Category Archives: narrative

2024 Continuing Education

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This 14th year of business was a mixture of delving into some new content; reviewing the basics; and specialized training. I love the variety of sources to inspire my work–and the challenge to tailor experience with each particular client.

I went to a workshop about “divine” and “shadow” femininity and masculinity earlier this year. As a therapist and sex therapist, of course I’ve been analyzing relational and internal energies for my whole life. I see some real limits to associating energies with gender and am committed to fluidity and curiosity. At the same time, the lens of “divine” feminine and masculine is an interesting way to highlight qualities that someone of any gender can incorporate into life, with or without a partner. I’m also fascinated by the shadow aspects. While some religions may prescribe gender roles, they are silent on the shadow side–the problematic ways that gender roles hurt people. In this other framework, divine femininity relates to deep strength in vulnerability, creativity, radiance, acceptance, presence, compassion, timelessness, and flow. Toxic or shadow femininity is associated with hyper-etiquette, passive aggression, gossip, perfectionism, false humility, covert competition, and/or helplessness. Shadow (or “toxic”) masculinity, as many of us know, relates to violence, aggression, entitlement, hostility, impulsivity, bravado, and being caviler. Divine masculinity is protective, providing, initiating, activating, adventurous, focused, grounded, and direct. Anyone can have any of these traits. The shadow sides of each relates to how people cause harm and/or unconsciously sabotage themselves. This framework is one of a thousand that can help us self-assess our growth edges and practice them with ourselves and in relationships.

Another workshop I took this year was back to basics: Interpersonal Psychotherapy (IPT). It’s a comprehensive treatment theory for depression, anxiety, and trauma that involves assessing and treating 4 domains: interpersonal disputes, role transitions, grief, and interpersonal deficits. Intervention techniques include communication analysis, interpersonal inventory, role playing, assertiveness training, and building social support. I also studied an Interpersonal Process Approach book (different from IPT) with a supervisee.

For sex therapy, I attended the AASECT national convention again. This year’s workshops included:

  • The Room Nextdoor: Neural networks and Sexuality (with Emily Nagoski, author of Come As You Are and Come Together)
  • The Fight for LGBTQ Rights in an Age of Fear-Based Politics (with Representative Zooey Zephyr)
  • Black Male Sexualization (with Yamonte Cooper)
  • Intersex Narratives: Navigating Identity, Advocacy, and Sexual Health (with (Pidgeon Pagonis)
  • Navigating Intimacy with Autism
  • Reimagining Menopause and Beyond: A Journey of Empowerment and Clarity
  • Sexual and Reproductive Reality of Breeding Kinks
  • Centering Latinidad in Sex Education, Counseling, y Therapy
  • Assessing Sexual Dysfunction and Preventing Early Onset Psychosis

Additionally, I started learning how to combine two of my specialties. I took a course in combining EMDR and Ketamine-Assisted Therapy. It helped me sharpen both skill sets and develop a couple protocols for combined treatment. Both EMDR and Ketamine-Assisted therapies may help tap into unconscious material and enhance neuroplasticity. This is a treatment option for some people with depression and trauma.

I also completed my last year coordinating trainings with the Queer Affirming Therapist Guild and attended the American Academy of Psychotherapist conference (previous blog post). It’s been a great year!

Beliefs about Growth & Change

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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.
  • Congruence is vitality. Congruence means authenticity; we can be respectful without masking. Therapy may be a low-stakes opportunity to increase your genuine self-expression, a key ingredient for both autonomy and intimacy.
  • When magic happens in therapy, it’s usually around a Corrective Emotional Experience. If a client is repeating any unconscious patterns or assumptions, 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

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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

On Fire

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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.

Decentering the Norm

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I attended a 3-day workshop titled “Decentering the Norm: Social Justice Transformations in Sex Therapy, Counseling, and Sex Education.” Some highlights included:

  • sex tools that enhance or enable pleasure for people with disabilities
  • connecting pleasure with personal power and agency (rather than, for example workaholism)
  • a discussion of “sanism” and introduction to Mad Studies
  • how queer theory intersects and modifies attachment theory

Body Image and Sexuality

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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.

Healing Body Memory of Trauma

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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.

Originals

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I enjoyed reading Originals: How Non-Conformists Move the World. It’s a collection of case studies, from technology entrepreneurs to social justice advocates, where creative-thinking overcomes status quo obstacles. It’s hard to be an Original without feeling isolated at times, so the stories and sociology research in this book are a welcome companion. The book also gives examples and tools for facilitating more Original leadership and cultures.