociation, like many patterns, develops as a protective pattern but when it stems from more intense childhood neglect or emotional or physical abuse, it can begin to show up as “parts”. A person may have a part that functions well at work for instance, but then have other parts that start to interfere with and undermine a person’s good intentions and desired outcome in other areas of life. And, dissociation can really get in the way of therapeutic work, particularly trauma work, if the therapist and/or client don’t know it’s happening.

I’ve been reading some pretty dense books on dissociation as I’ve been going through trauma focused Brainspotting and EMDR trainings in the past year. (My most valuable training has been with Dolores Mosquera, who also has helpful books.) This ginormous book however, feels critical for self-education on dissociation. It’s taking me SO MUCH TIME to try get my head around the concepts but slowly I’m able to grasp the terms. And, more importantly, I’m able to recognize dissociation more easily and be able to talk about it more comfortably with my clients. PS -There’s also a workbook for clients to use but I haven’t read it yet.

Brainspotting – What the heck is it?

img_20191101_155130__01__01.jpgAfter spending nearly a year contemplating whether to train in EMDR or Brainspotting, I’ve chosen the later.  Already, I’m introducing it in client sessions and find that even newer clients, with whom I don’t have a more familiar rapport, can quickly get comfortable with, and benefit from it.  Don’t hesitate to contact me if you are curious to try even a single session.

From the Brainspotting website: Brainspotting locates points in the client’s visual field that help to access unprocessed trauma in the subcortical brain. Brainspotting (BSP) was discovered in 2003 by David Grand, Ph.D. Over 13,001 therapists have been trained in BSP (52 internationally), in the United States, South America, Europe, the Middle East, Asia, Australia and Africa. Dr. Grand discovered that “Where you look affects how you feel.” It is the brain activity, especially in the subcortical brain that organizes itself around that eye position.

Struggling with “commitment”?

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I’ve not yet been married. And so many people use marriage to gauge people’s capacity for commitment. For years, I didn’t argue with this, but it always got under my skin.

I WOULD say I’m a runaway. I ran away from corporate NYC at age 27 to pursue a dream to cook on sailboats and be a photographer around the world. I ditched the East Coast to feel out a vision of life in San Francisco. Then I cut out of San Francisco to take over leadership of a non-profit I unintentionally launched in South Los Angeles.

As I moved through my 30s and into my 40’s, I got little anxious about this commitment thing.  Was being single, kid-free, and a renter-not-a-home-owner, all evidence of a lack of ability to commit?  I had to REFRAME to avoid going into existential overload.

Today, I can look back and see my FIERCE COMMITMENT – to TAKING RISKS, FOLLOWING DREAMS, TRUSTING MY GUT, and to visiting my dearest loved ones, who simply aren’t all in one place. And, though it didn’t feel like a commitment until recently  (I didn’t “sign up” for it in advance), I HAVE stuck through 12 years of running and funding a youth-focused non-profit. Which, also led me to get a degree in clinical psychology, which led me to complete the nightmarish MFT licensing process so I can now be your therapist.

I’m committed to being PRIMED TO PIVOT – to taking even small steps towards dreams, ideas, instincts, and visions without knowing where they may go. I’ve seen over time, what can happen when you choose to take at least ONE step toward a new idea, then maybe another. These first teeny steps are some of the most powerful commitments.

An intro to Gestalt?

Some clients ask me – what is Gestalt therapy?  My top line response is that it’s about the relativity of perception, and how we can learn more about how we are perceiving the world and others so that we can have an expanded ability to choose how we want to respond to the world/others as part of reducing shame, increasing connection with others, alleviating depression, creating more hope, etc.

Gestalt theory can be DENSE. Add to that, not everyone in the Gestalt world agrees on the various theoretical concepts (as it probably should be). To increase my own understanding of Gestalt therapy, I train with the Pacific Gestalt Institute, and I slowly work my way through recommended books from my instructors and my own Gestalt therapist. One book I have YET to finish after owning it now for almost 3 years is Gordon Wheeler’s Beyond Individualism. It’s dense but it helped me make sense of some of the Gestalt theories about self/other and what is in between.

WOW. The Poet X – Adolescence, pitch perfect.

 

I can’t remember the last time I really loved a book. (Reminder – I’m still working to increase my attention span for fiction to its pre-grad school levels. I’ve not recently read a ton of books.) This book however, sunk quickly into my heart. Elizabeth Acevedo crafted this tight, lyrical tale tracking the trials of Dominican teen, Xiomara Batista, as she navigates some of the most painful edges of adolescence growing up in Harlem.

What REALLY resonated with my therapist side is how, at one point in the story, Xio’s family members converse with someone outside the family and it helps bust their family system wide open. Much needed air flows in. I won’t spoil it, but it served as a powerful reminder of how, when you expand the nuclear family to let in other voices, it can relieve the pain and the pressure from struggling family members. Marriage is challenging. Raising children is Crazy Town. Adolescence is Nuts. Add to that, societal pressures, social inequities, and intergenerational trauma; few of us get the benefit of being raised by self-aware, stress-free, highly communicative, unconditionally loving parents. In the absence of stellar parenting, it’s hopeful to remember what families can gain when they invite in mentors, therapists, friends, kin, and clergy to breathe new air into fixed, dark spaces and help dislodge painful patterns that keep families stuck.

All this existential crap

I’ll reference several books here. Don’t be fooled. I’m no longer the focused reader I was when I was little, geeking out on the stacks of books I’d bring home from the library. Today I’ve still got stacks of books but mostly I skim, gleaning for top-line ideas. Things I’m reading lately pertain closely to the topics that came up a lot in sessions over the holidays – family, isolation, depression, anxiety.

In The Gift of Therapy, Irvin Yalom wrote that freedom is a topic that rarely comes up in therapy, which is weird. I bring it up often with my clients. We talk about Kierkegaard’s term – the dizziness of freedom – and how hard it can be, particularly for so many of my clients who are freelance and single, to identify and stay on a course that brings reliable or continuous professional and relational satisfaction. Particularly at the holidays, when work tends to slow down (even in The Industry), people are left figuring out how to fill up voids that are left when busy-ness and deadlines fade.

There’s lots to say about all of this but in this moment, I want to offer an author, two books, for those who are struggling to makes sense of a modern world that can feel like TOO MUCH and TOO LITTLE at the same time. Annie Dillard is a favorite. I like her because she is super curious and prolific in her writings about the natural world, and she lives boldly in it. I was surprised early on to learn she was a Christian, as I didn’t think those with scientific minds would believe in a personified god. (Later in life she did become, as she put it “spiritually promiscuous”.) How can you keep ANY faith in a world that can be so filled with horror and injustice?  Annie’s Pilgrim at Tinker Creek, and For the Time Being respond to this question.

A comparative religious studies and Asian studies major in my undergrad years, I was often asked, “Well what do YOU believe?”  I still tell people – I have faith in chaos. The universe is remarkably ordered but with that, there is rupture and destruction. I remain grateful that my life and my mind have remained mostly ordered, manageable, and ultimately, hopeful. My work in the world is to help create order and hope for others. I attempt this through my non-profit, RootDown LA, and now through my therapy work.

 

Have I lost a client (to suicide)?

This is going to be a work in progress.

So clients ask me – have I had a client commit suicide?

(Some initial thoughts/questions from a therapist who works in the addiction field and has been asked this question more than once…)

Yes, I have lost (a former) client to suicide.  But would he have shot himself if he could have kept drinking?  He’d stated to his dad that he didn’t want to live if he couldn’t drink.

Do you consider an overdose suicide?  If I tell you my client OD’d but I know he didn’t want to die, would I have to convince you, (or myself) that my client truly OD’d but he definitely did not want to die?

Some family members assume and tell me, that I likely knew their son/daughter better than anyone else – better than they did.  What if that were true?  And how do the law/ethics of my license curb what I could even say about that?

That’s about all I have to say at the moment.

I may be a licensed therapist but…

 

A I'm not judging you

I just posted a question on a Facebook forum that asks other therapists how they handle the phenomenon of having other people (non-clients) ask if we are analyzing them or telling us mid-conversation, “Oh, you’re doing XYZ because you’re a therapist.”  This can feel particularly daunting when we therapists are just getting to know someone.  How do we convince our friends, family, dates that our therapist hats are checked at the door?

When this happens to me, it makes me feel like the other person imagines I have SO much of my own stuff figured out that I somehow retain the bandwidth to figure out his/hers as well. Clients pay for that bandwidth. Friends, family – dates?!  Do not.

Non-clients – rest assured! We therapists are still figuring it out, just like you. It takes energy to do the work we do well – staying aware of OUR stuff, while paying attention to and being curious about our clients’ stuff.  I’m lucky to have had amazing therapists and teachers and mentors who remind me – there IS an art and a SKILL to what we do, and we can’t do it, 24/7.  We certainly aren’t aiming to do it when we’re unwinding at happy hour or going on a date with you. I personally relish the time I spend with the non-clients I choose to bring into my life. I look more forward to what they can teach me about themselves and ME, than what I might be able to analyze about them.

 

Kermit the Frog as Higher Power?

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Have you avoided 12-step programs because of all that “God stuff”? Developing a sense of Higher Power doesn’t have to be about praying to a personified god. Rather, it is a cognitive act – choosing to tap into a more wise, kind, or sane voice in your head when you start to feel overwhelmed or lost. Particularly for those of us who tend to get monkey mind, getting stuck in internal fights or negative thinking patterns, taking a break to check in with that higher voice – “Hey, it’s me here. My monkey mind won’t shut up. I could use a little help.” – can be quieting.

Yesterday I was communicating with a client* who’s new to 12-step programs. She’s got a Christian orientation and was having difficulty thinking about Higher Power because she feels she’s in a “weird place” with God, as though God is not a fan of what she’s been up to lately. I suggested, “Maybe HP’s aren’t here to give us things. They are here to watch over and be a supportive ear, no matter what we are doing. Picture an HP just sitting in a chaise lounge, sipping ice tea and loving us and we can just pull up a chair if we need a chat. HP may not even care if we come hung over and stinky.”

She promptly sent me this:

 Kermit

And we both LOL’d and I wrote “Kermit the God! Maybe Kermit will be your idea of HP and help you keep your sense of humor on your path?”  I sent back that image above –  Kermit’s feet by the pool – and my client said YES she was going to try meditating by the pool and be twins with Kermie.

#clientsarecreative #higherpower #selfcare #mentalhealth #meganhansontherapy #12step #la12step

*When it’s clinically indicated, I have some text communication with clients between sessions. All clients mentioned in posts agree to have me share stories from our work.

 

 

The LA River, Field Theory & Gestalt.

IMG_20170823_193106-2In preparation for year 2 of the weekend training at the Pacific Gestalt Institute, I’m reading Gary Yontef’s Intro to Field Theory. Field theory in Gestalt relates to the complexity of determining variables that inform a person’s experience in any given moment. It’s related to the process of how we perceive, think, and react to the circumstances surrounding us.  How does this relate to the LA River?  Read on…

I’ve spent the majority of my non-profit and therapy careers working in jails, inner city high schools, underserved neighborhoods, and addiction treatment centers. My students and clients know, I’m a systems person. I don’t look at my individual clients as isolated entities. Rather, they are products of their own complex biology, chemistry, and the forces that have surrounded them since conception. Many have experienced and caused havoc in their own and other’s lives – it’s not what they wanted or intend. My goal is not to “fix” clients, but rather to understand how their own creative and intuitive abilities have helped them survive and navigate their own complex systems so far. We then work to figure out how their best ideas and instincts can be utilized so they can establish new, healthier systems and thrive again.

Last summer, while contemplating some life changes I want to make, I spent a lot of time sitting by the LA River. YES! We do have a river in LA and yes, it’s filling back up with water and wild life. Once free flowing, the river wreaked havoc for the region with sporadic flooding until the 1930’s when the Army Corp of Engineers encased the river’s beds in concrete.  However it left the river seeming less than alive. The LA River now has been taken under the fold of various non-profits who are working to figure out how, even with the concrete encasement, the river and it’s surrounds can thrive again.

Yontef likens the Gestalt “field” to a river:

The natural organization of the field is like a river finding its natural course by interacting with the other forces of nature, as opposed to concrete pathways being added to force the water into rigid and predetermined pathways. When there are problems or dysfunctions in the organization of the field, the solutions are also present in the dynamics of the field (Wertheimer, 1945)

When I read that, I think of how many of us struggle to change ourselves before better understanding ourselves. It’s hard to change what we don’t understand. As hard as it can feel to look closely at our most challenging patterns, it’s really where lasting change begins.

One warm night, I took a grieving friend to the river and we put our toes in and felt our feet carried by the currents. The water was at once, refreshing and probably carrying trace contaminants. Much like therapy can feel at times, the water felt kind of slimy but also healing and hopeful.