Ketamine-Assisted Therapy

I graduated from the Integrative Psychiatry Institute this May! 250 hours of education in psychedelic-assisted therapy was time well-spent.

I’ll be offering ketamine-assisted psychotherapy Tuesdays, starting July. For ketamine, I’m supporting other local therapists and their clients, offering brief treatment that augments their current work. A round of ketamine-assisted psychotherapy with me would include:

  • consultation with the primary therapist
  • preparation meetings with the client
  • a 3 hour medicine meeting (with supportive dialogue and assistance)
  • two integration meetings (engaging a plan that applies the ketamine experience to broader mental health concerns)
  • referral and consultation back to the primary therapist

If you’re interested in this treatment, please contact me at julia@juliacounseling.com 🙂

2019 Summary

Thank you 2019! Here were the highlights!

  • attended a 40 hour EMDR training
  • hosted a panel presentation of conversion therapy survivors
  • studied the enneagram
  • obtained a Missouri counseling license (in addition to my Kansas one) & became a registered clinical supervisor
  • favorite clinical book I read this year: The Velvet Rage: Overcoming the Pain of Growing up Gay
  • studied men & depression and narcissism
  • facilitated a sex education program for adolescents
  • organized five continuing education events for therapists (Helping Transgender Clients in Transition; Becoming a Resilient Leader; Understanding LGBTQ+ in Islam and Middle East Culture; Sexual Identity, Behavior, and Fantasy with Sexual Trauma Survivors; Therapeutic Touch Practitioners–a Collaborative Resource; and Therapeutic Considerations with LBGTQ+ Active Military and Veterans)
  • joined a biweekly consultation group with 3 other professionals

Dare to Lead

I’ve been enjoying Brene Brown’s new book Dare to Lead and decided 2019 is my Year of Leadership 🙂  I previously resisted being a leader because I’ve seen poor examples. I overlooked many positive examples of leadership. The DTL workbook helps self-assess leadership skills and is giving me courage to make more leadership contributions.

 

On Fire

I’ve been reading Woman on Fire: 9 Elements to Wake up your Erotic Energy, Personal Power, and Sexual Intelligence. The 9 elements are: Voice, Release, Emotion, Body, Desire, Permission, Play, Home, and Fire. Amy Jo Goddard offers worksheets and exercises in each chapter to help individual women explore their sexual stories while identifying any stuck-ness, growth edges, preferred experiences, and experiments. I may refer to some of Goddard’s activities and resources as tools to bolster therapy.

Body Image and Sexuality

Positive sexual experience can be a great way to feel gratitude for one’s own body. Unfortunately, many people’s negative body image interferes with their ability to be truly present with themselves and inhibits their pleasure. Dr. Emily Nagoski identifies some concrete practices to build self-love at the end of her TED Talk: Confidence and Joy are the Keys to a Great Sex Life. Over the last couple weeks, I have been reading her book Come as You Are.

Erotic, Non-Sexual Experience!

I returned from another week of sex education. I took courses titled the Exceptional Sex Therapist (3 days); Resolving Trauma Through Somatic Experiencing, and Sexuality & Culture. Surprisingly, my favorite course was Introduction to Tantra. Before this course I thought Tanta was having sex for 24 hours at a time, which seemed kind of like a waste of time, honestly. I learned, instead, that tantra is a way of experiencing the eroticism in everyday life, sometimes without any specifically sexual encounters. Tantra is welcoming inter-connection while maintaining a primary connection with oneself. Eroticism bigger than sex—sensory and intellectual pleasure of many types and more of an attitude than particular events. Since March 17th, I keep going back to the 8 Principles of Tantra so I will briefly describe them here.

  • Everything is an Experiment: Beginners mind, openness to experience, observation, willingness to gather data
  • As Within, so Without: what happens in the world affects our individual experience; we need to prioritize and reset our bodies; we can offer our balance to the world
  • Tapas and Spanda: in a concrete visual form, these are the eyes in the yin and yang that reflect the healthy healthy “masculine” energy within “feminine” energy and the healthy “feminine” energy within “masculine” energy. The tapas is about patient, non-attached willpower and the spanda is about a sense of wonderment, thrill, and joy.
  • Inner Marriage: the healthy interconnection of dual, or contrasting energies within oneself. A well-integrated person is able to be consistently present in the world.
  • Multiple Realms of Consciousness: everyday waking consciousness, mythical consciousness (symbols, projections), magical consciousness (big energy, transformation), and integral consciousness (all levels of consciousness simultaneous)
  • Ascending and Descending Currents: chakras
  • Transformational Healing Power of Pleasure: this may be my favorite principle–that pleasure can heal! As a trauma therapist and human being, I know that people can get stuck in trauma, vigilance, and guardedness. True pleasure is the opposite! True pleasure can restore our bodies and clear our minds. While sometimes pleasure can invite trauma processing (for example, someone can remember a painful event while laying on the beach) it also provides a welcome, stabilizing context for healing. It’s important to differentiate impulse and addictions from pleasure.
  • Love: love, like pleasure, heals. It also connects people and connects humans to their surroundings.

 

Healing Body Memory of Trauma

I took a recent training with Yudit Maros called “Brief, Solution-Oriented Trauma Resolution.” This training specifically focused on troubling sensations in the body that may periodically resurface after the trauma. The BSOTR protocol helps a client attend to and correct the aftershock disturbances in the nervous system and one’s negative self-identity. Here are the most basic steps:

First, the therapist helps the client identify and practice a resource state called grounding. I can guide you through a visualization exercise that depersonalizes the pain and provides more comforting imagery, which tends to regulate the nervous system. We identify and develop comfortable imagery that helps you reset. Then, I ask you to scan your life history for anything that feels pleasurable and safe. We detail key components of the experience and you practice re-experiencing the positive experience and people. Later, we scan your life history again for an unpleasant or traumatic experience. I interview about what you would have preferred to experience. Then, I facilitate your current, grounded self attending to and taking care of your younger, distressed self through a series of self-care invitations, visualizations, and self-dialogue. When it appears that you have been a loving guide to your younger self and you have nothing left unattended about the chosen difficult experience, I invite you back to the here and now of the therapy room.

If you are interested in experiencing this BSOTR process or have any questions, please let me know.

Shame Shields

I took a webinar with Brene Brown called Shame Shields. Dr. Brown is mostly known for her research on shame, worthiness, and healthy vulnerability. Her research reveals these core tenants about shame:

  • We all have it
  • No one wants to talk about it
  • The less you talk about it, the more you have it
Shame and addiction are interlinked. Addictive behaviors are an attempt to numb, or shield the shame. However, their effectiveness is short-lived and the shame resumes.
Dr. Brown, and separately–researchers at Wellesley College Stone Center–discovered there main subtypes of these shame shields:
  • Moving away — Avoiding, leaving the room, spacing out, daydreaming, distraction
  • Moving towards — Hyper-appeasing, over-flattery, buttering up, sucking up
  • Moving against — Attacking other people, inducing shame in other people
All three shields are an attempt to deflect shame away from the person. Here’s Dr. Brown’s recommended alternatives for shame resilience:
     1) Recognize triggers
     2) Reality check messages
     3) Reach out
     4) Speaking shame
I know these four prescriptions are easier said than done so I am happy to help be a part of the process.

Why do People Sexually Harass?

It’s almost a daily headline the last couple months: Prominent Man Investigated for Sexual Harassment.

Outside the context of each specific accusation, many people are asking: Why do People Sexually Harass? I will attempt to answer that question. It’s NOT a commentary about specific cases, but a broader analysis. I’m not sure whether other researchers & theorists have arrived at the same hypotheses. Mine are a result of my broad professional experience and critical thinking. I have not done a lit review on the matter (although it’s on my to do list). Without further delay, here are my theories:

  • Narcissism: the hallmark of narcissism is a lack of empathy or regard for others’ safety, feelings, and/or independence. Sometimes this deficit comes from unprocessed shame (i.e. the person is not dealing with their own issues so they distract themselves by gaining influence over others). A narcissist also copes by pursuing pleasure, in this case, sexual gratification or interpersonal dominance.
  • Unclear sense of self: Similarly, some people confuse what they want by projecting it on to others. Rather than own and disclose their desire in a straightforward manner, a sexual assaulter may justify their actions by claiming that the other person wanted the behavior. Lots of unhealthy mind reading. Victims are often criticized & burdened for not speaking up. Unfortunately, less discussed is the lack of openness and honesty from the sexual harasser. Sexual harassers are frequently dishonest with their own intentions.
    • Blurred boundaries at workplaces: People who struggle to separate their personal life from their professional life are not skilled at understanding themselves separate from their immediate context. They are at risk for blurring other boundaries, between themselves and other people.
    • Compartmentalization: The flip side of the coin is compartmentalization. Sexual harassers may locate the harassment experience into a corner of their awareness, sealed off from the rest of reality. Effectively, compartmentalization is a type of denial, or delusional boundary formation.
  • Lack of Comprehensive Sexual Education: An absence of healthy sexual discussions produces ignorance and assumptions. Many people associate ALL sexuality with secrecy and shame. Secrecy and shame are the building blocks of sexual abuse. Or, a person can be so sexually permissive that they do not acknowledge the difference between harmful sexualization (imposing on others) vs mutual sexual pleasure. Comprehensive sexual education facilitates self-awareness & dialogue about the healthy diversity of sexual desire and healthy approaches to it. In consensual exchanges, each person is empowered to identify their sexual and non-sexual desires. If there is a conflict, safety is prioritized. For people who missed the boat, I will make another blog post about specific resources for healthy sexual dialogue.
  • Objectification: “noun. The action of degrading someone to the status of a mere object.” People may reduce other people to sexual targets rather than incorporating their other qualities, e.g. creativity, sensitivity, vulnerability, intelligence, etc.
  • Body Privilege: This phenomenon comes in at least two forms.
    • Male privilege: As a general category, men are granted more social license to impose their sexuality as part of their inherited gender script. Dominant social dynamics teach women to be passive receivers. It doesn’t have to be this way–yet this tradition is enforced by many formal and informal social mechanisms.
    • Attractive People: People who are socially-evaluated as attractive may internalize the message that their body is their main source of worth and connection. They may over-rely on physicality in order to deal with loneliness. This dynamic can be described as self-objectification (see objectification, above).

If you would like to discuss these ideas in more detail or conduct an internal exploration, feel free to contact me.

Science of Trust

I took a webinar with John Gottman of the Gottman Institute called “The Science of Trust.” Perhaps Gottman is most famous for his “four horsemen of the apocalypse” theory–that contempt, stonewalling, criticism, and defensiveness poison intimate relationships–and that the long-term success of a partnership can be calculated according to the frequency of these problematic dynamics. This particular webinar about trust explored active, healthy alternatives to repair interpersonal wounds.

Essentially, cognitively-based repairs (appeals to reason, logic, and problem-solving) aren’t as effective within intimate relationships as emotionally-based repairs. For example, empathy, self-disclosure, and investing extra attention/participation into the partnership all work at the emotional level. Emotional interventions help relax someone in distress, thereby encouraging them to make any decisions outside of duress. Within an intimate relationship, logic and “fixing” other’s problems can be experienced as dismissive, shallow, or intrusive.

Many people are not taught intimacy skills–it’s not a formal study in primary school. Some of us learn from family and community role models–other people don’t have this access or experience.

After an interpersonal or developmental trauma, a person is likely to experience hypervigilance–fight/flight responses–and/or avoidance–flight/freeze responses, even within more moderate conflicts. Effective conflict resolution within a healthy relationship requires active participation, deliberation, and transparency from all involved parties. Often, a partner can facilitate a step down the scale of hypervigilance. Gottman and others use the acronym ATTUNE to describe this stance in more detail: awareness, turning towards, tolerance, understanding, non-defensive responding, and empathy. For a great video on empathy, click here: Brene Brown on Empathy.

Does this mean everything has to be hearts, puppies, and sunshine? NO! If people interrupt their conflict or trauma processing, something like the Zeigarnik Effect is likely to happen–people will remember (often at inopportune times) experiences they haven’t ATTUNED to in a healthy relationship. If we haven’t ATTUNED to a partner’s distress, we are most likely telling a negative fictional story about our partner’s abilities.

People who avoid relational conflict have a tendency toward infidelity and and other betrayals, which likely create more (internal) conflict and avoidance.  People who address conflict also practice relaxation and co-construct viable creative solutions, over time, with additional input & information.