Last Thursday’s SCOTUS ruling on marriage equality was a great victory for the same-sex couples across the country.  Millions of allies were celebrating. I’ll admit, my social media pages were covered in rainbows, just like everyone else’s.  Victories like this give us hope, and the strength to carry on for the battles ahead.  So, I invite all allies to join their LGBTQIA loved ones by expressing their joy and support.  I would also like to remind everyone that marriage is not the be-all-end-all of LGBTQIA rights…and that posting rainbows is not enough.

Let us not allow the SCOTUS victory to eclipse our awareness of some of the other events that have been prominent in the media, in recent weeks.  Let us not forget that we have a long way to go.

Here’s a recap (this all ties together)

Caitlyn Jenner’s coming out represents a victory for Trans women.  She was lauded for her bravery, and rightfully so. Still, she was subjected to many indignities, including questions about her genitals.  We must ask ourselves whether it would be appropriate to ask a cis person such a personal question in casual conversation.  The answer is, unequivocally, no.  So why do we ask trans people such humiliating questions?

It is also important to remember that not all trans women share the same privilege.  Her facial feminization surgery alone cost $70.000.  99.9999999999% of trans women cannot afford this, yet they are ostracized and oppressed for not “passing.”  Trans women are still subjected to the same unrealistic beauty standards that cis women must endure.

Would Caitlyn have been so accepted if her Vanity Fair image looked like a photograph of the average 65 year old woman?  How about if she had bald spots or facial hair?  Probably not.  A trans woman is viewed as successful if she meets our conventional standards of beauty.   I was excited to see a courageous and creative response from the transgender community on Tumbr, when a group trans people posted authentic images of themselves, confident and photoshop-free.   I highly recommend that everyone check it out.  This is what real beauty looks like…and it’s about time we made an unflinchingly critical inquiry into our assumptions

Meanwhile, the incident around Rachel Dolezal reminds us that we still carry the assumption that Trans people are “pretending” to be who they are.  So many people have been saying “If a man can say he is a woman, a white person can say they are black!”  Um, no.

Both gender and race are lived experiences that one understands from early childhood.  Transgender children may experience profound distress when their physical characteristics do not conform to their experience of themselves.  The distress is worsened by the social expectations around them.   There is no documented experience of a white person experiencing such distress because the color of their skin does not conform to their identity.

Black children certainly experience racism very early in life.  Many white people grow up with the assumption that we are allowed to take risks, make mistakes, break the rules and learn from our experiences.  We do not always realize that there is privilege connected with these assumptions.  Our experience is not, and will never be, the same as the lived experience of people of color.  It is not acceptable for us to co-opt an identity that does not rightfully belong to us.

Check out this video by Kat Blaque, who eloquently explains the difference between Caitlyn Jenner and Rachel Dolezal:

We cannot neglect issues of race, when engaging in discussion about LGBTQIA rights.  In the wake of the Charleston shooting and numerous other acts of racially motivated violence, we cannot ignore obvious evidence that racism is still a thing.   Trans women of color are dis-proportionally affected by acts of violence, and their pleas for help go unanswered by the police officers who are sworn to serve and protect.

Back to that whole “Marriage” thing…

When we think about “gay marriage”, what is the image that comes to mind?  For many cisgender, heterosexual white people, the image may look a lot like our own image of ourselves.  Are we seeing people of color?  Are we seeing those outside the gender binary?  Are we seeing the trans people who can’t afford the nice wedding that so many of us dream about, who are struggling to feed their children because they face employment discrimination?  When we think about marriage, we need to think about the full experience of the human commitment to love. That may include the courage to commit in the face of a world that does not provide the safety necessary to create a life together, and possibly raise a family.  That is great courage, indeed. How do we honor and celebrate that?

For white, cisgender allies, we can honor that love by continuing to ask ourselves the difficult questions about how we can be better allies.  What can you do, in your community, in your workplace and in your social network, to create a more inclusive environment?

I’ll give you a hint:  it starts by listening to people whose experience may be different from your own, and admitting that you don’t know everything.  It is only through open-hearted listening, humility and personal response-ability that we, as allies, will create the change that still needs to happen.

I have some exciting news.  The next WINGS conference will be held on September 11th and 12th.  If you don’t know about the WINGS foundation, they are an amazing organization that provides peer-led and therapist-facilitated groups for survivors of childhood sexual abuse, and their loved ones.  I have been co-facilitating a group in Aurora since July of 2014.  It has been (and continues to be) one of the most rewarding experiences of my career.

This fall, I’ll be presenting at the conference, with the assistance of my ever-awesome co-facilitator, Masako Suzuki.   I thought long and hard about the subject matter for my talk.  I decided that I wanted to present on something that is not frequently discussed:  touch.

Touch has a multitude of health benefits.  It has been shown to lower blood pressure and support healthy immune function.  It releases oxytocin, the bonding hormone that increases trust and reduces stress.  While modern humans in the US rarely touch each other, our non-human ancestors were much more hands-on in their relationships.  Primates spend 10-20 percent of their day grooming each other.  For many domestic animals, grooming and cuddling is an important part of any social interaction.  Have you ever looked at two cats, curled up together on the couch and felt jealous?  I know I do.  Both of my cats are fixed, of course, so I know it isn’t about sex.  Yet, they have an instinctual wisdom that draws them together, for safety and comfort.  I am often saddened that humans do not have this with each other.

Part of the reason for this is trauma.  For some of us, we have been so injured by inappropriate or violent touch that friendly affection feels threatening.  “Touch ambivalence” is a commonly recognized trauma symptom.  We might crave the sense of security that comes with touch, but when we actually receive touch, we instantly become uncomfortable.

Some trauma survivors have told me that they just don’t like to be touched.  I always respect their boundary and do not challenge their assessment of themselves.  At the same time, they often come to an awareness that this isn’t 100% true, 100% of the time.  Often, they do not like to be touched without warning. They do not like to be touched without permission.  They do not like to be touched unless they initiate touch.  These are all completely acceptable boundaries, and all of us have the right to set them.   We even have the right to say that we want to be touched, and then change our mind two seconds later.  This is an example of trusting our own nervous system, an essential step toward healing.

I decided to give a presentation for survivors who want to have a healthier relationship to touch.  I’ll be providing further details as we get closer to the conference, but here’s a brief description:

Current research on mental health and neurological development indicates that touch is a basic human need.  Unfortunately, those of us who experienced sexual abuse may find touch extremely triggering.  We may be aware of wanting hugs or other forms of affection, but fearful that our boundaries will be violated if anybody touches us.  This workshop will focus how to ask for what we need while empowering our ability to say “no” to what we do NOT need. While physical touch will not be a part of this workshop, we will participate in experiential exercises on setting healthy boundaries.

I’ll also be providing more updates about the conference in general.  We always have a number of skilled presenters, offering workshops geared toward survivors, loved ones and clinicians.  I hope to see you there.

I am going to talk about a subject that is sensitive for many people who have experienced trauma:  forgiving one’s abuser.

Many of us hold forgiveness up as an ideal.  Our spiritual tradition may teach us to forgive.  We may have been taught to love our enemies, or turn the other cheek.  For some (but not all) people, forgiveness can be healing.  But what does it mean?

Forgiveness does not mean condoning what happened.  It does not mean that the person in question was not responsible for their actions.  Most importantly, it does not in any way diminish the fact that the abuse was deeply and profoundly harmful.  If we choose to forgive, this does not mean taking away our permission to feel whatever we need to feel about the abuse.  This might include grief or outright rage.   All of these feelings are part of the healing process.   It is important to have compassion for ourselves when those feelings come up.

In time, though, comes the realization that we do not want to be swallowed up in anger and grief.  It saps our energy.  It keeps us from noticing the moments of joy, warmth and humor that show up spontaneously in our lives.  While traumatic experiences can change us, they do not define who we are.  Sometimes, forgiveness means choosing to live our lives on our own terms, rather than letting trauma dominate our existence.   When we take time for self-care, we have more energy to have compassion for others.  This may, eventually, include compassion for our abusers.  We may come to a place where we do not wish them harm, or even wish them healing from whatever suffering led them down the wrong path.

In some cases, this can be a spiritual resource.  Compassion feels good!  If a client has a belief that their God wants them to be compassionate, then compassion can feel like a spiritual experience.  I’m 100% in favor of people having as many healthy spiritual experiences as they want to have.  So, if a client comes to a place where they are able to do that, then I offer my full support.

That said, it is important to remember that not everyone reaches this place…and that’s OK. If we can’t forgive, it does not mean that we are unable to heal.  It also does not mean that we are, in some way, less moral or spiritually enlightened than the person who IS able to forgive.  It can be very empowering to say “I choose not to forgive.”  Sometimes, THIS is the statement that allows us to move past the trauma.  It sets a clear boundary, which we may not have been able to set, in the past.  This can be an important step toward healing, because it acknowledges that we have choices, and are NOT powerless.

If somebody you love is recovering from trauma, it is important not to have an agenda about forgiveness.  They will forgive when and IF they are ready.  The most helpful thing you can do is listen, and remind the person that you love them…whatever their choice may be.

Spirituality can be one of the most valuable resources that people have, on their healing journey.  Positive effects of religion on mental health have been well documented.  People who attend religious services have been shown to live an average of 7-14 years longer than people who do not.  The benefits of spiritual community have been so well-recognized that Atheists and free-thinkers are finding ways to build that community for themselves.

It is vitally important for a counselor to support their clients’ spirituality, however they may define or express that.  Most therapists will say that they do this, and for the most part, they are sincere.  They can meet challenges, however, when they run into spiritual practices that are unfamiliar for them.   The therapist may give off a “vibe” of being uncomfortable even when they have good intentions.  This can lead to clients feeling guarded about their spirituality, afraid to discuss it even when it is relevant to their mental health.  It can also lead to them terminating therapy prematurely, and feeling uncomfortable with seeking therapy again.

This is an experience often reported by people who identify as Pagan, Wiccan or Earth-based in their spiritual tradition.   The clinical community has taken some steps in the right direction.  Wicca is becoming more accepted as a spiritual path.  I was pleased to see that the Wings Foundation mentions Wicca in their chapter on Spirituality, in the member handbook.   While I would prefer to see some recognition that not all Pagans are Wiccan, the inclusion reflects an understanding that most alternative religions are life-affirming and supportive.  This is contrary to the dangerous stereotypes perpetuated by a small handful of Christians, who were raised to believe that Pagan ritual is ritual abuse.

For a trauma-informed counselor, the term “ritual abuse” brings up nightmarish visions of unimaginable cruelty.  These images can be haunting.  It can lead us to experiencing a sense of protective outrage on our clients’ behalf.  It can also lead us to have some apprehension when clients mention that they are part of a fringe religious group.  Is it a positive support network, or an abusive cult?  Having worked with members of the Pagan community, I can assure you that it is most likely the former.  That said, reports of abusive groups are not unheard of, and I am always deeply saddened to hear about religious leaders that abuse their power.  These occurrences seem not to discriminate based on tradition.   Abusive acts are perpetrated by Protestant ministers or Catholic priests as well.  Abuse by religious leaders is always unconscionable, and counselors need to have awareness of what does (and does not) constitute an abusive situation.

Here are some things to be aware of:  

-Hierarchies:  If the organization has a “high priest” or “high priestess”, what does the client’s relationship to that person look like?   Most high priests or priestesses earn their title by doing a tremendous amount of personal and spiritual work.  They may provide valuable services such as spiritual mentorship, weddings, baby blessings or rights of passage.   In a healthy group structure, the leader will relate to their duties with dedication and humility.

-Money:  Is the group asking for more money than they need, to keep the organization functioning?  There may be member dues or occasional requests for donations.  This covers the cost of ritual space, supplies and printer ink for educational materials. It is also important to remember that some spiritual teachers spend a tremendous amount of time and energy doing their work.   It is reasonable to charge for classes or other professional services that are offered. However, if the organization demands a huge financial sacrifice on the part of members, this is a red flag.

-Sex:  Many Pagan groups honor sexuality as sacred, when it takes place between consenting adults.  This may very well be a part of ritual, for some people.  It should never be a requirement for initiation or membership in a group.

-Secrecy:  If there is a vow of secrecy, there may be a good reason for it.   Some Pagan organizations involve intense personal work, and this work cannot occur without trust between members.  There is also a widely held belief that revealing details of rituals may interfere with the energy of the group.  If a client does not want to tell you about what happens in ritual, you will need to respect that boundary.

In a sense, all therapists take a vow of secrecy, by virtue of beginning our practices.  We know the damage that can be done by violating our client’s confidentiality.  Sometimes, we all need to be selective about what we share with others.  Empower your client’s decision to be selective, even with you.

Transparency:  There should be some disclosure about why major group decisions are made, where the money goes, and how hierarchies are set up.  Group leaders should be approachable, respectful of dissenting opinions and available for questions.  While decision-making power might not always be “equal”, nobody should be treated as powerless or without value.

Relationship to non-group members:  Be cautious about groups that look down upon other religious traditions, discourage members from joining other groups, or negatively impact relationships with those who are not part of the group.  If your client starts to lose relationships with family or friends after joining the group, concern may be warranted.

Concluding thoughts: 

I would like to call upon all counselors to use common sense, and apply basic clinical skills. Rather than evaluating a client’s spiritual practices based on a conventional understanding of religion, notice how the client relates to those practices.  Do they talk about them with a sense of joy or excitement?  How does their practice affect their lives, outside of ritual?  Does it give them a sense of meaning and contentment?  Remember, spiritual paths can be challenging, but any challenges that the client faces should enhance their lives in some way, even if the benefit is not immediately obvious to you.

Any competent therapist knows what trauma looks like.  They know how to evaluate an abusive relationship.  If the client’s ritual group resembles an abusive relationship, or they return from ritual with trauma symptoms, act accordingly.  Unless these symptoms are showing up, then you have nothing to worry about.

Also, above all, remember that your alternatively spiritual clients are human.  They will experience spiritual doubts and existential angst, just like anybody.  For example, they may question whether the Gods exist.  They may question why the Gods did not protect them from the traumas that occurred.  They may get angry with their Gods, and may need to express that in therapy. Sound familiar?  Any therapist who has dealt with grief knows what it is like to hold the space for a client who is angry at God, the Universe, or whatever higher power they have in their lives.  Your job is not to question their beliefs or hold an agenda about how the internal conflict is resolved. Your job is unconditional positive regard. Everything else is just details.

“Complex” PTSD is well recognized in clinical circles, despite the APA’s refusal to acknowledge it in the DSM-5. This unofficial diagnostic category represented a dramatic shift in our understanding of trauma. It led us to a more compassionate understanding of symptoms that were once dismissed as attempts at manipulation. Even in the early days of my career, some colleagues discouraged me from paying too much attention to clients who engaged in self-harm or expressed recurrent suicidal thoughts. Why? Because there was still the belief that they were just “doing it for attention.” This was a mere 10 years ago. This is an exciting time to be a therapist, when our understanding of trauma is evolving at a rapid pace.

As a general rule, most human beings have a natural biological drive toward health. Self-destructive behavior defies the fundamentally sacred instinct that allows us to grow and evolve as a species. So, why would anybody harm themselves, through self-mutilation, substance abuse or any other high-risk behavior?

The answer: It is precisely because of our fundamental desire to survive that we will employ any and all means to avoid things that feel like death.

For those who do not have complex PTSD, most normal life stressors do not feel like impending doom. Such people have well-regulated nervous systems and a capacity to calm themselves down. They can accept criticism, make mistakes, handle rejection and weather emotional storms that naturally arise from being alive. When you suffer from complex trauma, the emotional reaction to such circumstances is so intense that you may experience emotional shutdown, AKA, dissociation, sometimes manifesting as depersonalization, derealization and a general sense of either feeling like you do not want to exist or already DON’T exist as a real person. In some circumstances, external means of self-soothing must be employed to return to a state of equilibrium. Those who have learned DBT skills or similar interventions may have developed safe ways to calm themselves down. Those who have not learned such skills may resort to behaviors that are a serious threat to themselves or others.

I’ve got two things to say to people who struggle with these compulsions: It’s not your fault, and it does get better.

Complex PTSD does not result from a single traumatic incident. It results from chronic and prolonged exposure to situations perceived as life-threatening. It is impossible for a person to learn how to calm themselves down if they have lived in a world that is never safe. Why calm down? Another threat is just around the corner. In many (if not most) circumstances, the trauma occurred in early childhood, when the vulnerable nervous system was still developing. In cases like this, the nervous system learns to stay in a state of constant agitation and/or shutdown. Many SE practitioners describe this as living with the brakes on and the gas pedal floored at the same time.

I’ll say it again, in case you need to hear it:  It’s not your fault. Congratulations on staying alive. You’re stronger than you think, and the world is better for having you in it.

With regards to “it gets better”, here’s how it happens:

You find a small island of safety. Here’s the trick…it has to be an island that you create for yourself. If it’s conditional on another person constantly being around, it’s not going to feel stable. No matter how much you love someone, or how much they love you, nobody can be around 100% of the time. Actually, your loved ones will be better support people for you if they take time for themselves. So, let your island be something you can control.

No matter how small that island is, let yourself trust it, and enjoy it completely. Five minutes of fresh air? One chapter of a good book? Great. Stop thinking about how it won’t last. Yes, I know it’s hard. Stop, or at least notice the gaps between worrying. I guarantee they are there. Let yourself sink into that island. Watch it grow. The more you attend to that place and nurture it, the larger it will get. I promise.

As you notice what it’s like to feel pleasure, tell yourself that you deserve pleasure. I know, I know…this is hard too. You may need to hear it from a therapist on repeated occasions. Eventually, though, you will find that you start treating yourself like a human being. This leads to the belief that you deserve to be treated like a human being by others around you.

You start to set boundaries. Toxic relationships either become less toxic or fall by the wayside. The friends who matter stick around. New friends come in as you feel more comfortable reaching you to people who are good for you. Your support system widens, and your relationships deepen. You no longer feel like somebody who is constantly in need of help, but you know how to ask for help without feeling ashamed.

This all takes time, and patience with yourself. Therapy will initially focus on getting the self-destructive behaviors under control. DBT or recovery groups may be recommended in addition to individual therapy, if the behaviors are severe. Working on the actual trauma will happen once safety is established. Therapeutic progress is often measured in years, rather than weeks or months. Medication may be necessary, at least on a temporary basis. There will be setbacks. There will be plenty of opportunities to forgive yourself, and learn what it’s like to deserve forgiveness. That, in and of itself, can be a healing experience.

I have one last bit of good news: you made it through this entire article. That probably means you have a sense that some if it is true…and that you can make it. All of the work mentioned above is a lot of work, but you probably have a sense that life is worth it. Otherwise, you wouldn’t be looking up therapists and thinking about getting help.

Congratulations on taking the first step. You can do it.

Often times, new clients come to my office without much prior experience of therapy. Sometimes, I am the first therapist they have ever seen.   Some nervousness is understandable, if you have never been to therapy before. It is not uncommon for me to hear questions like “how do I do this?” or “where do I start?”  There is no need to worry about doing therapy “right”. That said, there are several things you can do to maximize the benefits of your sessions.

–Come early:  Allow yourself some extra time, in case of unexpected delays.  This will ensure that you get the benefit of the full hour, instead of losing precious minutes trying to find a parking space.  This is also a way to help yourself arrive in a calmer state, giving you more energy to focus on the work we do together.

-Come often:  Weekly therapy is usually recommended, at least in the beginning.  Some clients reduce the frequency of their sessions to bi-weekly, as they start to feel better. This is totally fine, and actually a great indication that therapy is serving its purpose.  Regardless of how you choose to set your schedule, it helps keep that schedule consistent and predictable.  This gives therapy a sense of continuity and flow.

-You do not need to rehearse:  Some people set very specific expectations of what a session will look like. Often, these expectations include discussing upsetting or traumatic material.  While telling your story can be important, it can be counterproductive to focus on traumatic memories outside of therapy.  Rehearsing the story can lead to re-living the memory.  This can actually exacerbate PTSD symptoms, rather than healing them.

When you feel ready to work with a traumatic memory, make note of this in a journal (without going into detail) and bring the journal to session.  Then, we can discuss how to work with that memory in a slow, supported way that will not lead to re-traumatization.

-Plan something fun or relaxing after therapy:   Therapy is not always an intensely emotional process, but sometimes it can be.   It is helpful to give yourself a “break” after a session.  If you have a strong sense that you need a walk or maybe a nap, listen to your body and do what you need to do.  If you need time to yourself, turn your phone off.  If you need friends around you, call somebody and go out to dinner.  Of course, it is possible that you will need to return to work, class or other obligations after therapy.  If that is the case, plan a “break” later on, when you have time.  Give yourself something to look forward to.

-Have your own vision for therapy:  Have a clear idea of what you want your life to look like, once therapy is complete.  What has changed?   What type of work are you doing in the world?  What do you do for fun or spiritual fulfillment?  What do your relationships look like?   This vision can change or evolve as therapy progresses, but it is important for that vision to be there.  That way, you can gauge how well therapy is working.  It will also give you a sense of when you are ready to complete therapy, since the decision is ultimately yours.  Your vision may be discussed periodically during the course of therapy, to make sure we are on the same page.

-Talk to your loved ones about therapy:  Nobody heals in isolation.  Discuss your progress with a trusted person who can support your vision for recovery.

-Have a sense of humor:  Therapy does not have to be serious all the time.  After all,  therapy is a human relationship, and healthy relationships involve humor.   Laughter can be a great resource.  Allow yourself to play a little.  You deserve it.

I am filled with musings and ponderings after a week of Advanced Somatic Experiencing training with Steve Hoskinson in Burlingame, CA. My career is a process of lifelong learning, and I always enjoy my  SE workshops. On the surface, they may just seem like opportunities to grow my professional skills.  They are more than that, though.  They are similar to meditation retreats.  I always return feeling renewed and reaffirmed in the intention of my therapeutic practice.

Pretty much any modern therapist will tell you that most of the healing process comes from the client, not the practitioner.  I know that I have said this, time and time again…to the point that it may seem trite.  Right now, however, I am so profoundly aware of the truth of this statement.  It feels appropriate to share this with any clients who may be seeing this…be they past, present or future.

As I have undertaken my private practice journey, I have been continually impressed by the resiliency of the people I work with.  All this SE training sounds complex, but it has taught me essentially one thing: How support people to show up as who they are, and engage in a process of radical self-acceptance.   When people allow themselves to be present with themselves, holding a non-judgemental awareness, it’s amazing what happens.  I see people make healthier choices.  They start eating more nourishing food. They set better boundaries with the people they love.  They quit their jobs and find work that feels congruent with who they are. They choose healthier relationships.  Why?  Because they start trusting their own guts, and the awareness of what they really need arises naturally.

You all did that.  I didn’t do it for you.  I’m just here, sharing in your excitement and joy as you embrace your own wholeness.

And so, it is with excitement and deep appreciation that I return to Colorado to resume my work.  I would also like to extend my appreciation to everyone in the SE community, for making every training feel like a homecoming.

This is a reminder that I need for myself, sometimes, and I thought I would share it with all of you.  Do you have a mile-long “to do” list?  Remember, all you can do is all you can do.  It is important to listen to your body and track your own level of energy.  If you’re honestly out of oomph, take a break!

Do you beat yourself up when you do not accomplish everything you set out to do?  I know I have a tendency to do this, sometimes.  I found myself doing it a lot less once I realized that self-punishment does not lead to increased productivity.  Actually, it does quite the opposite…it saps the energy that I need to fuel my passions and accomplish my goals.

So, treat yourself gently, today.