New Office Location

My office is upgraded as of January 22, 2024! Those who know me know this search has been a year in the making. In the end, I’m collaborating with one of my favorite healing spaces: Arbor Vitae!

Arbor Vitae is only 5 blocks from my current office. It also houses 4 yoga studios; a float spa; saunas; a cold plunge; multiple massage therapists; an acupuncturist; and other healers. There’s also a cafe on site. The building has more plants than some retail nurseries!

Arbor Vitae translates to “tree of life” and is also the name of the white matter in the brain that processes sensory and motor information. I look forward to seeing you there!

Beliefs about Growth & Change

Here are the nuts and bolts–what I think I know about change and resilience

  • The capacity to fully experience both pleasant and unpleasant experiences is key. A wide Window of Tolerance is healthy.
    • Avoidance and denial are only useful short-term survival strategies. Are you able to fully experience and express your unpleasant experiences in real time? Or the soonest appropriate time? This is what grief processing is all about. If the pain is not honored, it may be waiting in the wings to surprise you and project itself into even more situations down the road. Take your devastation seriously (yet don’t act impulsively). Acceptance and meaning develop out of emotional truth (both pleasant and unpleasant truths).
    • Less discussed is Positive Affect Tolerance. Positive affect tolerance is the ability to fully embrace pleasant experiences (love, joy, success, etc). Many folks harbor unconscious fear when a pleasant experience presents itself because they are bracing themselves from future disappointment and pain. They would rather control their experience than ride the emotional highs and lows. This emotional numbing is an understandable strategy yet ultimately limits internal and external connections.
  • Grief is a part of life. If you want to minimize the expense of therapy in your healing journey, you may want to do some serious grief journaling
  • Identify the emotional longing underneath your disappointments, frustrations, and desires. What are you truly longing for? It may not be in line with your initial words or assumptions. For example, if you’re overtly wanting sex, you might be longing to play, be cherished, or to connect. Once you clearly identify your deep emotional longing, you can generate additional approaches.
  • When magic happens in therapy, it’s usually around a Corrective Emotional Experience. If a client is repeating any unconscious patterns, assumptions, and solicitations, I do my best to respond in a way that is helpful, yet goes off-script from the pattern. Relational dynamics that are experienced earlier in life sometimes become expected, maybe even facilitated, unconsciously. The corrective emotional experience can open doors that may increase relational options outside of therapy. This kind of exploration is a huge part of what makes therapy different from other relationships, like friendships or colleagues.
  • Projections. There are a million things I could say about projections. They can wreck havoc on relationships or, if brought to awareness, can be useful in self-development. Recognizing projections can lead to healthy vulnerability and communication. Everyone makes projection errors. When we recognize projections, we can practice self-compassion and repair.
  • Inner child. Self-parenting is cheesy but real, valid, and often necessary. Neglect is gradually healed by taking the inner child seriously and responding with appropriate, consistent self-care (and community-care if you can find it). Our younger selves can be attended to in the here & now.

2022 & 2023 Continuing Education

Here’s a quick list of my studies the last couple years…I love my job!

(My year with the Integrative Psychiatry Institute is included in prior posts, skipping it here)

SUPERVISION

  • Clinical Supervision: Ethics & Effective Practice*
  • Ethical Frameworks for Multiple (Dual) Relationships

SEXUALITY

  • Minimizing STI Stigma with Inclusive Education
  • Building Queer Families: Conception, Emotional & Legal Issues, and Resources^
  • Sex Positivity: what it is and isn’t
  • Issues & Clinical Implications around BDSM/Kink and Non-Suicidal Self-Injury*
  • Sex & Consent in Contemporary Youth Culture
  • Decolonizing Mental Health & Sexuality through Irreverent Comedy
  • Sex after Sexual Assault
  • Pelvic Floor Health and Vitality: from Pain to Pleasure*
  • Trauma-Informed Assessment of LGBTQ+ Youth^
  • Emerging Trans: Therapists’ Role in Supporting TNB Young People^
  • LGBTQ+ Older Adults: Strategies and Recommendations^
  • Non-Monogamy/Polyamory Panel^
  • Rewiring Trauma through Kink^
  • Gender-Affirming Letter Writing for Clinicians^
  • Play Therapy with LGBTQ+ Youth: Caring for the Child, Collaborating with the Parent^

EMDR

  • Easy Ego State Interventions*
  • EMDR & Mindfulness*

OTHER

  • Ethics of Self-Disclosure
  • Suicide Prevention
  • Grief & Bereavement in LGBTQ+ Communities^
  • Borders & Walls: Facing the Other*
  • Differential Diagnosis with DSM 5*

*Longer events, ranging from 4 hours through 4 days

^Events I volunteer organized speakers for the Queer Affirming Therapists Guild

Ketamine-Assisted Therapy: Procedures and Safety

After graduating from the Integrative Psychiatry Institute this May (250 hours of education), I’ll be offering ketamine-assisted psychotherapy, starting in July. 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:

  • a consultation with you and your primary therapist
  • medical screening with a physician (referral available) who would prescribe you the Rx if indicated
  • Counseling/preparation meeting(s)
  • a 3 hour medicine meeting (the last hour we talk/process)
  • a follow up integration meeting within 2-3 days of the medicine meeting
  • consultation and referral back to the primary therapist and any additional resources
  • additional rounds if indicated

Safety:

Ketamine therapy is not for everyone. I have seen it effective for treatment-resistant depression and obsessive-compulsive disorder. Manic or hypomanic states, personality disorders, and/or a history of psychosis contraindicate ketamine. Ketamine involves altered states of consciousness that can increase client vulnerability and projection. I’ve heard of misuses. For the safety of everyone:

  • I follow best practices in the field (from my clinical training as well as the Big Tent community and the Jules Evans substack)
  • medicine meetings are videotaped and securely stored according to HIPAA protocols
  • I do not touch clients
  • there is no communication between client and therapist between meetings, except to schedule meetings, or in case of an extreme emergency
  • clients are welcome to bring a calm, quiet support person observe medicine meetings
  • All ketamine treatments are conjunct with psychotherapy (this is not necessarily true of IV clinics or “underground” practitioners)

I’d be happy to answer any questions! julia@juliacounseling.com

2021 Continuing Education

I attended and organized many programs this year. LMK if you would like to discuss!

I attended:

  • Sexual Development and Attitudes of African American Women
  • Sex and Sexuality in the Muslim Community
  • More than Medicine: Alternative Treatments for ADHD
  • Sex Therapy with Religiously Conservative Clients
  • Inter-generational Transmission of Trauma on Adult Sexual Intimacy
  • Couples After Pregnancy: Intimacy & Sexuality
  • Racial Literacy: Racial Stress in Therapeutic Relationships

I also organized events through the LGBT Affirmative Therapists Guild. I facilitated the event & discussion and other professionals presented on the following topics:

  • Hormone Therapy with Transgender Clients (medical provider panel)
  • Weight Stigma
  • HIV+: What Therapists Need to Know
  • Lesbian-Affirming Client Care
  • Reflections from LGBTQ Community Members

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.

 

Becoming a Supervisor

This Spring, I’m supervising 4 graduate counseling students in their Practicum field experience. I’ll help new counselors evaluate their work and design treatment plans. To prepare, I am taking two courses:

  • “Clinical Supervision: Mastering the 4 Stages of Development” with Robert Taibbi, LCSW
  • “Using Deliberate Practice to Enhance Clinical Skill Development” with Tony Rousmaniere, PsyD

Besides helping other counselors, it will help me continuously re-evaluate my own skills and assumptions.

Defining Success

I used to work in a university Career Services center. There, I learned that one of the toughest job interview questions was, “How do you define success?” It’s time I answer that question myself.

From my experience, productive counseling meetings incorporate three main therapeutic skills:

  • I provide concentrated attention: capacity to listen, presence, and track the main points from our prior conversations
  • I help someone expand their story: exposing & exploring additional layers
  • I offer concrete options, alternative actions, and resources