I’m an EMDR Convert

Call me weird but my niche is trauma. Over the last 25 years I have gotten really good at hearing, discussing all kinds of awful stories from clients. I can hold these stories, and at the end of the day, I go home and live my life as if some spacey force field surrounds me from absorbing the pain into my own heart. Recently however, I decided that I could not be a trauma therapist if I did not know anything about EMDR therapy. The most I remembered from the first time I heard about it (in around 1993) was about watching a pencil eraser go back and forth and somehow people felt better afterwards. It seemed a little like voodoo to me. But after the last 3 months of training, I decided that it’s more like magic.

Real magic, like having my own wand in Diagon Alley with Harry Potter and friends and knowing all the right spells and potions at my disposal. Okay let me qualify this: I am a total newbie. I literally just finished the second weekend at the Maigberger Institute in Boulder, Colorado, with the amazing Barb Maiberger. Barb teaches four groups per month, then follows them up with online meeting consultations. I have had a private practice for a few years and many of my established clients were psyched to try this modality with me and I have been able to witness some amazing things in a short period of time. So before I say more – just what the heck is EMDR therapy, you ask? Well, I am here to tell you, since one of the assignments is to draft an explanation for my clients.

Eye Movement Desensitization and Reprocessing therapy is a modality that can be used with adults, teens and young children. It has been extensively researched and shown to reduce symptoms associated with most kinds of traumas and generally disturbing events and emotions. There are 8 phases that will take place as the client is ready for them.

The treatment will use one or more of the following types of Bilateral/Dual Attention Processing stimulation (BLS). This keeps the client and therapist in the past and the present at the same time: Each client can choose what they prefer: Eye movement by following an object, hand buzzers, tone through headphones, tapping by the therapist or self-tapping.

EMDR Therapy does not erase memories, it merely takes the emotional connection away from an event so that a person can recall and discuss the events without distress or disturbance. Research has also shown that the brain continues to re-process even after the session and well into the future. Clients may experience dreams, flashbacks, emotions and other sensations following the treatments especially after the trauma work begins. This is normal as it shows that your nervous system is doing its work.

Many of you may have heard that in June 2019 the creator of EMDR, Francine Shapiro, passed away at the age of 71. She discovered the properties of her theory quite by accident, as many good ideas come along, and being open to something that the Universe was trying to tell her. As a graduate student in Psychology, she followed up with good old-fashioned inquiry and research and started nothing short of a revolution. People with long term traumatic symptoms – war veterans, crime victims, people with chronic pain got relief! Even after years of traditional therapies, within a few sessions, they were able to think about or talk about their traumas without feeling as though it was happening all over again. Like I said: Magic.

Ok, magic and science. One image that came up in my mind when watching my first demonstration on Day One was the idea of hypnosis. In the movies, we always see some Victorian doctor in a gray suit with a curly mustache swing a big, gold, pocket watch in front of someone’s face until they become sleepy. In this state, the doctor is able to access memories, or implant some suggestion that later comes out unknowingly as a behavior the doctor wanted the patient to complete. Okay, that is pretty creepy and not what the purpose of any legitimate therapy is. But the bilateral stimulation has definitely been known for a while as a powerful method for brain stimulation. Plenty of new science on the brain is out there and practitioners, writers, researchers are clamoring to have the next breakthrough: like plugging our heads into a screen and making images appear. I’m not so sure that is a world I am interested in, as my reality, anyway. I’ll take it as science fiction instead.

I am a convert now. I don’t hear all the stories as much in sessions. I find myself taking deep breaths with my clients, nodding, and saying “go with that,” a lot while observing waves of emotion in my clients through their tears, twitches and relaxation responses. They end their sessions looking like they just came out of a nice dream, stretching and smiling, yet they were fully awake in the room the whole time. I tried it while in training, as we have to do on one another, and discovered that a number of things that used to get me going on an angry rant are no longer bothering me. It is a very peaceful feeling, to be able to let it go. I have studied for 25 years to do play therapy, Cognitive Behavioral Therapy (CBT), Solution Focused Therapy, art therapy, and this is becoming my go-to and I don’t have to give up any of the above! I hope to keep going to get certified, which will take a couple years to do, so until then I will keep practicing, training, and consulting. Advice? Interested therapists should find an EMDRIA approved training, and don't cheap out on this one. There is too much to learn in what might look like a bargain. Potential clients: always look up where your therapist got their training, just in case they did cheap out! 

A Year of Self Help Reading – Braving the Wilderness

Last year, I started a book club. Yes, I know, very un-interesting of me. However, I had been inspired to start this club due to Brene Brown’s book “Braving the Wilderness” that I read about a month before the first meeting was held. The idea was also a way for me to try to meet new friends, since I work an an independent practitioner with no day to day coworkers. The book club was dubbed The Personal Development Book Club in my community and has had a nice core group of women for a little over a year now. Braving the Wilderness poses the challenge to people to truly be themselves, hold on to their beliefs, even if they are not in the majority opinion in the crowd they happen to find themselves in. This can mean finding yourself in a hostile environment, or finding yourself left completely alone and ostracized from your community based on your expressed beliefs. The fear of this happening also keeps the status quo nice and strong, which in turn keeps many people quiet and complacent instead of speaking up.

I had recently found myself holding different beliefs from those around me – I am an East Coast Liberal (woot woot) who grew up in a pretty diverse neighborhood and City (New York) with little affluence or buffering from the harsh reality of poverty and crime. My friends were White, Jewish, Jehovah’s Witnesses, Black, Dominican and Puerto Rican, Cuban, you name it.  I have seen how social programs, multi cultural public schools and curriculums, scholarships, gun buy-back programs and access to cultural experiences can bring a child out of the cycle of poverty and make a dream a reality. However, when I moved to Colorado, I found a much less diverse population, less diversity in political opinions and a more traditionally “conservative” viewpoint. I stood out when I spoke up.

I am perfectly comfortable with this, I am diplomatic to be sure, but I don’t back down if someone gets offended and tells me I’m wrong. I also don’t go looking for a fight; I simply “speak truth to bullshit,” as Brene puts it. If you think immigrants are crossing the border to come to live in your house, I will ask how many times this has happened to you or your loved ones. I already know the answer.

What I wanted to do with my book club, is to help others sort through the moments in life they have felt on their own and empower people to embrace their role and comfort in The Wilderness. I knew that in order to accomplish this, we all needed support from one another and some analysis of those defining moments to try to change. A person can read all the self help books in the world and never be a different person. They could quote all the authors they wanted and never be a different person. Having others to listen to you, speak truth to your bullshit, give you honest feedback and a plan for the next opportunity, is priceless. In the group, I am the only therapist, but it is not group therapy. A therapist can also do these things in a mental health setting. People willing and able to try make the difference.

In short, I highly recommend this book. It is well written and research based. Brene Brown doesn’t just throw out a word like “belonging” or even “love” without creating a questionnaire, holding a focus group, coding and analyzing data and then presenting a formal definition. As far as self help books go, that is also priceless. Many books also use real data to support their assertions, but not all. Every month we post the date and book to the neighborhood and hope for a few new faces. The book club read a different book and got together to discuss the concepts and how they can be applied to life. I will usually print out some questions I find online, sometimes from the authors themselves and sometimes from other book club sites. And as book clubs go, there is plenty of talk about our lives, eating and sipping wine, and forming lifelong attachments.

GOALS

One of the most common sources for anxiety in people who want to achieve anything is how to set a goal. We tend to see the final result and we have no idea how to get there. To get to the magic coast, we have to hike through the desert, climb the mountain, battle the troll under the bridge, avoid the enchanted forest... these are the steps involved. There are always more than we realize.

I often hear, "I want to start my own business," or "I want to move out into my own place and be independent," and are overwhelmed by the task. The reason is: it's just too big. So how does a goal oriented person begin? 

There are several options:

SMART goals. The accepted way to write a goal is the SMART format. And yes, if I am your therapist, I will have you write it down someplace. A journal, a white board, the bathroom mirror - if that is where you will see it. 

S: Specific. What are you trying to achieve. The result of your efforts. 

M: Measurable. How are you going to quantify your success and progress? In terms of money? Lowering or increasing scores on a test? 

A: Achievable. If your goal is to grow wings and fly away then you're just setting yourself up. 

R: Realistic. You aren't going to play professional basketball if you are only 5' tall. But you may have other options for your talents. 

T: Time limited. What time frame are we looking at? What date are you aiming for?

So here is an example based on the above breakdown: (GOAL) Start a business

 (Tasks/action steps)

Write a business plan and submit to a loan officer for a business loan. 

Criteria will include type of business, current earnings, market research, etc

Use skills obtained in business school and enlist experts on subjects of xyz to consult/be on board of directors, etc

Due date for plan: (set dates for 1st, 2nd and final draft) Submit to Bank: (set date). 

There are probably many other tasks in starting a business but the idea is that you break down your lofty hopes and dreams into workable parts. 

If you have many hopes and dreams, then listing those in a grid format can also help break them down and prioritize. What do you want to / or have to get done in the next 30 days? 6 months? 1 year and 3 years? You're making 4 boxes and sometimes the tasks and goals will be moved up or moved farther out depending on what is going on in your life. 

I have one client who is using an app called "Epic Win" to record goals. What makes this app different is that it is based on role playing games (RPG). You are a character, and the more you meet your goal deadlines the more your character gains points that are applied to looks, charisma, etc. For younger people who play RPGs regularly this can be especially appealing. The app isn't free but it's not expensive. It's certainly a creative way to achieve!

Another creative option is the vision board. There are many many tutorials online about these. If you are unclear of what direction you want to go it, doing one of these may assist you in determining a course of action. It's also a wonderful way to procrastinate!

Are you ready to get started? I am including a handout on SMART goals and a goal grid here. 

Set those goals and smash them!

Animals in Therapy

The vast majority of people love animals – a cat, a dog, bird, lizard, rabbit, horse or even a mouse. They show us love as much as we show them, and it’s completely unconditional. Almost any domesticated animal can be a comfort animal or have therapeutic benefits – there is no certification for this but it helps to have a therapist write an official letter indicated a child or adult needs their companion to address mental health symptoms. Often therapists are asked to do this so a family can move into a new apartment with strict rules about pets. There is an enormous amount of research already on the books about how animal contact can improve post surgery outcomes, improve social contact in older adults, increase walking times and distances for dog owners, experience a generally higher sense of well-being through their pets.

So why would someone need a therapy animal? All you have to do is adopt a pet and all your troubles are gone, right? I am writing this because I have an amazing dog, a 6 year old black Labrador retriever named Rocky. He’s calm, intuitive, quiet, completely harmless to kids and older adults. I do not have any certifications at this time in doing any “real” therapy work with him but often kids or adults ask me to bring him in. I let everyone know that while he’s healthy, has all his shots, but I am not covered to use him officially. They don’t care; and I am not worried that he’ll hurt anyone. I’ve seen toddlers manhandle him and all he does is lie down and get comfortable. When you stop patting him, he’ll nudge you or put his paw on your knee to remind you that he’s still there. I have a security system because frankly he would just lick a robber to death.

To use an animal for therapy, you need a therapist. The animal can’t go to school for that. The animal should pass a screening for the right behavioral attributes and have basic training for obedience. Many therapists have their own pets – horses at a ranch, dogs, cats, goats. People who are anxious benefit from talking while petting the soft fur – that tactile stimulation can help ground people in the present moment, and help them connect back to their body (see my NARM post) as so often people will disassociate when stressed. Children who have impulsive behaviors learn more empathy so see that their rough treatment might not be the right way to get the animal to “make friends” with them.

The animal therapy has specific goals for treatment. It is the primary intervention for the client. The other type is animal-assisted therapy (AAT) where the animal’s presence is secondary to the therapy going on. An animal can get a reticent child into the office, or motivate a teen to engage, or be a surrogate face to talk to when in distress.

My favorite example of Animal therapy is from the first book written by abduction survivor, Jaycee Dugard. She wrote that for her first session she was handed a saddle and assigned to saddle a horse (something she had never done before). Her two daughters did fine. She could not do it, after many failed attempts. Her therapist then asked her why she did not ask for help? This then spurred a discussion and realization that for years she could have asked for help while living with her captors. Everyone brings something different to therapy, and animals can offer something different and unique to each situation either as the therapy or as a jumping off point. 

Finding a Good Therapist

After you have decided to find a therapist, and you meet them and you begin. How do you know you have a good therapist? How do you know that what you need from them is going to be met?

Therapists are human beings, and they make mistakes. They say something too deep too quickly, or make an assumption, or look a little glazed over for a moment… This can happen from time to time. But the experience of being in therapy is much bigger than these little moments between you.

Your therapist should be open to your questions about their practice. What is your therapist’s theoretical framework? What is your therapist’s approach to helping people with your particular concerns? Where did the therapist get their training? If you get a sense that the therapist doesn’t want to answer or is impatient with you, keep looking, especially if it bothers you.

Your therapist should have an idea how long treatment should take, ideally.

Your therapist should check in with you about how treatment is going, on a regular basis.

Your therapist should, at least on the surface, appear to be organized and grounded, as a person. As I said before, they are humans, they’ve had bad experiences, they have problems too, but their problems should not spill into your therapy.

Your therapist should seem like an individual person, rather than a textbook. You should be able to get a sense of their personality in sessions. They use themselves in sessions.

Your therapist is not dominating the conversation with anecdotes about their own lives. They should spend most of their time listening and encouraging you to speak, explore and process.

Your therapist should adhere to ethical rules and guidelines. They don’t invite you to parties, or accept your invitations to barbecues or make uncomfortable suggestions. In Colorado, it is illegal to have a dual relationship with your therapist, including dating and sexual relations. They are in a position of power in your life and it would be exploitative and abusive to engage you in non-therapeutic activities.

Your therapist should inform you prior to the start of treatment of the above, to make sure you are going to be a good fit to work together. Your therapist should be confident enough to say, “we might not be a good fit, I can help you find someone who is.”

If you think I am a good fit for you – give me a call and put me to the test! www.aliceriley.net

Book Report

I have been reading and listening to Healing Developmental Trauma by Drs. Heller and LaPierre that is mostly about the Neuro Affective Relational Model (NARM) of working with people (adults) who have experienced early trauma. What is interesting about it is that it is about more than "shock trauma" which is what most of us think of - child abuse, neglect, a severe accident. They define Developmental Trauma as much more encompassing, even pre-natal insults like a surgery, or a depressed mother. I thought right away, if that is the case then we all have some kind of trauma, and a lot of it makes us different from one another. I used to think that "bad things" happening (and subsequent survival) make us just that more interesting as people. Most of us go on from there, to survive and thrive.

Obviously, my focus in my work is on the adults (and kids) who experience the shock trauma. But as simply as I can explain NARM, here it goes. Our bodies are regulated by our mothers, at first, through gestation, and then through the bonding period. Our parents hold us, feed us, sleep by us and we learn to feel safe and calm and "regulated" neurologically. We become organized and our brain and endocrine systems function optimally. We enjoy good nutrition, health and connected relationships to others assuming that love continues throughout our childhoods.
When that bonding and meeting of needs is disrupted, both early on and throughout our development, our bodies become disorganized and dis-regulated. We learn adaptations to survive the abuse or neglect. Humans (and animals) have three autonomic responses to danger: Fight, Flight, or Freeze. An infant can only do one of these things: Freeze. They will stop crying and disassociate from the body to ignore hunger, a wet diaper, pain. Babies and children will cease to recognize needs and have needs to preserve the minimal bit of relationship with the parent that they can get. As they get older they continue to protect the parent relationship by appearing compliant and good. They are not however, connected to themselves or others, they are not developing their own identity or knowing what they need from the environment. They do not recognize that the failure was in the environment. Instead they just know they "feel bad" and later they simply "are bad."
I wanted to cry listening to and reading this, for the babies out there who are enraged when they even have to "cry it out" as some professionals propose. There are many people who are now adults who experienced this, and just this lack of responding can create lifelong effects. Frequent disassociation, anxiety, panic attacks, health problems, relationship issues. I feel vindicated as I recall my own parenting - I held them, responded to them, bonded to them and I still strive to meet their needs as they grow.
There are five adaptive styles/organizing principles that can become survival mechanisms that go on into adulthood. I can list them but going into all of the traits and treatment here is way beyond my blog scope: Connection, Attunement, Trust, Autonomy and Love/Sexuality. Surviving as a baby or child is one thing, the problem arises as adults because we're not babies anymore. We were abandoned, but no longer. We were harmed, but no longer. Yet people are going through life as if the trauma is still happening and they often can't even put their finger on WHY they still feel bad. NARM does not focus on repeating the past traumas, it focuses on helping people remember without re-experience of it through connecting back to the body and learning to regulate their own biological systems. Developing identity and the ability to deeply connect to another person.
The use of this model in treatment is complex and requires a lot of study, practice and supervision. One of my goals is to do the 12-18 month program. For now I have to say that just having this understanding of the brain's development has made a difference in my practice. I do have a fair number of clients (in person and online) who seem to have one of the Adaptive Survival Styles and trying to do this kind of work online while completely DIS-Connected to them is potentially disastrous. I am ambivalent about continuing as an online therapist for this reason. After all, connection and relationship is what therapy is about, and then sending clients back into the world to try to connect and build relationships with others. It is important to continue learning, be humble, genuine, self aware, regulated and Connected.

Does My Child Need a Therapist?

                 I see a lot of posts, memes, blogs about parenting, about how our kids “drive us crazy” or got into trouble at school for some mischief or even for bullying another child. I have friends ask me often if they should take their child to counseling for sometimes “normal” things related to the child’s particular temperament, and sometimes for what is a good catch on the part of the parent. How would you know if your child is having issues beyond what you, as a parent, can help?

                The critical question I am going to ask is, “does the child’s behavior or mood prevail across two or more environments?” If a child is struggling to concentrate in school, misbehaves, can’t stay in their seat and blurts out in class, but is quiet and pleasant at home, sits and reads, then I would think there is some school anxiety vs ADHD (attention deficit hyperactivity disorder). If a child is moving and off task at home and at school, and in a museum and a grocery store, then we might be looking at ADHD. Confused already? That’s why getting answers from a person and not your Google search is important. There is a lot to consider and asking is perfectly reasonable. Children with ADHD don’t always need a therapist, unless some of their adaptive behaviors have become habits and they need help with social skills and parents may need help adapting their own skills to the child who needs a lot of patience. Kids can usually be easily treated with medication that the pediatrician can prescribe (a simple questionnaire should be given to the teacher and an EKG is usually completed first). Be sure to ask a lot of questions – parents need to know everything they can.

                Similarly, the behavior is not only taking place in multiple environments, but is interfering with normal daily tasks. A child who is developing OCD (obsessive-compulsive disorder) will eventually forego pleasurable activities to complete the compulsive behavior they “need” to complete to resolve the worry in their mind. Most people have a superstition or two, but if a child cannot get dressed before going through several perfect renditions of their task, (flipping the light switch, a chant, touching objects in a certain order) there is a problem.

                If you have answered “yes” to either or both of the above questions (2+ environments, interfering with fun), you may need a professional consultation. It does not mean something is “wrong” with your child, or your parenting. Imagine if your child needed a life-saving medical service, and you decided, “no, it’ll be okay without the intervention?” You wouldn’t likely do that, would you? You’d take your child for the appointments until they were cured. Letting an emerging mental illness go untreated is a threat to the child’s future, so it’s better to get help now while their brains are workable. Yes, many of these illnesses also come out as adults, and we can’t always predict it, but kids can learn valuable coping skills to handle stress throughout their lives. And parents don’t always know the best way to manage childhood anxiety, depression, OCD, ADHD. When you love someone as much as you love your child, your emotions get mixed in all too easily.

                Ask your child if they are worried about anything. Tell them you can find someone who can help them feel better. It might not even take very long for relief. A good child therapist can help bring out issues through drawing, through games and help the child identify and verbalize what is worrying them. The therapist can help parents respond more effectively to their child and teach them skills to self-regulate, communicate and listen. Call a therapist, ask the questions, and make the appointment. A wonderful adulthood awaits your child.
ARileyLCSW@live.com. 

Online Therapy Part II

So it has been 4 weeks or so since I became active with the online therapy company.

Here’s the breakdown: The first two asked to be transferred within 2 weeks. One transferred and I think the other ended up cancelling. Not a good fit. The first one gave me a “bad” review however, when I talked to the quality assurance therapist, she saw how engaging this client would have been difficult no matter what (and she was demanding that I respond 7 days a week) and gave me some good hints about her process. The second one, I think got offended because I didn’t receive her message after a week and I was sending her notes about getting her engaged in treatment. She didn’t respond to asking about working with me despite my error. This month, one client decided she really didn’t like texting, and because it’s a slower process than traditional therapy. So... a rough start.

But even in traditional therapy, a therapist has to take time to get to know people otherwise how can we really be helpful? One of the hints is that after 2 more weeks, you ask about how the client likes the platform? Then you ask about your work together. You propose this structure during the introductory 10 minute free video chat. Seems to help set a pace for clients. Will do.

So now I have about 5-6 clients, most of whom are new but engaged in the process. I can pick up a max of 4 new clients per week. I have done some brief video chats with them, which I offer in the second week. Some like that, some don’t. But they all say they like seeing my face so they know who they’re texting – they see my photo on the profile page but I don’t see theirs. I more easily match stories to faces so it helps me keep track a lot. I have a client in the UK, which is really interesting, and the others are in Colorado, near and far. Picking up clients is a bit like bidding on a cow at the State Fair – you have to be scanning the “online office” when they post new clients to be matched. You have to check for your state and then reply quickly if it’s someone you want to work with. I have found that Fridays are good days but it means connecting over the weekend a bit so they don’t get discouraged. For just one person here and there I can manage that. It feels a little trollish to be doing that, vs going out with the kids or friends…

I tell people I respond at noon(ish) and 8:30(ish). We have to check twice a day. Some people write more than others, obviously. One person asked me to write even if she didn’t, just to let her know I was there and thinking of her. Sometimes I find myself still out running errands or at lunch at noon so there’s a little issue with time management here and there. And my younger daughter is staying up a little later so I switched from 9 to 8:30 to get a jump on tucking in time. She’s ten but she still likes me to stay with her until she falls asleep. I both love and loathe it… On Fridays I respond around 5PM while I am at Taekwondo with my aforementioned child. That way everyone’s weekend can begin…

So this has been a private practice supplement and also a JOB as a practitioner. Very interesting as an experiment in a new treatment modality and a social movement. I honestly wish I had heard of it 2-3 years ago, I could have used the side income, the experience. But here I am… Jumping in with both feet. In October I begin a “Business School Bootcamp for Therapists” program to help me revv up my practice and give me some skills to be successful. I can’t afford not to be, and I really like being my own boss. I will likely write about my upcoming experience and new insights into this whole thing. 

Care of the Self

When I was in graduate school, I did a mini thesis for my first research class about the differences between self care in Social Work Students and Business students. I don't remember what my results were. I did a survey; and while administering the survey in the business school, I met a really sweet man from Spain and la la la l'amour l'amour... Anyway, I am pretty sure social workers don't do a good job in general at taking time for themselves.
It's not just about taking time, it's about creating balance. I used to get flack from my boss when I left work at 5 to go down the street to work out at the Brooklyn New York Sports Club. She thought that staying late was a badge of honor. It showed her boss that she was dedicated and... what? There was a schedule of emergency coverage. There was no need to stay late and tick off boxes on a to do list. I always made a point to get the work done in the work hours because I valued my non-work time. I valued working out/staying fit, doing art work, meeting friends for dinner. So if there was nothing that could wait, I left the office. I saw what my then supervisor's life was like and I wanted no part of it. She was engaged with no wedding date set, she smoked, she was out of shape and she stayed at the office til 8PM or later. No, thanks.
Perhaps she saw me as a slacker? I really don't know, and I don't care. I had heard about burn out (this was my first job in Social Work) and I didn't want it. I had enough to worry about. When my father became seriously ill, I used him as the reason I left - and often I did go straight to his home. But after I went to the gym. How I looked after him until he died, worked full time and put myself through graduate school is no mystery - I took care of myself.
So I am a self professed self care junkie. Perhaps that is why I don't really get burned out and I've stayed in the field this long when many of my friends went to other professions (teaching, law, massage therapy). When Pinterest came out - and some of you know this - I was HOOKED. Holy crap now I know why people get addicted to drugs. I had two children and I had stopped making time for creative projects; I could not stop looking at all of the things I wanted to do and all of those creative ideas. I think it was at least 2 years before I could slow down, narrow down my choices (believe me I wanted to try Everything). It opened up a chasm of NEED for me. I needed that outlet. I am a creative person and I needed the inspiration. It led to so many good things for me, creatively and professionally. So poo-poo me all you  like about it. I just didn't realize that I was engaging in self care when I sheepishly had to come clean to a colleague about my online addiction - it had become a bit of an office joke, my constant screen scrolling. Half the time I didn't even see what was on the screen because my brain's "open tabs" where processing at the same time. She said she understood that I do it for "self care," and it not only let me off the hook, it validated me.
I thought Self Care meant getting a facial and a massage, but it's more. It's reading a book for an hour, it's sticking to a routine, it's mopping the floor with music on your headphones. It's making room in your life for the fullness of life. NOT just being a social worker and putting your clients first. And if you have kids? You MUST put them ahead of work, and your spouse needs your smile, your hand squeeze, your listening ears. If you find that you can't appreciate any of these things, it's time to schedule a vacation - even a local one where you explore your own region with a road trip or a family movie night. You must turn off the phone and turn on your attention to what is important in your life. Because if you don't you won't have a 1. job or 2. a life. Either extreme is misery.

Therapist or Coach?

Recently I was asked to see some kids whose parents are worried about them. They don’t talk much, they mope around the house, and other vague complaints. Engaging kids who don’t want to be “in therapy” is a unique challenge. I have to sell it to them and often I end up going the route of coaching for a time, instead of therapy. This is especially helpful with teens, who often are blowing through their adolescence with no understanding that their childhoods are coming to an end. So what should we do? We make a plan. We start imagining life in the future, where will you live? Will you have a job? Will you go to college? How will you get into a college? Suddenly, reality sets in and they start engaging a little in the work of therapy because they don’t want to live with mom and dad forever. And that is a good thing.

I wanted to write this entry about the difference between coaching and therapy – so I Googled it, of course, and read a few REALLY dry, matter of fact explanations, and yes, other blog entries. I don’t want my blog to be one of the boring ones.  Coaching is much more directive, and it’s not for people whose mental health is not stable enough. I see people for therapy because their symptoms are such that they cannot cope with the life they are currently living. They are depressed, or debilitated by anxiety, or their traumatic experiences are overwhelming them. These people need solid interventions and relief first.

A good coaching candidate is someone who is blowing through life. Or stuck in a rut but not meeting DSM V criteria. People who just don’t know where to go next or how to identify that next step. I have a friend who wants to move to my State but knows the salary won’t be comparable. I suggested taking some courses in business/non profit management or become a certified project manager because I know those are skills that are sought after. Plus I know that this friend has tuition reimbursement through his employment. While I don’t yet know if he took my guidance, it gave him some ideas and options that he had not thought of before. As a clinical supervisor, I learned in a post graduate class that “supervisors don’t know better, they know different.” The same is true for a coach. Now you want to be careful to not overwhelm someone with all of your ideas for their life. I have had that experience as well, with someone who threw out so many possibilities in one breath I completely zoned out. A coach should listen to where your particular passion lies. She was well meaning but the advice was all over the map.

Keep in mind that I have years of education and experience as a clinical social worker, while a coach can wake up one day and say, “I’m a coach” and charge you $100/hour to coach you. Many of them don’t have specific training or credentials, and there really aren’t any real credentials at this time, not in the way there are for mental health professionals. Someone who is a coach should not be trying to treat your panic attacks or your teen’s cutting behaviors. Be sure you are finding that you are benefiting. Just like a good therapist, a good coach is worth every penny. 

Welcome

I recently quit my day job. I have worked full time since 1993, fresh out of college and trying to save the world. Well, not really. I wanted to make a difference, even if it was for one person. I think I managed that. I was a caseworker in Brooklyn for kids in foster care, I was a hospital social worker for the pediatric crime victims unit at Bellevue, I was a therapist for Catholic Charities, I worked in cardiac surgery for a stint at Columbia. When I moved to Denver I knew I wanted to supervise and I loved doing that for 8 years. And then I was done.

I had a make a plan over several months how to transition from "working for the man" to working for myself. My father was self employed for most of my life - what I remember. I thought I could never live like that - not knowing how I was going to pay the bills. But once I started digging around, I realized I had the key already. I worked in Child Welfare, I am a subject matter expert in child welfare, trauma, and therapy. I am also a painter and studied art in a specialized High school and in college as well as going to classes at the Art Student's League of NY. Everyone said, "you should be an art therapist." I thought I needed to go back to school. I was wrong!

I am already a Licensed Clinical Social Worker, and an artist. I had joined a mobile painting party company in the fall for fun - to get out and meet people and "teach" them painting by showing the group how to do a painting from start to finish. Easy right? You'd be amazed at how anxious people would get. They think it's funny when they say "I suck at this," but I was stunned by these reactions. It felt like part of my work was helping people overcome psychological barriers to be able to say, "I am making something nice," instead of being self deprecating. So I started some groups at work, with caseworkers, making mixed media paintings that were meant to reflect who they are and how they cope with their difficult jobs. Amazing art was created!

So I began applying for contracts and to serve Medicaid clients (for child welfare). In talking to people I found that there are few child therapists who really know this population and fewer still who do art therapy, let alone directive, trauma informed play therapy. I am not a playmate, I am a therapist.

While I am still advertising myself as a clinical supervisor (for those who want to consult or get license hours), I still feel the need to make a wider impression, to make that difference for children, for their parents, for people who have been harmed and want to heal. So the blog was born. I don't write it for money or fame, but I am never opposed to money... let's just be honest. Starting out is scary - there's no weekly check that gets mailed out automatically unless I have CLIENTS.

Be sure to check out my website: www.aliceriley.net

thanks for reading!  Comments are welcome - next topic: COUNTERTRANSFERENCE!