Newsletter Archives

Bernice is a 48-year old African American woman who was diagnosed with stage-four lung cancer in August. Unfortunately the diagnosis came in the midst of an extended depressive episode. She has no support system and her husband has recently become physically abusive. She is desperate for someone to talk to and help her work things out.

Maggie had Hodgkin’s Lymphoma at age 16 and then breast cancer at age 34 and recently had a bilateral mastectomy. She is unable to work due to the neuropathy in her hands and feels directionless in her life.

Anna’s relationship with her husband has always been difficult but now with her recent stage two breast cancer diagnosis, things have gotten worse. She and her husband want couples counseling with a Spanish-speaking therapist.

These three women are typical clients in the Women’s Cancer Resource Center’s Free Therapy Program. Their issues are “every day” in some respects and yet dire with the added challenge of cancer. Being a therapist in this program is a privilege because the issues these women face are literally life and death.

As most of us know, there is a great need for therapy services in low-income and uninsured communities. The American Cancer Society issued a compelling Report to the Nation, which found that poor Americans were receiving substandard health care. As mortality rates for cancers have improved for certain populations, African American and Latino women continue to present with late stage diagnoses and die from this disease. This is especially of concern in Alameda County, one of the most racially and ethnically diverse regions in the nation and where 11.5% of the population lives below federal poverty level resulting in disparities in disease, disability, and healthcare. As a result of the economic downturn, resources for therapy, cancer screening, diagnosis, and treatment continue to diminish. Barriers such as limited English proficiency and illiteracy, and patient-health provider communication difficulties due to cultural beliefs, and myths and fears about cancer often delay treatment resulting in a more advanced cancer presentation at the time of diagnosis.

The Women’s Cancer Resource Center (WCRC) is at the forefront of providing services to all women with any cancer, from all backgrounds, economic abilities, and ethnicities. Our clients include women with new diagnoses, in remission/survivorship, living with metastatic disease, and receiving end-of-life care. We provide an array of programs designed to help our clients cope with the physical and emotional changes caused by diagnosis, treatment, and the challenges of caring for someone with cancer. The Free Therapy Program, offers 12 free psychotherapy sessions to low-income and/or uninsured individuals and couples that desire a safe place to discuss any issue related to their cancer diagnosis.

Who does the therapy? Therapists and interns just like you who are in a private practice and want to volunteer in a meaningful way. Therapy can take place in the therapist’s office – which makes it a convenient volunteer opportunity - or in a private space at WCRC. The therapists are the newest intern to the most seasoned Psyd’s, PhD’s, MFT’s and LCSW’s. We have therapists from all cultural backgrounds and three that speak Spanish fluently.

The Free Therapy Program volunteers offer 12 free fifty-minute sessions after which the client can become the therapist’s client if a fee can be agreed upon. Volunteering can lead to practice building. The therapist also receives clinical training on end-of-life issues, and cancer, through bi-monthly seminars held at WCRC. These trainings are enriching networking and community building events.

This program is only one of the many that the Women’s Cancer Resource Center (WCRC) provides for our community. We provide information on prevention and early detection and do outreach to underserved communities throughout the East Bay. Core programs are led by staff and volunteers and include: information and referral to community resources, support groups, in-home support, psychotherapy, emergency financial assistance, cancer and wellness workshops, and navigation through an often complex and overwhelming health care system to ensure appropriate care and treatment.

Though the majority of our clients are diagnosed with breast cancer, WCRC serves all women with any cancer and all programs and services are FREE of charge.

As with all our programs at WCRC, volunteers are the heart of the Free Therapy Program. Currently the program has 30 therapists actively seeing clients. We are consistently recruiting a diverse group of therapists to meet the needs of our clients. We are hoping to attract therapists in the East Bay and San Francisco. We are especially interested in therapists who identify as African American and who speak Spanish fluently.

For more information, contact Ali Vogt, MFT at ali@wcrc.org 13a42d64d98a45a1__GoBack. To learn more about WCRC please see www.wcrc.org.

Ali Vogt, MFT, is the Clinical Manager of WCRC’s Psychotherapy Programs. She also has a private practice in San Francisco and Oakland where she works with adult individuals and adolescent girls.

When I was in my early 20s I went to a bioengergietc therapist.   She watched me walk and told me specific accurate info about myself.  That experience blew me away.   Now I teach this.

What seemed mysterious to me at that time is actually a learnable skill once we start to look for the somatic signs.

For example, we generally unconsciously feel drawn to someone who approaches us with an open posture and a buoyant walk.   Conversely we may unconsciously shy away from people who carry “heavy energy” as illustrated by their posture, their facial expression, their walk and their demeanor.

These same reactions affect us in our role as therapists when we are working with our clients.  As therapists, our task is to make the unconscious conscious.  When we fail to pay attention to these subtle and not so subtle somatic cues in our clients, we are not only missing an essential diagnostic tool but we are also relinquishing the opportunity to present the client with an irrefutable truth.  

The body never lies.  As we know, we can all verbally deny.   But our bodies never lie. 

For example, a woman came to see me for complaining of right hip pain that she had since the birth of her child some 15 years ago.   I watched her walk and saw that her gait was compromised such that the optimal rotational mechanism of a healthy joint was altered.   During treatment I worked to balance her imbalanced musculoskeletal system using chirppractic skills, craniosacral  therapy and mind body awareness.  Therefore, while I was working with her, I continually explored her responses to the treatment, both physically as well as emotionally.   During the third session, as I loosened some very tight muscles in her hip, she burst into tears as she remembered the origin of her injury.    

During the birth of her daughter 15 years prior, she was delivering in a teaching hospital.  While under spinal anesthesia, a resident doctor innocently and inadvertently pressed on her left thigh pushing it beyond its normal range of motion, causing the pain that she had suffered for all these years.

What a huge and surprising discovery.  The rest of our session focused on her rage at this pain that she suffered from for so long as well as the corresponding cost to her sexual pleasure.  .She admitted that she and her husband have had significant sexual issues that began after the birth of her daughter and finally now it made sense that it stemmed from this hip injury. 

As a psychotherapist, you might meet this woman in couples counseling.   The sexual issues may have become elaborated into believes about either her or her husbands inadequacies, loss of self esteem, and/or verification for shutting down in the relationship. .

But if you looked at her gait, it would become obvious that her two hips were not moving synergistically.  Her left leg was rotated outward while her right seemed normal. 

While you may not diagnosis the source of her gait, a relevant question might be to ask if she has pain in her leg.  And if so, how long has it been going on?  

The point of all this is to encourage therapists to begin to see their clients and look for meaning not just in the words they say but also in their physical actions. 

Here are some simple guidelines to look for:

How does someone walk in to your office?

How does someone sit down?

How do they hold their head?

How do they hold their chest,?

What are the position of their shoulders?

What story is their posture saying?

Just this little awareness can make a big difference in the way you see your clients and can significantly open the lens through which you can see this person.   By doing so, a greater potential exists to incorporate the integration of the  mind and the body in your treatment.

Dr Nicky Silver will be offering a presentation to The East Bay Therapists Association on Wednesday October 3^rdfrom 10 AM -12 PM. at  St Mark’s Methodist Church at 415 Maraga Way in Oriinda, CA

Dr Nicky Silver has been a practicing chiropractor for over 30 years.  She has studied extensively with The Center for MindBody Medicine with Dr. James Gordon as well as with holistic health pioneers, including Dr. Bernie Siegel, Dr. Carl Simonton and Dr. Elisabeth Kubler Ross

Dr Silver uses gentle chiropractic care, craniosacral therapy and creative processes to support her patients in living a life with less pain and more vitality.   A main focus of her work is teaching skills for self care.  Her office is located in Oakland.   Website is drnickysilver.com

 

Attachment is the fundamental drive in human beings. It is a drive that brings aggression and sexuality to its defense and to its enhancement, and it is the precursor to human love. It is gained through the delicate interplay of vocal tone and facial expression, through body to body communication, through the dyadic system of care that develops when the mother attunes to her baby. When attachment fails through the significant interruption or destruction of this system, the infant suffers not only what appears to be irreparable emotional harm but significant brain damage. Sebern Fisher (1)

Just as I began to hope I might soon settle down into the tranquility and wisdom of middle age, I find myself running around the country to trainings, poring over brain twisting books, spending all my money on consultation and scrambling up a wall-steep learning curve. It all began at the annual Boston trauma conference last June. I've been attending it religiously over twenty years, it is where I have often first learned of what would next inform or revolutionize my practice. It was there that I first heard Bessel van der Kolk talk about the traumatized brain; it was there that I first heard Allan Schore speak about attachment neuroscience; Pat Ogden and Peter Levine talk about trauma and the body; and Francine Shapiro's discovery of EMDR. But over the last few years there has not been much there that was new to me. I figured the trauma field had begun to plateau. This year I thought I was just going to see my friends.

I was surprised to find something new to me being showcased there; neurofeedback. In particular a practitioner named Sebern Fisher presented cases and described work with complex PTSD and Dissociative Disorders, showing video clips of clients saying such things as "What we achieved in a year and a half with neurofeedback, would have taken me a whole lifetime of any other kind of psychotherapy. “ I was intrigued. I had never even heard of this.

Admittedly I have never been able to make peace with how long it takes to heal trauma, or for that matter how long psychotherapy takes. It seems profoundly unjust that people must not only suffer horrors, indignities and injuries in childhood or whenever during their lives, and continue paying for years for what they never asked for. The quest for a methodology to expedite this has always motivated me to learn more and better methods. I listened to Sebern and others. A number of presenters who work with children talked about ADD, ADHD and Autism spectrum disorders, and seeing remarkable results in ten or twenty weeks of twice a week 30-minute sessions. Only because it was this conference, organized by someone as highly esteemed, brilliant and research based as van der Kolk, could I consider believing what I was hearing.

I promptly came home, and after signing up for the training, went out in pursuit of a neurofeedback practitioner. I always insist on experiencing first hand, any methodology I intend to practice. I was surprised to find few neurofeedback therapists in the Bay Area. I ended up with a woman in Palo Alto and began my ritual schlep down to the Peninsula every week.

After about the second session, I was amazed to find myself feeling astonishingly calmer and happier, and things just didn't bother me. I continued the sessions for a total of about 20, over about 6 months. I was repeatedly amazed at the changes I observed in myself. Always right on the edge of being OCD, I observed my character loosening and becoming more flexible. Things I had chronically been anxious or even scared about seemed to spontaneously fall away, my husband with his jaw on the floor observed me rather effortlessly making decisions that would have been unthinkable for me before. Clearly my brain was changing, and so differently from how I had ever before experienced myself changing through psychotherapy. It was not by will, effort or intention, but simply showing up for the sessions and submitting to a truly effortless process. The only effort really was the schlep to Palo Alto. So I have embarked on a journey, attempting to make sense out of this. I took the training, and have begun to practice and observe what happens with clients in this most remarkable process.

Peak Performance for Every Brain

So what then is this neurofeedback? It emerged in the 1960's out of biofeedback. In effect it is operant conditioning, not unlike dog training. As I explain to clients, when the puppy pees outside you give her a cookie. Every time she successfully pees outside you praise her and give her a cookie. After a while, you don't have to give her a cookie anymore. She just knows to pee outside. Neurofeedback works according to the same principle.

The underlying theory is that in effect, all mental disorder (and many physical disorders too,) are dysregulations of arousal. In the world of trauma we have known this for some time. The traumatized person, with an overactive amygdala, swings between hyperarousal and hypoarousal, with the gravest of his or her difficulties being the inability to self regulate, or calm down.

We also know from attachment neuroscience that the infant's brain develops in resonance with the brain of the good enough care giver. When the caregiver is dysregulated, dysregulating, or absent, the infant's brain development is destabilized or stalled. And the capacity for self regulating affect and experiencing essential calm and joy, is elusive at best.

Where the notion of dysregulated arousal was easy to integrate into my previous thinking. What I had never realized or thought about before, is the specifics of arousal, the actual firing of the brain. Neurons fire at different frequencies. When too many neurons fire at too high of a frequency, we experience hyperarousal, perhaps anxiety or rage. When too many neurons fire at too low a frequency, we might experience depression, numbing or dissociation.

Of course different brain areas will have optimal ranges of firing frequencies. For example the prefrontal, executive functioning area of the brain optimally fires at a moderately high frequency required to sustain focus, concentration and mental energy. If frequencies are too low in the front of the brain, one might suffer diffuse attention; lack of motivation and follow through; or flat affect.

In the brainstem area, resides the function of calming the nervous system and body. If the back of the brain is firing too high, we are unable to calm down or sleep well. That is when the individual might be prone to substance abuse, overeating, compulsive behavior, or some activity pursued in the service of calming down. So in every brain, in each site of the brain, there are optimal frequencies, optimal levels of neuronal firing, and of course optimal ranges for desired function. We want the front of the brain to slow down in order to relax and sleep, we want it to perk up for driving or taking an exam. What neurofeedback does is train the brain to fire in its optimal range at any given site. It is peak performance training for any brain.

Mirroring and Validating

First attachment theory and later interpersonal neurobiology, have taught us that the brain develops in resonance. Through the experience of being mirrored and validated, through a consistent empathic response that comprehends and attends to her communication, the infant self emerges. The caregiver sees and communicates, “I see you, yes!” As Alan Schore (2) and Daniel Siegel (3) have taught us, through an interplay of right hemisphere to right hemisphere “contingent communication” the organ of the self, the brain grows, and with it the capacity to self regulate. Our offices are filled with young and old who lack or long for these experiences due to trauma, neglect, or some other loss or disruption. Their worst suffering is in the realm of relationship, which really is the most important thing there is.

That is what brought me to relationship work. The agony and loneliness of dysregulated relationship for many is unbearable. Besides psychotherapy, I learned one way to repair both the missing experience of mirroring and validation, and to heal the injury of relationship, to be in couple’s work that incorporates a communication style that is all about mirroring, validating and empathy (4.) It works powerfully, and is probably the most difficult work I know from the client’s perspective. Often it takes time. Many of the injured are not so fortunate as to have a relationship within which to do such work, or are too troubled to tolerate its pain or duration. For some, their partners lack the stamina.

I believe that neurofeedback replicates the dynamic of mirroring and validating. Ironically the computer with its graphics or mechanized beeping reflects the rhythms of the brain waves back to the brain, indicating “Yes! That’s it! That’s good! Do that some more.” Hard wired for positive re-enfocement, the brain complies. Neurofeedback research with other mammals shows the same result. This makes intuitive sense to me. John Gottman the marriage researcher translated it to science 20 years ago, demonstrating that relationship stability requires a 5:1 ratio of positive to negative. (4)

Timing is Everything

So how does this stuff work? After a painstaking assessment process, the therapist determines which are the brain areas most central to the symptomatology. Of course in the case of trauma and many other attachment injuries, we know the amygdala is the key site. Electrodes are located on the scalp to be in contact with the site in question, and the computer is set to the optimal range of neuronal firing for that site. The complex science of brain wave rhythms is beyond the scope of this article. Suffice it to say, part of why the learning curve has been so steep for me, is that the therapist must become fluent at knowing about both anatomy and the electrical functioning of the brain. Where I was familiar with biochemistry and even a bit about cerebral blood flow as per neuroimaging spect technology, electrical firing was a whole new world to me. I have come to learn that timing is everything and has tremendous impact on neurochemistry and blood flow. The rate per second or per cycle at which neurons fire, as measured in hertz, is in effect they key to mental health, or so believe the practitioners and researchers of neurofeedback. When the timing of the brain’s firing is optimal symptoms disappear, even symptoms of which we were not aware.

The computer is set such as to monitor the rhythm of firing of the various brain waves. When they are firing in the optimal range for that wave, the computer emits a signal communicating “That’s good! That’s good!” It might be a beep or a gong or a picture on the computer screen. The positive feedback, like the puppy’s cookie, trains the brain to keep it up. And the brain does just that. Outside of its owner’s awareness, the brain continues the dance of firing in resonance with the computer and over time comes to prefer the rewarded rhythm. Like the puppy, over time, the reward is no longer required and the brain leaves its training wheels and keeps going that way. The computer does not add anything. It simply measures and reflects, mirrors and validates.

The client does not have to remember heinous scenes, feel painful emotions, does not even have to talk. The process goes on outside of the client’s awareness. For those jaded by years of therapy, sick to death of their own tired horror story, it is a dream come true. They can have healing essentially just by showing up. They can even fall asleep during the session and the brain keeps working and benefitting. Imagine being able to snooze and win!

It does sound too good to be true, I know. And yet my experience continues to be astonishing. One woman, Rhonda, was referred to me recently by her psychodynamic therapist. After many years of good therapy she had a traumatic athletic accident, not only terrifying but disfiguring. Even a year out from the trauma her symptoms would not abate. Both she and her therapist were frantic as her flashbacks and emotional activations began to jeopardize her employment. She was desperate enough to try anything.

Assessment revealed that Rhonda had a whole childhood of chronic abuse that exacerbated the adult trauma. After her first session of amygdala training she began to calm down. She felt hopeful, although she considered the possibility that it might be placebo, or the prospect of something different. But by the fourth session when both she and her therapist were amazed at her resilience and rapidly growing stability, in addition to the increasing calm and confidence, she already began referring her friends to me for neurofeedback. Even the physical pain of her injury was abating. This is only one of many examples of the wonders I have seen even in the short time I have been practicing. Of course it sounds like snake oil. It would have to me too if I had heard about it from anyone but van der Kolk. Seeing is believing.

So I am studying neuroanatomy and physiology (and a fair amount of arithmetic!) like a madwoman so inspired to learn this. It seems to be what I have long been searching for: a way to move people quickly through trauma, and really most any other affliction. I am increasingly coming to believe, it is dysregulation of arousal, most often rooted in disordered attachment that underlies most if not all symptomatology and pathology. To me it makes sense.

Of course there are transference issues. I now touch my clients, pasting the electrodes on their head and ears. I am actively messing up my clients’ hair! And as Fisher points out (6) the attachment disordered might relate to the computer like a rivalrous sibling, apparently compelling the therapist’s attention and interest. I too have had these experiences. Yet as the brain gets trained, either the stability becomes available to work with the transference issue, or the symptom just simply vanishes.

Neurofeedback is not a substitute for relationship work or the depth work of psychotherapy. Rather, like medication it may provide the stability requisite to making progress possible at all. Speaking of medication, many clients find that as the brain finds its peak performance zone, their medication dosage initially begin to feel like an overdose, and even eventually become superfluous. Another perk. The intrigued, curious or skeptical who wish to read more might have a look at www.eegspectrum.comwhich recommends readings and has archives of articles on many subjects. Or give me a call. Maybe I’ll hook you up!

The perennial question is, why doesn’t anyone know about this? First I would say is the old koan about research money: it takes large scale research to gain validity in today’s world. In order to get research grants a certain amount of validity is required, to warrant the investment; and of course the way to the validity is the large scale research... The deep pockets for research money are with the government and the pharmaceutical companies. So people like van der Kolk fight for grant money from the National Institute of Health. Fortunately he is intrepid and tireless. As for the pharmaceutical companies, why would they consider funding research for a methodology that promptly gets large numbers of people off their meds?

Additionally touchy feely and/or deeply feeling therapists, not unlike myself, might balk at a methodology with a beeping computer as its medium, likening it to the monkey baby’s wire mother. My 20 year old niece, now an undergraduate studying for a career in psychology recently said to me, “This works so quickly, aren’t you worried that everyone will get better so fast that you won’t have any clients?”

1. Fisher, Sebern F. Neurofeedback: A Treatment for Reactive Attachment

Disorder From the web site of EEG Spectrum International .

2. Schore, Allan, Affect Regulation and the Origin of the Self: The Neurobiology

of Emotional Development. New York. Lawrence Erlbaum Associates Inc.

1994.

3. Siegel, Daniel, The Developing Mind: Toward a Neurobiology of

Interpersonal Experience. Guilford Press. New York. 1999.

4. Hendrix, Harville, Getting the Love You Want, A Guide for Couples.

Henry Holt and Company. New York. 1988.

5. Gottman, John, Why Marriages Succeed or Fail: And How You Can

Make Yours Last. Simon and Schuster. New York. 1995.

6. Fisher, Sebern F., On Becoming a Neurofeedback Therapist: Thoughts on the

Integration of Psychotherapy and Neurofeedback. From the web site of EEG

Spectrum International.

Ruth Cohn, MFT and AASECT Certified Sex Therapist, is in private practice in Oakland. Also certified in EMDR and Sensorimotor Psychotherapy, she specializes in work with adults with histories of childhood trauma and neglect and their intimate partners and families. She is currently preparing for certification in EEG Neurofeedback. She can be reached at cohnruth@aol.comor www.cominghometopassion.com.

CAMFT and California Senate Bill 1172 (Risks of SOCE)

EB CAMFT was the first CAMFT chapter supporting SB 1172. This historic bill could be the first in the nation that would ban sexual orientation change efforts--SOCE--for minors. Other terms for SOCE are "reparative therapy," "ex-gay therapy" or "conversion therapy."

SB 1172 passed the legislature in August and is now waiting for the Governor's signature.

The bill is needed to protect queer and questioning youth from approaches that claim to reduce or stop the development of their same-gender erotic attractions, behaviors and identities. Years ago the major national psychological organizations affirmed how risky and unhealthy SOCE is, yet the damaging practices have not stopped.

The bill is needed because decades of trying to affirm being LGBTQ or questioning has not stopped the psychological damage from a small group of practitioners of "reparative" methods. Survivors of receiving "ex-gay" practices when they were teens report having lasting psychological damage from what was done to them as youth.

The state board of CAMFT has opposed Senate Bill 1172. While they were working with a coalition of organizations to change the bill, EB CAMFT, SF CAMFT and LA CAMFT became supporters, along with AAMFT of California, NASW of California and many other organizations.

CAMFT was in a coalition with other organizations opposing the bill until mid-August when the California Psychological Association broke with the coalition and moved to supporting the bill. Santa Clara Valley CAMFT followed them in becoming supporters. The California Latino Psychological Association recently also became a supporter along with many other organizations.

This photo shows therapists from Gaylesta, the LGBTQ Psychotherapy Association of the SF Bay Area, with staff from Equality California, delivering petitions for SB 1172 to Governor Brown's office. Over 50,000 signatures supporting SB 1172 were collected from around California and outside the state. Equality California is a sponsor of the bill and works with the legislature to further LGBTQ rights and improve queer health through legislation.

The BBS is a supporter of SB 1172.

The Pan American Health Organization, recently called for national legislation against SOCE. "These practices are unjustifiable and should be denounced and subject to sanctions and penalties under national legislation," said Dr. Roses, director of PAHO. Dr. Roses went on to say, "These supposed conversion therapies constitute a violation of the ethical principles of health care and violate human rights that are protected by international and regional agreements. http://www.dayagainsthomophobia.org/Media-Release-World-Health,1557.

There will certainly be more news about SB 1172 soon. Please sign Gaylesta's petition and distribute it freely. You can also call the Governor's office and express your support as a licensed, or prelicensed, mental health provider: 916-445-2841.

Gaylesta's petition is at:  http://www.change.org/petitions/protect-youth-from-being-forced-into-ex-gay-therapy-sb1172

A bill similar to SB 1172 is expected to be introduced to the New Jersey legislature before the end of September 2012.
 
Jim Walker, MFT
510-684-4508  cell

As a psychotherapist in private practice since 1984, one of my specialties is helping clients manage stress in their lives. Those of us in the helping professions are especially susceptible to stress. This article is about a relatively new way to help with stress and work burnout: taking a career break.

For the past few years I was entertaining the idea of taking what I was calling “an adult gap year”. I found many articles on high school/college aged teens/young adults taking a gap year, but nothing on adults doing this. Then I read an article in the New York Times on Meet Plan Go and Sherry Ott, introducing me to the term I had been looking for: “career break”. I attended the conference they were having in San Francisco in October 2011 and took my career break the following spring.

A career break is simply time away from your job. There is no “right” way to take a career break, only that if it is less than a month it’s more of a vacation. The word sabbatical is often used and is the same concept.

There are many benefits to taking a career break and traveling. For a profession like ours most reasons are obvious such as returning from traveling refreshed, replenished, gaining new perspectives and having time to not think about your clients. People who take career breaks often return with a more positive outlook on their job and life in general.

But there are other benefits as well that have been substantiated through research.

Psychologist Lile Jia at Indiana University published an article in the Journal of Experimental Social Psychologythat says distance can make you more creative. The implications of his research show that traveling to faraway places and communicating with people dissimilar to us can help increase creativity and lead to considering novel alternatives.

A study from the Kellogg School of Management in Chicago also supported the research that living abroad boosts creativity. This study showed that the experience of another culture endows us with a valuable open-mindedness, making it easier to realize that a single thing can have multiple meanings. People who travel are more willing to realize that there are different ways of interpreting the world.

Jia’s work and the study at Kellogg showed that traveling not only helps your creativity but also improves your problem solving abilities, skills that are imperative in our field.

If you do decide take a career break, be prepared for internal and external blocks. Society’s norm is to work until you get old (or sick) before you can take your break, so when deciding to take a career break, encountering mental and social hurdles are common. You will have to explain yourself to family and friends, because right now taking a break when you are healthy and younger than retirement age is the exception. Sometimes using the word “sabbatical”, a term people know, will help explain what you are doing, but you will still find many family and friends doubting your decision.

Maybe you have told yourself this same narrative, i.e. I will work and work until I retire. But in our field, there usually isn’t a set age to retire, and if you are in private practice, no one is “retiring” you. Just like with any big change in your life, if you take all this in and tell yourself “I can’t do this”, you never will.

Logistically, therapists often are worried about what will happen to their clients. Those in private practice might also be worried what will happen to their business. You need to treat this the way you do other planned (or unplanned) absences such as maternity leave, caring for a sick family member or leaving your agency job. Regarding your clients, you give adequate notice, find back-ups when needed and arrange for a return date. As with other absences, you share as much or as little as you want based on your theoretical perspective and the particular client’s needs. As far as your business, you need a plan to have it back up and running upon your return. Before leaving could be a good time to use a practice building consultant so you can return to a thriving practice.

Future articles will give specifics on how to therapists can plan for a career break including dispelling the myths of why you can’t do it (too expensive, it will ruin my career, I can’t go with my family, I can’t go alone, it’s too dangerous, this isn’t the right time, etc.), practical planning tips and how to manage your private practice or job before and after your career break.

Thousands of people are now taking career breaks. It is possible. You will return with new motivation and renewed energy for the wonderful work we do. Consider taking a career break because you deserve it. And the best reason isn’t deep or clinical or psychological or particularly introspective; do it because it will add to your happiness.

REFERENCES

Jai, Lile, Hirt, Edward & Karpen, Samuel. Lessons from a Faraway land: The effect of spatial distance on creative cognition. Journal of Experimental Social Psychology. 45(5), September 2009, 1127-1131.

Lehrer, Jonah. Why We Travel. The Observer. (3/14/10).

Maddux, William W. & Galinsky, Adam D. Cultural borders and mental barriers: The relationship between living abroad and creativity. Journal of Personality and Social Psychology. 96(5), May 2009, 1047-1061.

Stellin, Susan. Practical Traveler: Making the Dream Trip a Reality. New York Times. (10/17/10).

ON-LINE CAREER BREAK RESOURCES

http://meetplango.com/ (extensive links, meetings, tools for taking a career break)

http://meetplango.com/san-francisco/ (Information about the 10/16/12 S.F. conference)

http://franwickner.com/?page_id=7 (practice building workshops, consultations and on-line e-books on the business side of your practice.)

Fran Wickner, Ph.D., MFT has been a licensed MFT since 1983. She has a private practice in Albany, CA, serving individuals, couples, families and teens. For over 25 years Dr. Wickner has also been helping clinicians grow their private practice both with and without managed care. Her website, www.franwickner.com has information about her practice and her consulting business including practice building workshops, consultations and downloadable practice building packets.

On October 16, 2012, Dr. Wickner will be a speaker at the MEET PLAN GO! Conference in San Francisco, CA http://meetplango.com/san-francisco/ .

You can contact her at franwickner@hotmail.com or 510-527-4011.

The practice of Hypnotherapy is interactive and directly engages the client’s unconscious resources through verbal and non-verbal communication while the client is in the hypnotic state. Therapy done in this expanded state is greatly enhanced and supported because the client is able to access information, healing, creativity, memories and insight that is not normally available when in the waking conscious state.

By engaging a transpersonal or spiritual form of hypnotherapy, the client’s personal transformation can be supported even further. Invoking client’s higher Self (or higher power, or the Christ with in, or Buddha wisdom, or the Divine Self, called by many names) aligns clients in accessing profound states of consciousness similar to those experienced in deep meditation or in profound states of presence: states when the egoic or self- involved consciousness is transcended or simply out of the way. Healing and profound change can take place, often fairly effortlessly, through these transpersonal states of consciousness. Clients report that these expanded states of consciousness change them in lasting positive ways. Clients realize that, for instance, they have sadness, but are not the sadness. They can potentially experience themselves as spiritual in essence: as a spiritual being having a human experience.

In traditional talk therapy, the client works from the conscious egoic level most of the time, and in many ways she keeps reinforcing the stories, identifications and negative patterns around her difficulties by focusing on them and taking about them over and over again on a conscious level. In talking about the problems and feelings there is the hope that the client will have a spontaneous breakthrough of insight and change. In contrast, by dialoguing with the higher Self directly in a trance state, the hypnotherapist and client can elicit direction from the higher Self as to what focus and issues need to be addressed and guidance as to techniques and approaches to take. For instance, if a client comes into hypnotherapy wanting to release a symptom of claustrophobia, the therapist and client can, in trance, ask the higher Self what would be most effective focus and hypnotic approach in the session: inner child/inner family work, skill rehearsal, a childhood or past life regression, or processed that release anxiety. The session, therefore, is directly guided by the part of the client that already knows the cause of the fear and what the client needs to release it. The client’s wisest part is directing the therapy and helping both the client and hypnotherapist to give structure to the session and to support the step by step unfolding of the hypnosis process. The hypnotherapist helps the client to access her higher Self and supports her in cultivating ways to communicate and form an inner relationship with the higher Self so that it becomes a trusted and readily available resource not only in a hypnotic state, but in also daily life.

How will the client know when she has accessed this higher Self? The higher Self is loving, supportive, non-judgmental, offers gentle nudging, has the perspective of the big picture, is compassionate, and is focused on the good of all concerned. The higher Self may come in a visual form as an archetype, deity, symbol, or a representation as a self-actualized self. It could be perceived as an inner voice or telepathic communication. It could communicate through a knowing or body sensation. Every client has a unique experience of it. The higher Self is a direct link to an intuitive experience of the highest good and connection to the divine.

Working with a transpersonal form of hypnotherapy is often a mystical and spiritual practice for the client. She can learn to access and utilize expanded states of consciousness directly, at will, and for a variety of personal goals and purposes. The process of being in an expanded state is just as healing and significant in supporting change as is directing the state of consciousness towards a therapeutic personal goal or outcome. For the client in the hypnotic state, accessing awareness of the higher Self becomes a profound teacher of how our consciousness works to create our realities. These hypnotic states become vehicles through which we can re-create our realities. The practice of this form of hypnotherapy is a form of spiritual practice that puts us directly in touch with our spiritual nature and how our consciousness creates the forms and structures of our lives.

In hypnotically accessed transcendent states, you begin to have a new sense of self and a new way of relating to the challenges in your life. Through higher Self awareness and presence, you become dis-identified from your stories, negative patterns, and symptoms.

If you are interested in engaging in this transpersonal and spiritually focused form of hypnotherapy, interview a potential hypnotherapist to discover if the hypnotherapist invokes and works directly with the client’s higher Self as a co-therapist, resource, and inner guide for the client in the session. If so, you can be assured that the content of the focus of the hypnotherapy session will have absolute integrity and authenticity that comes from this wise and loving aspect of Self.

Holly Holmes-Meredith:
Doctor of Ministry, MA, Clinical Director,
Licensed Marriage Family Therapist, Certified Clinical Hypnotherapist,
Board Certified Regression Therapist

Holly's teaching and therapy is grounded in a solid twenty-five year background in education, psychology, hypnotherapy and metaphysics. She teaches with an engaging expertise, ease and competence that builds professional skill and confidence in her students. Holly integrates a psycho-spiritual perspective in her teaching, models client empowerment and practices hypnotherapy as an art. In the last ten years she began studying and adding hands on healing and energy therapies to her work including Reiki and EFT.

Holly has a private psychotherapy and hypnotherapy practice on site at HCH at the Transformational Therapy Center which she founded in 1986. She is especially skilled in regression therapy, pain management, working with phobias, anxiety, and spiritual issues.

Holly is an examiner and a founding member on the Board of Directors for the International Board of Regression Therapy.

She was awarded her Doctorate in Ministry degree in 2007. Holly's dissertation on Hypnotherapy as a Spiritual Practice is in the process of being re-written as a Hypnotherapy text.


Originally published at http://hollyholmes-meredith.blogspot.com on March 26, 2010

By Jim Walker, LMFT

The EB CAMFT board gave their support to SB 1172 at their May board meeting. Senate Bill 1172 would regulate sexual orientation change efforts--SOCE--otherwise known as "reparative therapy," "conversion therapy," or "ex-gay therapy." The latest version of the bill may be found here http://www.leginfo.ca.gov/bilinfo.html  by searching for SB 1172.

The bill would ban attempting SOCE on minors, and it would require an informed consent for SOCE on adults. The informed consent would notify the client that SOCE is found to be potentially harmful by such organizations as the American Psychological Association and other national mental health organizations.

Earlier this year, statewide CAMFT announced their SOCE policy--asking mental health professionals who provide therapy to those seeking sexual orientation change "to do so by utilizing affirmative multiculturally competent and client-centered approaches that recognize the negative impact of social stigma on sexual minorities." http://www.camft.org/Content/NavigationMenu/ResourceCenter/SOCE/default.htm 

Organizations that have supported SB 1172  are the Pacific Center in Berkeley, the Women's Therapy Center of El Cerrito, Gaylesta [the LGBTQ Therapists' Association of the SF Bay Area], the Lesbian and Gay Psychotherapy Association of Southern California and the California Division of the National Association of Social Workers.

SB 1172 was authored by Senator Ted Lieu (D-Fullerton) with support from two LGBT rights organizations, the National Center for Lesbian Rights and Equality California http://www.eqca.org/site/apps/nlnet/content2.aspx?c=kuLRJ9MRKrH&b=5609563&ct=11722129&notoc=1 Equality California and the National Center for Lesbian Rights are known for their courageous work protecting queer people and their families.

So-called "conversion therapy" has been in the news lately. The eminent psychologist who claimed in his 2003 study there appeared to be change in sexual orientation "in very rare cases" recently revoked his study. He apologized to the gay community.

The Pan American Health Organization, the oldest health organization in the world and part of the World Health organization, has called for national legislation against SOCE. "These practices are unjustifiable and should be denounced and subject to sanctions and penalties under national legislation," said Dr. Roses [director of PAHO]. "These supposed conversion therapies constitute a violation of the ethical principles of health care and violate human rights that are protected by international and regional agreements." http://www.dayagainsthomophobia.org/Media-Release-World-Health,1557

Most recently the Southern Poverty Law Center filed an ethics complaint to the American Psychological Association and the Oregon Psychiatric Association on behalf of an Oregon man who alleges he was subjected to SOCE. http://www.washingtonpost.com/national/oregon-man-says-psychiatrist-tried-gay-to-straight-conversion-therapy-against-his-wishes/2012/05/23/gJQA3MMJlU_story.html?wpisrc=emailtoafriend

It is very noteworthy that these major organizations consider supposed conversion therapy as a violation of clinical ethics.

Senate Bill 1172 will come to a vote before the whole Senate before or by June 1, 2012. In addition to the support of CA-NASW, one of the largest mental health organizations in California, the bill's authors have been seeking support from smaller organizations such as the California Psychological Association and AAMFT-California. Statewide CAMFT and other organizations have been negotiating for amendments to the bill before supporting it.

________________________________________________________________________________________________

Jim Walker, MFT, is in private practice in SF and Oakland where he specializes in working with couples and with healing from trauma. Among his many activities, he's volunteering with the Pacific Center on starting their continuing education program this fall.

Jim Walker, LMFT
510-684-4508  cell
Offices in Oakland and San Francisco
http://mindbodytherapyservices.com
http://lgbtcounseling.com

By: Peter Carpintieri, MA, LMFT

Overview:

The purpose of this article is to share some ideas and experience regarding psychotherapy and the Twelve Steps and working with clients in Twelve Step Recovery, offer some guidelines and suggestions for working with recovering clients, and invite dialogue and conversation within our community to better serve this population.

There is a fair amount of ambivalence, if not outright distrust or disdain, in both communities, regarding the value and effectiveness of the other. Many a joke is cracked and a good hearty laugh had at the expense of psychotherapy during the course of Twelve Step meetings around the world, where therapy is often regarded as a total waste of time and money. At the same time, I have noticed an equal ambivalence or doubt, if not ignorance, among therapists, regarding the value and effectiveness of the Twelve Step Recovery experience for those who rely on it.

While there is some truth to both of these points of view – psychotherapy is not useful for all addicts in all situations and some addicts do use the Twelve Step programs as another escape from the deeper and more challenging issues they face - for the most part, my experience has been that psychotherapy and the Twelve Steps, when used together to complement each other and practiced in the spirit of cooperation, are a powerful force for healing and transformation which can mean the difference between true happiness in recovery and continued relapse and suffering. Furthermore I've found that the Twelve Steps and psychotherapy are not only compatible but are, in a sense, merely different approaches to, and contexts for, the same process: discovering and bringing to light that which blocks or obstructs our capacity for joy and aliveness, and cultivating a more balanced, fulfilling and joyful way of life; one that is sustainable over the long haul.

The Twelve Steps invite us to look closely at our thoughts, feelings, motives, beliefs, attitudes, dreams, fantasies, and conduct, and to discuss these with another human being, in the interest of freeing ourselves from the bonds of suffering, and living happy and productive lives. These elements comprise a process of becoming more aware of how we actually live, moment by moment, and finding a fuller and freer way of living; an invitation to deeper awareness and connection. Psychotherapy is, in my view, a similar and, in some instances, nearly identical process. The containers and interventions may differ but, ultimately, the goal and the essence are the same.

Particular concerns:

Many people in Twelve Step programs arrive at a point in their recovery where therapy becomes an key part of the process. For many, this is a troubling and challenging dilemma. The prospect of trusting someone who may not be in recovery with intimate, shameful, painful feelings and experiences, may feel risky at best and life-threatening at worst; particularly after one establishes trust, sometimes exclusively, with sponsor(s) and friends in recovery.

Many, if not most addicts - and by addicts, I mean all types of addicts: food addicts, sex and love addicts, debt and spending addicts, gambling addicts, drug addicts, alcoholics, relationship addicts, codependents, come into recovery realizing their lives are in serious, even perilous danger. The realization and acceptance of this fact, is, ideally, the foundation of recovery. It's what makes one willing, as the book “Alcoholics Anonymous” (aka “the Big Book”) says, “to go to any length,” (p. 58) to recover. If our life is on the line, we are more likely to try things that our fears, defenses, and habitual patterns would have us resist or outright refuse to try. For many addicts, anything that feels like it may topple the apple cart of recovery, or “sobriety,” in the largest sense of the word, feels life-threatening. Therapy may very well fall into this category.

For many addicts, keeping things simple and routine is extremely valuable in avoiding slips and lapses that can prove quite dangerous. Entering therapy to work on issues that have long plagued them, even in sobriety, can feel like walking a tight rope with death on either side. “What if my therapist and my sponsor don't agree? What if my therapist suggests I do something that the program would discourage? What if I get triggered by something my therapist says and relapse? How can I trust a therapist anda sponsor and a Higher Power? I don't want to upset the apple cart; I've been sober – or abstinent – too long.” A well-informed, aware therapist can offer a quality of aid and support that can make this journey less treacherous – both literallyand emotionally – for a client in recovery. A firm knowledge and understanding of the Twelve Steps and the Twelve Step recovery process as it is commonly practiced can provide the therapist with a greater ability to support the client's recovery, while doing the therapeutic work that can foster the growth and development the client so desperately needs.

Some practical suggestions:

Here are some practical suggestions for improving your effectiveness when working with clients in 12-Step Recovery:

Attend open 12-Step meetings, particularly in the fellowships to which your clients belong.

Read AA literature and literature from other fellowships; specifically:

• Alcoholics Anonymous ('the Big Book')
• The Twelve Steps and Twelve Traditions (AA)
• The Twelve Steps of Overeaters Anonymous
• Co-Dependents Anonymous (the CODA 'Big Book' )
• How Al-Anon Works
• Sex and Love Addicts Anonymous (S.L.A.A. 'Basic Text').

Ask how many meetings your client is attending. Ask if that's enough. Ask how long it's been since they spoke with their sponsor and how often they speak. Take an interest in their relationship with their sponsor and the others they attend meetings with.

Take an interest in their recovery and how it's going for them. Ask them what step they are on and how they are progressing. Inquire about their relationship with God or Spirituality or a Higher Power; this is an essential element of the recovery process and one that often poses difficulties along the way.

Familiarize yourself with the Twelve Steps so that you can relate directly to your clients' experience and understand what they are talking about.

In many ways, working with clients in Twelve Step Recovery is like working with any other cultural difference: the more we can learn about it - from our clients, our own research, consultation and immersion - the better equipped we are to help them.

Reference cited:

Alcoholics Anonymous. (2002). Alcoholics Anonymous Big Book, 4th Edition. New York, NY: Alcoholics Anonymous World Services.

Al-Anon Family Groups. (2008). How Al-Anon Works. New York, NY: Al-Anon Family Groups.

Alcoholics Anonymous. (1981). The Twelve Steps and Twelve Traditions. New York, NY: Alcoholics Anonymous World Services.

Anonymous. (2012). Co-Dependents Anonymous, 1st Edition. New York, NY: CoDA Resource Publishing.

Anonymous. (1993). The Twelve Steps of Overeaters Anonymous, 1st Edition. Rio Rancho, NM: Overeaters Anonymous, Incorporated.

Augustine Fellowship. (1986). Sex and Love Addicts Anonymous: The Basic Text for the Augustine Fellowship. San Antonio, TX: The Augustine Fellowship.

_________________________________________________________________________________________________

Peter received his Masters Degree in Counseling Psychology, with a Transpersonal Focus and a Specialization in Child and Adolescent Therapy, from John F. Kennedy University. He is also Certified by the Kripalu Yoga Institute in Lenox, MA as a Holistic Health Counselor / Educator. He was originally trained in the Humanistic Client-Centered and Gestalt methods, gradually incorporating a myriad of other methods and approaches, 25 years of Zen Buddhist practice, and his training in Holistic Health Counseling and Education into his practice as a Psychotherapist. He also completed 12 units of Early Childhood Education at Merritt College and taught preschool for three years. Peter specializes in working with people in 12-Step Recovery, those who have survived the suicide of a loved one, adolescents and their families, and spiritual and existential dilemmas. He lives by the lake in Oakland and has an office in South Central Berkeley.

Peter Carpentieri, MFT

peterc.mft@gmail.com

510-338-8042

Comments and inquiries welcome.

By Jacqueline Holmes, M.Ed., MFT

In our popular culture there is a focus on being thin and controlling one's weight and food through dieting. As a result of the dieting mentality we clinicians are seeing increasing numbers of clients struggling with Binge Eating Disorder (BED). An estimated 3% of women and 2% of men are suffering from BED nationally according to a study done by NEDA (National Eating Disorders Association). That is more then all the people struggling with Anorexia Nervosa and Bulimia combined. Binge eating is a natural response to dieting, since the client is often starving while dieting and this can set the body up to crave more food. This type of eating pattern can also interrupt the normal response to hunger and satiety. When you add the emotional drivers and stress of the behaviors, you create a binge eater. Many therapists miss the signs that this is a serious problem for their client and that if it is an untreated behavior it can become a more chronic issue.

The binge eater frequently can feel invisible or even discounted since they aren’t starving or purging, so they wonder if they even have an eating disorder. In January of 2012, Binge Eating Disorder was added to the DSM-IV adding some validity to the symptoms and behaviors with which these clients are struggling. The client may report that they can’t stop eating and then they continue to fixate on how to control their weight as it fluctuates with the binge episodes. To cope, they may restrict their food intake or over-exercise. As with all eating disorders the binge eating is also related to psychological issues like low self-esteem, stress, depression, anxiety and trauma. Over eating has become a popular coping mechanism to avoid more difficult feelings and situations.

Often the habit of turning to food for comfort, control or self-pleasuring can create new problems like increased depression, isolation, medical complications from poor nutrition and weight gain. My clients often say that it “doesn’t matter what the feeling is the answer is food!” “If I’m sad I eat. If I’m mad I eat. If I’m bored I eat. If I feel lonely I eat, and so on.” Food isn’t the answer to a feeling and we have to learn the difference between feeling hunger and these other feelings. If there are other feelings present then we need help the client to find ways to experience them and to decrease the self harming behaviors.

Breaking free from binge eating isn’t only about managing a food plan and increasing exercise, though those techniques can be helpful. It's also important to explore the triggers and underlying psychological drivers that take us to food for comfort.

There is an answer to anger, sadness, boredom and loneliness and that is finding ways to feel them and to learn about how to manage them in daily life. Identifying the situations and triggers for the binge can be helpful in developing other strategies for coping, rather than turning to food. Some helpful tools are: Keeping a “feelings journal” and becoming curious about the desire for food. Developing compassionate self-dialog around the following questions: When do I binge? What do I choose to binge eat? How am I feeling before, during and after the binge episode? Is food going to help or hurt me right now? The goal is to develop awareness and decrease the shame and judgment about the behaviors.

Helping the client to begin to ask themselves, “What else could I do?” is an empowering technique. It can be very helpful to assist the client to develop other forms of self nurturing and self comforting. “What other activities do you have that make you feel good?” Something like reading, taking a walk, calling a friend, playing an instrument, doing a hobbyundefinedknitting, painting, craft work or just tinkering and completing a chore.

I also feel it is vital to break the isolation of binge eating. You can recommend the client seek out a support group with other people who are seeking recovery. OA (Over Eaters Anonymous)and ANAD (National Association of Anorexia Nervosa and Associated Eating Disorders, Inc.) groups as well as recovery groups for people coping with eating disorders can be very helpful. The important thing is to allow the client to talk and not feel shamed or judged.

Working with eating disorders can also give us an opportunity to look at our own beliefs and habits around our own bodies. Our attitudes and comments are closely watched by the client. When we express appreciation and care for our own bodies we become a role model for health and body acceptance.

Jackie Holmes, M.Ed., MFT has been working with Eating Disorders for over 30 years. She offers individual, couple and family therapy in her private practice at the Concord Therapy Center. She has worked all levels of care: Inpatient, Partial, Intensive Outpatient and Outpatient settings, working specifically with Eating Disorders.

She is on the adjunct facility at John F. Kennedy University and UC Berkeley where she teaches continuing education classes in the Eating Disorders Certificate programs. She frequently is a guest speaker at conferences and schools where she speaks on a variety of topics related to recovery and healing from these deadly diseases.

casaserenaedp.com

By Jim Walker, MFT

On March 9, 2012, CAMFT's state board approved a policy about SOCE and posted it to CAMFT's web site. To inform EB CAMFT membership about this, I was asked to submit this article because of my efforts with part of CAMFT's process with developing a position on SOCE.

SOCE is an umbrella term for sexual orientation change efforts.  Methods that are purported to be therapy such as ex-gay therapy, reparative therapy and conversion therapy are examples of SOCE. Many people who have survived SOCE report being very psychologically and spiritually scarred as a result of this so-called therapy. The spiritual abuse happens when the sexual orientation change efforts come within a religious counseling context, particularly when the so-called therapy happens through what is called "Christ-centered relational healing."

CAMFT has seen intense struggles during the past four years about taking positions on mental health and family health not coming from heteronormative values. Years ago other mental health organizations such as the American Psychological Association and the National Association of Social Workers issued supportive policies for same-gender loving people's health and for supporting nontraditional gender identity development. The appeals coming from CAMFT members during the last four years for CAMFT to follow suit have deeply threatened some CAMFT members and leaders.
  
The history behind CAMFT's SOCE policy development started more than two years ago. After a LGBTQ advocacy group called California Therapists for Marriage Equality (CTME) advocated and won a policy statement from state CAMFT for marriage equality in 2009, and after CTME convinced CAMFT, the Gottman Institute, the Women's Therapy Institute and other organizations to join an amicus brief against Prop 8 in February 2010. In March 2010, a much smaller group of us organized ourselves to appeal to CAMFT to issue a statement on SOCE.

By June 2010 a proposal had been created by Lisa Maurel, Bruce Weitzman, James Guay, Jurgen Braungarten, Sheila Smith, LaDonna Silva and myself. Where hundreds of therapists had been involved in urging CAMFT to make a statement about marriage equality, only a couple dozen, if that many, were interested in starting to advocate for a statement about the harms of SOCE.

We submitted our proposal to Mary Riemersma (CAMFT's former executive director) to give to the board. She wanted the proposal to go first to the ethics committee. It went to the committee, which did not advance the proposal. Bruce Weitzman from the board of SF CAMFT then took up the efforts of advancing a proposal to the state Board. The original proposal would have been lost if it were not for members and state leaders advocating continually throughout the years for a statement specifically about SOCE.

The statement released by CAMFT about SOCE earlier this year is a very, very different statement than the one proposed in 2010. In the circle of contacts I have from CTME and from the original CAMFT listserv from the CAMFT community forum, the announcement drew lots of attention. I don't know how to gauge what attention it drew in the larger membership. The therapists who've been waiting for almost 2 years had mixed opinions about how worthy a policy it was.

It really matters when mental health advocates speak up about the health issues of those who are stigmatized and struggling in our society.  The American Psychological Association has done an incredible effort in this regard. Although not a expert on the APA, I believe the APA has done it for the most part through the volunteer efforts of their members. Those policies and guidelines have made their way into proposals for legislation and court decisions. What the eminent American sociologist Jane Addams said long ago is so true, "Progress is not automatic; the world grows better because people wish that it should, and take the right steps to make it better."

In the next article I write I want to report on how CAMFT could be impacting the development of a California bill that would ban SOCE from being practiced on minors. That bill is SB 1172, authored by Senator Ted Lieu (D - Fullerton) and supported by Equality California and the National Center for Lesbian Rights.

Jim Walker, MFT, is in private practice in SF and Oakland where he specializes in working with couples and with healing from trauma. Among his many activities, he's volunteering with the Pacific Center on starting their continuing education program this fall. He thanks Caiti Crum for her help with this article.
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Jim Walker, MFT
510-684-4508  cell
Offices in Oakland and San Francisco
http://mindbodytherapyservices.com
http://lgbtcounseling.com