Los Angeles Chapter — California Association of Marriage and Family Therapists
Voices — September 2024
Guest Article
Understanding Everyday Forgetfulness and Cognitive Changes in Aging
Kim Scott, LMFT
Clients often worry about memory lapses, like forgetting why they walked into a room or turning the wrong way when heading to the doctor’s office or Pilates class. These instances are normal aspects of everyday forgetfulness and not signs of cognitive decline. Yet, when I turned 65, I also worried that these lapses signaled the beginning of Alzheimer’s.
Why Does Everyday Forgetting Happen?
Everyday forgetfulness is a common experience unrelated to age. People of all ages experience these lapses, but stereotypes about aging—such as referring to these memory lapses as “senior moments”—can often lead people to jump to the wrong conclusion. Normal forgetfulness can be caused by a variety of factors, such as distraction, stress, fatigue, or multitasking. Worry, depression, and lack of sleep can also contribute. However, there are some cognitive changes that are normal with aging, but these changes seldom impact the individual’s activities of daily living.
Types of Cognitive Impairment in Seniors
Other types of forgetting or cognitive impairment can be cause for concern. Cognitive impairment is a catch-all phrase encompassing various issues that affect a person’s ability to think, process information, or concentrate. It can range from mild impairment that is only noticeable during complex tasks, to severe, where an individual loses all verbal abilities and requires assistance with daily activities.
Cognitive impairment can be temporary, persistent, pervasive, or progressive. The most common causes of cognitive impairments among seniors are the 3 D’s: delirium, dementia, and depression. Other factors such as medications, medical conditions, anxiety, and isolation can also lead to reduced cognitive functioning. Mild cognitive impairment is a transitional state between normal aging and dementia.
Dementia can range from mild to severe and is irreversible and degenerative. Our hope is that through medical interventions the individual can slow the progress of decline. In the DSM-5, these disorders are categorized within the section on Neurocognitive Disorders. The term dementia is often used when the individual is experiencing memory impairment in several different areas, such as:
Alzheimer’s Disease is the most common cause of dementia. Parkinson’s is the second most prevalent neurodegenerative disorder in seniors.
Whereas dementia is often a progressive, gradual decline, delirium develops rapidly, often over days or even just hours. It may involve a disturbance in attention, memory, language perception, or disorientation and can fluctuate throughout the day. Depending on the cause, delirium can be reversible if caught quickly.
The Global Deterioration Scale provides detailed information on the various levels and types of cognitive decline that seniors may experience. As therapists, this is a good place to start when a client or family is describing concerns. It will help you distinguish between very mild changes and severe decline.
It is important to remember that depression can mimic cognitive decline, but once the depression is treated, the cognitive impairment recedes. Depression and anxiety can also co-exist with other forms of cognitive decline, as a change in mood is often one of the symptoms of dementia. In fact, a study done by Teri and Wagner (1992) found that approximately 30% of individuals with dementia also meet the criteria for a diagnosis of depression.
Understanding these distinctions can help therapists accurately assess the challenges their clients are facing with greater clarity and compassion, ensuring that their clients receive the appropriate care and support.
Assessment
The first step is a full assessment. This is extremely important because some causes of impairment may be reversible. A full assessment should include:
Therapeutic Treatment
Psychotherapy can be useful for clients with mild cognitive impairment and mild dementia. In addition to providing a place for the client to grieve their losses, the therapist can also help their client:
Sadly, too many clients have told me that their doctors brushed off their concerns as just part of being old. It is important to remember that even if we can’t turn back certain types of brain functioning, we can help our clients optimize the strengths and abilities they do have.
Kim Scott, LMFT is a licensed marriage, family and child therapist. She has a private practice in Granada Hills where she works with couples and individuals, in-person and via Telehealth. Kim has been licensed for 30 years and has expertise in working with older adults and women issues. To learn more about Kim's practice and to read more of her articles visit her website: www.kimscottmft.com
Therapists of Color (TOC) Mentorship Program
TOC Mentorship Program Committee Gears Up for 2024 with Enthusiastic Matchmaking
The Therapist of Color (TOC) Mentorship Program Committee convened in May to embark on one of the most anticipated tasks of the year: matching mentors and mentees for the 2024 cycle. The atmosphere was electric as committee members pored over interest forms, each brimming with unique stories, aspirations, and goals. The excitement was palpable, and the dedication to making thoughtful, intentional matches was evident in every discussion.
Reading through the interest forms was not just a task but a delightful journey into the diverse and dynamic lives of our applicants. Each form provided a glimpse into the passions and potential of both mentors and mentees, making the selection process both inspiring and challenging. Committee members were deeply moved by the enthusiasm and commitment shown by everyone involved, reinforcing the importance of creating meaningful connections that will foster personal and professional growth.
On June 1st, our 4th mentoring cohort began, with all our mentees successfully paired with licensed mentors of color. Mentors and mentees kicked off the 4th cycle by participating in a virtual orientation organized by the committee, where they learned about program highlights and available resources. We are one month into the 6-month mentorship program, and the feedback from both mentors and mentees has been exceptional. They appreciate the connections established and feel a great sense of relief knowing they have additional support within their professional village.
Our committee is steadfast in its mission to pair individuals in ways that will maximize the mentorship experience. We believe that these connections will not only provide guidance and support but also cultivate lasting relationships that transcend the program. As we move forward, we are filled with optimism and excitement for the incredible journeys that await our 2024 mentors and mentees. The TOC Mentorship Program is more than just a matching process; it is the beginning of transformative experiences that will shape the future of our community.
Congratulations again to all our 2024 mentors and mentees selected this year!
Keonna Robinson, MA, LMFT, is the TOC Mentorship Program Chair. Visit: TOC Mentorship Webpage. Email: Tocmentorshipprogram@lacamft.org.
The Ultimate Personal Reset: Take a Career Break!
Fran Wickner, Ph.D., LMFT
A career break is simply time away from your job. There is no “right” way to take a career break, but usually if it is less than a month it’s more of a vacation. The word sabbatical is often used and is the same concept. Others like to think of it as “incremental retirement.”
Maybe you have told yourself this 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.
There are many benefits to taking a career break and travelling. For a profession like ours, most reasons are obvious such as returning from travelling refreshed, replenished, gaining new perspectives and having time to not think about your clients. As noted in the research below, people who take career breaks often return with a more positive outlook on their job and life in general.
And 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 Psychology that says distance can make you more creative. The implications of his research show that travelling 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 valuable open-mindedness, making it easier to realize that a single experience 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 travelling not only helps your creativity but also improves your problem-solving abilities, skills that are imperative in our field.
If you do decide to take a career break, be prepared for internal and external blocks that can often lead to anxiety and then inertia. 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.
Below are a few simple tips on taking small manageable steps on how to get out of the “inertia zone.”
1. Read articles from people taking successful career breaks. You have already started; you are reading this article.
2. Start a CAREER BREAK folder. Include this article. Look up the studies referenced at the bottom of this article and include those. Add articles you find on places you may think of going, links that are interesting, etc.
3. Start dreaming of your ideal career break. Would it be slow travel, living in one place for an extended time? Or going to a few different places? Or both?
Where would you go? What do you want to see and do? This is the dreaming stage, it doesn’t have to be exactly what you would do!
4. Then make the idea real by saying it out loud. Even if you don’t know when or how you will do it, talking about it makes it more likely to happen. You will have to explain yourself to family and friends because right now taking a break when you are healthy and younger than when you plan on stopping work 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.
5. Talk to people who have taken a career break. You’ll find friends of friends, people online, or of course I would be happy to schedule a time to talk to you about this at any point in your planning.
Once you decide you really can do this, here are some of the common business concerns that therapists bring up when I help them plan their career break.
1. What will happen to my clients?
Logistically, this is usually the main concern I hear from clinicians. Those in private practice might also be worried about 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.
Most importantly, make sure you give adequate notice to your clients. This will vary client by client based on the work you are doing with them. 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.
Plan what will happen when you are gone. Will you do Zoom type sessions with them? Will they take a break? Will they see your backup clinician?
2. What will happen to my business when I return?
Plan a schedule for when you get back including scheduling in clients.
If in private practice it is often helpful to schedule some marketing activities to get you up and running: maybe have a workshop or a speaking engagement scheduled or an article timed to be published for when you return.
Before leaving could be a good time to use a practice building consultant so you can return to a thriving practice.
3. How can I make money when I’m away?
If appropriate, you may be able to do sessions with clients by phone or Skype or Zoom.
Maybe you want to teach a class or workshop while you are travelling. You can plan it on your own or contact a local university or counseling center.
4. What do I need to have in place before I leave?
Obviously, there are many things that need to be done before an extended absence, but here are the things related to the business of being a therapist.
You need a trusted clinician to:
Check your voicemail.
If you have a private practice office:
The basics above will get you on the path to join 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).
Fran Wickner, Ph.D., MFT has been a Licensed Marriage and Family Therapist since 1983. In addition to her clinical practice in Berkeley, Dr. Wickner is a practice building consultant and offers individual consultations and workshops as well as availability to speak to your consult group or professional association on all aspects of building and expanding your private practice. Website: FranWickner.com/ForTherapists
Member Article
Bulimia Urges Over 40: A New Challenge in Mature Years
Joanna Poppink, LMFT
At 40, many people find themselves re-evaluating their lives and wondering if they have reached the goals they once set for themselves. But for those who have struggled with bulimia in the past, this can be an especially challenging time. When eating disorder symptoms return how to overcome bulimia urges over 40 can seem like a daunting or impossible task.
After years of battling bulimia and its related guilt, shame, and fear, they found healing and freedom from the old urges to binge and purge. However, they may be unequipped to face new challenges facing them from this time in their lives. Given the violence of our times, political polarization, climate change, COVID, and economic uncertaintly, meaning and a sturdy sense of purpose seems elusive. In such uncertain and dangerous times, bulimic urges can emerge again.
It's possible to expand life, move beyond the old urges, and learn to cope with the difficult emotions associated with this new stage of life. The task is to find meaning in life as it is now and develop beyond the old need for bulimia to cope with current challenges.
Understanding Bulimia Urges Over 40
Recovery from bulimia can be a long and challenging journey, and it can become even more complex as we reach our 40s. At this stage in life, many people find themselves questioning their choices and wondering if they have truly achieved the goals they once set for themselves. Perhaps they have achieved their goals and now wonder what is next.
As we grow older, it is important to gain a deeper understanding of the urges that accompany bulimia. It is crucial to acknowledge that these urges are not a reflection of our worth or strength but rather a manifestation of the deeper emotional struggles we may be facing. This realization requires honesty and self-awareness, as we must confront the underlying reasons for the need for soothing through these urges and behaviors.
Psychotherapy can be an invaluable tool in this process. By delving into the roots of our eating disorder and exploring our emotions, we can gain insight and develop new coping mechanisms.
With therapy, we can learn to navigate the challenges that arise in our 40s and beyond with courage. We gain the resilience we need to re-evaluate our lives, release our imaginations and create a new future for ourselves.
To accomplish this, in addition to therapy, it is important to surround ourselves with a supportive network of colleagues, friends and loved ones who understand and validate our experiences. Building this support system can provide a sense of encouragement, belonging and connection, which is vital for our healing.
As we continue on our journey of recovery, we must remember to be patient with ourselves. Healing takes time, and setbacks are a natural part of the process. With each step forward, we are making progress and moving closer to a life of more healing and fulfillment.
Meaning of Bulimia Symptoms is Important in Recovery
Finding meaning is a crucial aspect of recovery from bulimia, especially after the age of 40. After years of battling the disorder, it's common to feel a sense of bewilderment and wonder what the purpose of all the recovery work was when we think we are back where we started. Of course, we are not back where we started.
We’ve created an improved life that is impossible to consider if we had continued to be mired down by our eating disorder. However, now is the time for finding new or expanded meaning in our lives. Old commitments may no longer apply or may be even more intense. A deep exploration of who we are now is called for. And that is what provides us with a sense of direction and helps us move beyond the need for bulimia symptoms.
When we find meaning in our lives, we are able to develop a new healing process that goes far beyond overcoming the disorder itself. Meaning in our lives allows us to create a sense of purpose and fulfillment that goes beyond the negative emotions associated with bulimia.
We want to rally our energies to build something. By identifying what truly matters to us and aligning our actions with those values, we can find a deeper sense of contentment and satisfaction. This is particularly important when you are over 40. Bulimia urges over 40 relate to the more challenging issues you face as a mature adult.
Finding meaning in recovery also helps us shift our focus from the past to the present and future. It allows us to let go of the shame and guilt associated with our past behaviors and embrace the growth and transformation that come with recovery. It gives us a reason to keep moving forward, even in the face of challenges and setbacks.
Bulimia Recovery involves Overcoming Shame, Fear, and Old Secrets
An obstacle to bulimia recovery, especially after the age of 40, is the weight of shame, fear, and old secrets. These emotions can be deeply ingrained and can hold us back from truly moving forward and embracing a fulfilling life.
Shame is a common feeling among individuals who have struggled with bulimia. It is often accompanied by a sense of unworthiness and self-judgment. However, it's important to remember that shame does not define us.
Shame is simply an emotional experience we can choose to let go of. By acknowledging our shame and working through it, we can start to heal and develop a healthier relationship with ourselves.
Fear is another powerful emotion that can hinder our recovery. We may fear relapse, judgment from others, or even the uncertainty of life beyond bulimia.
However, confronting and challenging our fears is an essential step in the healing process. By facing our fears head-on and learning to cope with them, we can gain the strength and resilience to move forward.
Old secrets, whether they are related to our past behaviors or the emotions we've suppressed, can also weigh heavily on us. It's important to recognize that keeping secrets can be damaging to our mental and emotional well-being.
Opening up and sharing our struggles with trusted individuals can be a cathartic experience. Through honesty and vulnerability, we can release the burden of old secrets and find the support and understanding we need to heal.
Developing a Growth Mindset for Long-term Bulimia Recovery
As we continue on our journey of recovery from bulimia after the age of 40, it's important to develop a growth mindset. A growth mindset is the belief that we can grow, learn, and change, even in the face of challenges and setbacks. It allows us to view recovery as a process of continuous improvement rather than a fixed destination.
To develop a growth mindset, it's important to cultivate self-compassion and patience with ourselves. We must acknowledge that healing takes time and that setbacks are a natural part of the recovery journey. Instead of beating ourselves up over mistakes, we can learn from them and use them as opportunities for growth.
Another key aspect of developing a growth mindset is embracing a willingness to try new things and step outside of our comfort zones. This can include trying new coping skills, exploring new hobbies or interests, or challenging negative thoughts and beliefs. By pushing ourselves to grow and expand our horizons, we can open ourselves up to new possibilities and experiences.
Additionally, developing a growth mindset involves cultivating a sense of gratitude and appreciation for the progress we've made. It's important to celebrate small victories along the way and recognize the steps we've taken towards healing. This not only boosts our self-confidence but also reinforces the belief that we are capable of change and growth.
Identifying Triggers and Building Coping Skills
Identifying Triggers and Building Coping Skills are essential components of recovery from bulimia after the age of 40. Triggers can vary from person to person and may include certain situations, emotions, or thoughts that lead to urges to engage in disordered eating behaviors. It's crucial to identify these triggers so that we can develop effective coping skills to manage them.
One way to identify triggers is to keep a journal and track patterns in our thoughts, emotions, and behaviors surrounding food and body image. By noting down these observations, we can begin to identify common themes or triggers that precede our bulimic urges. For example, we might notice that we feel more vulnerable to urges after a stressful day at work or during times of loneliness.
Once we have identified our triggers, it's important to develop coping skills to manage them. Coping skills can include a range of strategies, such as deep breathing exercises, practicing mindfulness, engaging in physical activity, or reaching out to a support person. The key is to find what works best for us individually and incorporate these coping skills into our daily routines.
Incorporating Self-Care Practices into Daily Life
Self-care is a vital component of recovery from bulimia, especially after the age of 40. Incorporating self-care practices into our daily lives can help us prioritize our mental, emotional, and physical well-being, which is crucial for healing and finding meaning beyond the old need for bulimia.
One important self-care practice is setting boundaries. As we recover, it's essential to establish limits and communicate our needs to others. This can include saying no to activities or commitments that drain us, prioritizing alone time for self-reflection, or setting boundaries around conversations and topics that trigger negative emotions.
Another self-care practice is nurturing our body through proper nutrition and regular exercise. Eating a balanced diet and engaging in physical activity can not only support our physical health but also boost our mood and overall well-being. It's important to focus on nourishing our bodies and being kind to ourselves rather than punishing or restricting ourselves with food or excessive exercise.
Taking time for relaxation and stress reduction is also key. This can involve activities such as practicing mindfulness, taking walks in nature, or engaging in hobbies that bring us joy and peace. Prioritizing relaxation helps us recharge and rejuvenate, allowing us to better cope with the challenges of recovery.
Seeking Professional Help and Support Networks for Bulimia Recovery
Seeking professional help and support networks is an essential part of the recovery journey from bulimia, especially after the age of 40. It can be daunting to reach out for assistance, but it is a brave and necessary step towards healing and finding meaning beyond the old need for bulimia.
A therapist who specializes in eating disorders can provide valuable guidance and support. They can help us understand the underlying emotions and triggers that contribute to our bulimia urges and develop healthy coping mechanisms to manage them.
Therapy provides a safe space to explore our thoughts and feelings, gain insight, and work through any lingering shame, fear, or old secrets.
In addition to professional help, building a support network of understanding and empathetic individuals is crucial. This can include friends, family, support groups, or online communities.
Connecting with others who have experienced similar struggles can provide a sense of belonging, validation, and encouragement on our recovery journey.
Celebrating Small Victories and Progress
In our journey of recovery from bulimia after the age of 40, it's important to celebrate the small victories and progress we make along the way. Every step forward, no matter how small, is a significant achievement and deserves recognition.
Whether it's going a day without engaging in disordered eating behaviors, challenging negative thoughts and beliefs, or reaching out for support when needed, each victory is a testament to our strength and resilience. By acknowledging and celebrating these accomplishments, we reinforce our belief in ourselves and our ability to overcome the challenges of recovery.
Celebrating small victories and progress also helps us stay motivated and committed to our healing journey. It provides a sense of fulfillment and satisfaction, reminding us of how far we've come and the growth we've achieved. It's important to take a moment to reflect on our progress, whether it's keeping a journal of achievements, sharing them with a trusted support person, or simply acknowledging them to ourselves.
Embracing a Positive Relationship with Food and Your Body
Developing a positive relationship with food and your body is a crucial part of recovery from bulimia, especially after the age of 40. After years of struggling with disordered eating patterns, it's important to foster a healthy and balanced approach to nourishing yourself.
First and foremost, it's important to recognize that food is not the enemy. It is essential for fueling our bodies and providing us with the energy and nutrients we need to thrive.
Instead of viewing certain foods as "good" or "bad," try to embrace the concept of moderation and balance. Allow yourself to enjoy a variety of foods without guilt or restriction.
In addition, focusing on intuitive eating can help you develop a positive relationship with food. Tune in to your body's natural hunger and fullness cues and honor them. Trust yourself to make nourishing choices that feel good for your body and mind. Remember, every body is unique, and what works for someone else may not work for you.
Joanna Poppink, LMFT, psychotherapist, speaker, and author of Healing Your Hungry Heart: Recovering from Your Eating Disorder, is in private practice and specializes in Eating Disorder Recovery for adult women and with an emphasis on building a fulfilling life beyond recovery. She is licensed in California, Florida, Oregon, and Utah. All appointments are virtual. Website: EatingDisorderRecovery.net
Personality Disordered Nation: Intergenerational Trauma and Systemic Cultural Dysregulation
Pamela Rosin, LMFT
Let’s talk about volatility and the contagion of dysregulation. Globally, collectively, our survival fear is activated. The stakes are high and the urgency is great. How can we best respond to all of this volatility? How can we help ourselves, each other and our clients?
As someone who supports family members of people with Borderline Personality Disorder, I see how BPD exists systemically, on vertical and horizontal axes. By vertical axis I mean how and why the disorder gets passed down generationally. By horizontal axis I mean how the disorder plays out culturally in society. The interplay of the macro and micro spheres exacerbates the phenomenon and makes healing extra challenging.
Vertical Axis- Intergenerational Transmission:
To summarize why the disorder is intergenerationally transmitted: for a person who grows up in a household with patterns of BPD there are many factors which contribute to their internalized core beliefs, somatic shape, capacity to self-regulate, and ways of moving in the world. Rather than have a carefree childhood, the child is parentified and understands their role is to prioritize the parent’s well being, including not to do anything that would threaten the relational bond. Rather than be soothed, they must soothe the parent. Rather than be held, they must hold their parent, in essence.
The lack of containment and soothing can result in important developmental milestones getting skipped, the child growing up with affective deficits and a decreased capacity to regulate.
When they have a family of their own, their unexpressed anger may have snowballed over time. Having children of their own may be a probe for their own grief for all that they didn’t get. They may be envious of their children’s innocence, youth, and possibilities.
Even as they do their best to parent their children, the weight of these deficits plus a lifetime of blame and shame cannot help but get woven into the relational bond. Sadly, the intergenerational perpetuation of this pattern is almost guaranteed.
Horizontal Axis- Cultural Dysregulation
Dysregulation is contagious and I see it happening on epidemic proportions with very little that supports healing in our culture at large. Some examples of volatility that mirror Borderline Personality Disorder include: polarizing view points, cancel culture, splitting, emotional swings, unpredictability, deindividualization and lack of social responsibility in social media communication, the media and how it’s utilized, not to mention conflicts that escalate to a deadly scale. Even the climate is volatile. With the pace and intensity of life, there is very little opportunity to respond rather than react. Volatile behavior is celebrated and encouraged, (or liked and shared). Taking an extreme stance and blocking out others’ points of view earns a sort of badge of righteousness.
How this affects us
As sensitive humans, we therapists are personally impacted by collective dysregulation. Add to that, the possibility that our impetus to become therapists had something to do growing up with developmental trauma, with threats to our Self development or in invalidating environments. This makes us best suited to serve clients with developmental trauma, but also makes us susceptible to getting caught in reenactments with them. Ay, there’s the rub.
It’s hard to stay conscious of this because the interplay of our clients’ material with our own often results in: us feeling trapped, checking out, referring out, burning out, armoring ourselves, dialing it in, etc. How can we notice something that makes us go numb? Plus, it’s huge work that we do, we use our heart all day long. Why would we want to lean in more when there’s volatility present? Our urge is to protect ourselves, naturally.
What is required?
I think it’s key to ask: what intrapersonal work is required that would support us to show up for relational repair? This is a deeply personal invitation to heal ourselves.
Some of what is required is personal inquiry in the form of countertransference work, boundary work, and deep self care. Knowing our boundaries and our personal material allows us to sense what is ours and what belongs to the client. Equipped with that clarity, we can seek to sense subtle undercurrents in the relational field. If we courageously name what we sense is happening relationally, then we can potentially access and leverage obstacles in the client’s relational dynamics. Plus, we can sense what they never received relationally and start to offer that to them.
When we heal our own nervous system, and cultivate mindfulness and genuine self-love, then we can offer co-regulation to our clients. To say, “it starts with the self,” just begins to scratch the surface. This is a deeply personal journey. As much as dysregulation is contagious, so too is co-regulation. This is an important reason to cultivate regulation personally. Healing our own nervous system on a cellular level not only gets us closer to wholeness and integration, it allows us to offer our clients more of what is needed because we have it inside. It’s a win win.
What is possible as a result
I would assert that it’s proportional: with great investment comes great potential reward. There can even be a circuit of reciprocal healing.
Left unexamined, our clients with developmental trauma or dysregulation may evoke subconscious patterns in us. Our version of fight, flight or flee may look like many things including armoring ourselves, dissociating, holding rigid boundaries, extreme appeasement, etc.
If instead we do the personal work around countertransference, our own trauma work, greater self-care, boundary work, etc., the potential for relational repair is great. Then we can relate to the client in ways unlike anyone else in their world has ever before.
As a result, we may notice an increased capacity to serve our most “challenging” clients, we become more engaged and satisfied by our work. As our work becomes more impactful, we feel better about ourselves and our practice. This in turn generates more energy and more capacity, and on and on.
None of this is easy, and requires support, inquiry, tools, community, and a high degree of self-care. But we are worth it and so are our clients.
Please feel free to reach out to me with reflections on any of what I have written here.
Yours in solidarity in important healing work.
Pamela Rosin, LMFT is the founder of ReParentive® Therapy. www.ReParentiveTherapy.com A graduate of Integral Counseling Psychology program at California Institute for Integral Studies, and a certified Hakomi Therapist, she integrates her professional acting background, a decade as a bodyworker, and years of teaching Shakespeare in prison. Pamela brings relational, loving presence, creativity, an ability to personalize the material, an emphasis on nervous system regulation, which supports integration and learning in her trainings.
Psychotherapy can be transformative in a democratic society, and can open intellectual inquiry that, at its best, influences and results in lasting positive change. In recognition of our shared humanity and concern for our community and world, LA-CAMFT loudly and overtly disavows all racism, xenophobia, homophobia, transphobia, sexism, Islamophobia, anti-Semitism, classism, ableism, ageism, and hate speech or actions that attempt to silence, threaten, and degrade others. We in LA-CAMFT leadership hereby affirm our solidarity with those individuals and groups most at risk and further declare that embracing diversity and fostering inclusivity are central to the mission of our organization.
As mental health professionals, we value critical reasoning, evidence-based arguments, self-reflection, and the imagination. We hope to inspire empathy, advocate for social and environmental justice, and provide an ethical framework for our clients, our community, and ourselves.
We in LA-CAMFT leadership are committed to:
(1) the recognition, respect, and affirmation of differences among peoples
(2) challenging oppression and structural and procedural inequities that exist in society, generally, and in local therapeutic, agency, and academic settings
(3) offering diverse programming content and presenters throughout our networking event calendar, as well as in our workshops, trainings, and special events
While we traverse the turbulent seas of the important and necessary changes taking place in our country, in order to form a “more perfect union.” we wish to convey our belief that within our community exists an immense capacity for hope. We believe in and have seen how psychotherapy, therapeutic relationships, and mental health professions can be agents of positive change, without ignoring or denying that the practice and business of psychiatry, psychology, and psychotherapy have historically been the cause of great harm, trauma, and emotional toll, particularly for people of color and other marginalized groups. We are committed to doing our part to help remedy that which we have the position, privilege, and/or resources to do so.
At LA-CAMFT events, all members are welcome regardless of race/ethnicity, gender identities, gender expressions, sexual orientation, socio-economic status, age, disabilities, religion, regional background, Veteran status, citizenship, status, nationality and other diverse identities that we each bring to our professions. We expect that leadership and members will promote an atmosphere of respect for all members of our community.
In a diverse community, the goal of inclusiveness encourages and appreciates expressions of different ideas, opinions, and beliefs, so that potentially divisive conversations and interactions become opportunities for intellectual and personal growth. LA-CAMFT leadership wants to embrace this opportunity to create and maintain inclusive and safe spaces for all of our members, free of bias, discrimination, and harassment, where people will be treated with respect and dignity and where all individuals are provided equitable opportunity to participate, contribute, and succeed.
We value your voice in this process. If you feel that our leadership or programming falls short of this commitment, we encourage you to get involved, and to begin a dialogue with those in leadership. It is undeniable that the success of LA-CAMFT relies on the participation, support, and understanding of all its members.
Standing together,The LA-CAMFT Board of Directors and Diversity Committee
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