Finishing Counseling: How To and Why a Termination Session is Important

Clinical supervision, therapist termination sessionA couple with whom I have been working just finished therapy. It’s almost always bittersweet to finish therapy with a client, but it is the icing on the cake. When a client is willing, it is important to do what is called a termination session. We did that today. It can be hard, but it’s important.

Throughout this blog post, I will use the term “termination” but “closure” is also an appropriate term.

What is a Termination Session?

A Termination Session is the last session at the end of a course of therapy. In general, the following issues are discussed:

  • How does s/he or they feel about finishing therapy
  • Goal assessment
  • What did the client learn; how did s/he or they heal
  • Challenges s/he or they still face
  • How will s/he or they handle similar issues in the future
  • Resources (including the therapist)
  • Feedback for the therapist (what was helpful and what would have helped)
  • What the therapist learned from the client; client’s strengths

Why is a Termination Session Important?


Therapist termination session closureIt’s purpose is to provide closure. Why is closure important? Many clients lack closure in previous relationships and situations. We can teach them what it is like to wrap things up well. To look at what was accomplished is very important. In sessions with clients, we look at the goals, where we started in relation to those goals, periodic status updates, and then where we finished. It helps both client and therapist to see the progress that was made and changes the client made in his/her life.

Challenges and Resources

It is common for the client to still face challenges in his/her life. Acknowledging what these are and highlighting the tools they have learned helps to see progress. We also talk about the resources the client has to face challenges in the future. The client often feels empowered.


Therapist termination session feedbackFor the therapist, feedback provides an invaluable source of self evaluation. It helps you improve, but it also helps you realize what you did well. As therapists we so seldom get feedback either way unless we actively solicit feedback. If you solicit feedback from a client, you need to be open to hearing both the good and the bad. Realize that most feedback is constructive and remain positive. They have been vulnerable in providing you feedback so be sure to thank them!

Why Doesn’t a Termination Session Happen and What to Do About It?

It can be difficult to have clients show up for the final session. Many clients schedule and either cancel or just don’t show up.

Why do people not want to do termination sessions:

  • They feel rejected by the therapist
  • It brings up feelings of situations that didn’t have closure in the past
  • They think they are done and don’t want to pay for another session
  • They don’t want to or never learned how to say goodbye
  • Fear of losing a support person
  • They don’t want to end the relationship
  • Clients may be afraid of critiquing the therapist

How to get the client to the termination session:

  • How to get clients to a therapy termination session clinical supervisionDiscuss the fact that many clients don’t want to come to a termination session and talk about it
  • Talk about what will be discussed in the final session so clients know what to expect
  • Explore the specific benefits of a termination session
  • Perhaps use a different word other than “termination” such as “closure” or “final” session

As a licensed therapist of over 20 years, I provide clinical supervision for therapists seeking LPC and LMFT licensure. I can help you develop the practice you desire and explore a variety of tools within your therapeutic frame.

Call me at (303) 444-2003 to schedule a supervision session.


Do You Have Flood Anxiety? 6 Ways to Feel Better

Rain, Rain, Go Away

Flood waters triggering

Floods can make you feel isolated.

With all of the precipitation we’ve been having here in Colorado (and other places), it’s a double edged sword. If we have a lot of rain, it can bring back many feelings including fear, anger and sadness. After the recent September, 2013 deluge, are you asking yourself, “Will I be dealing with floods again?” A dear friend of mine had her basement re-flood last week. For many people, other things happened at the same time as the flood. There were many losses. It is very common to wonder if a flood is going to happen again.

The Human Impact of Flooding

If we don’t have enough rain or snow, we look at having a scary fire season like we’ve had in recent years. Some of the fires include the Four Mile Canyon Fire, Flagstaff Fire, High Park Fire, Black Forest Fire, Haymen Fire, and Waldo Canyon. And that’s just within the past few years and within a 2 hour radius of Boulder County.

It’s confusing. Do we wish for rain or for it to stop? Many people have mixed feelings.

What’s Going On With Me?

Are you feeling/having any of the following that have been triggered by the rain?

overcoming flood anxiety

It’s OK to have these feelings.

  • anger
  • detached
  • sad
  • scared
  • panic
  • anxious
  • irritable
  • flashbacks
  • sleep difficulty
  • disturbing dreams.

You are not going crazy. These can be symptoms of PTSD. I was talking to a friend the other day and he was relating that he was experiencing nightmares and feelings of anxiety. These feelings were related to the recent rains we have been experiencing in Colorado. He hadn’t talked to anyone about this and, more importantly, he never dealt with these issues when the original floods occurred. Until he gets professional help to deal with his PTSD, every time we see a similar weather pattern, he is going to suffer.

6 Ways to Feel Better

There are many ways to help yourself and your loved ones feel better.

  1. The support of family and friends can relieve stress and reduce the symptoms of ptsd.Reach out to family and friends – As humans we have the wonderful ability to share experiences and support each other through tough times. If people helped you last time, remember that sense of community.
  2. Exercise – This helps relieve stress, even if you just go for a walk or get on the treadmill.
  3. Ground in the present – Fear is about the future. Right here, right now, everything is okay.
  4. Do things you like to do – Taking time for yourself can help refocus your attention away from all the bad news. It also releases endorphins in your brain, which helps you feel better.
  5. Eat well for you – Take care of yourself. While it’s easy to reach for comfort food, it only helps for a few minutes. The effect on your blood sugar and nervous system does not help with your mood.
  6. Seek professional help – Friends and family can be very helpful, but sometimes we need someone with specialized skills and tools to help us to break out of the cycle that is triggering the anxiety and other painful feelings.

If you want or need more help than this, call me at (303) 444-2003.

Through tools such as Brainspotting, I can help you feel better and break the symptom patterns that grab hold of you when it rains. Brainspotting is a non-verbal treatment tool that helps you reprocess past traumas. Clients who experience brainspotting are often able to eliminate the underlying sensitivities that are causing the problems.

Brainspotting in Couples Therapy: Does It Work?

History of One Couple in Therapy Prior to Brainspotting

mature couple in therapyMary and Dean (names and other details have been changed) and I had been working together for a while. When we started therapy, they had been married for over 17 years. Mary said she wasn’t sure she wanted to stay in the marriage. She said she’d been working so hard, had been to another therapist, but things weren’t getting better. Through us doing EFT (Emotionally Focused Therapy) and other couples’ therapy modalities, their marriage improved, but there was still one last big unresolved issue.


Couple with intimacy problemsWe’d worked through issues including communication, expectations, past emotional injuries, and shared living space. The last great frontier was intimacy. Numerous approaches were used. Things had gotten better but were still not where the couple wanted them to be. Mary wanted to make love with her husband. Both partners understood that making love included more than intercourse. Dean said he wanted to but made few attempts at connecting with her. Mary went through periods of hopefulness and hopelessness. We decided to try Brainspotting.

Brainspotting Treatment

Brainspotting in couples therapy in boulderBrainspotting is a non-verbal technique used to reprocess trauma or stuck energy. When I do Brainspotting with couples, the partners decide whether or not they want their mate present. In this case, Mary and Dean wanted each other present during the treatment. Prior to starting, each person talked about their potential triggers that got in the way of intimacy and sexuality. Mary decided she wanted to target depression; Dean wanted to target his fear of rejection. We spent one session on each target. Dean did his Brainspotting first. The next week, at check in (I often do this first thing in a session), Mary reported that Dean was approaching her more and that he was more available. Dean said he “felt like something changed in [his] brain”, and the he “felt lighter in general”.

Next, we brainspotted Mary’s depression. At our check-in the following session, she said the depression lifted pretty quickly after our session, and she felt much better.

Effect on Their Relationship Due to Brainspotting

Happy couple after brainspotting in BoulderAfter our session in which Dean brainspotted his fear of rejection, Mary said she felt like they had their marriage back. She said, “I feel like I have a home again.” After Mary’s brainspotting session, the couple felt like the depression was no longer getting in the way of their relationship.
While our work is not done yet, Mary and Dean feel like Brainspotting helped them get through a stuck spot. The couple said they feel like the Brainspotting was an important step in their process. When asked more about this, Mary reminded me that it was the relationship that we’ve built over time, the trust, that allowed them to Brainspot effectively.

Brainspotting to Help You Get Unstuck

Patterns can form in relationships the are unhelpful and even detrimental. Brainspotting can help you get unstuck and reprocess a variety of patterns that interfere with your relationship including:

  • Fear of rejection
  • Depression
  • Shame
  • Anger
  • Withdrawal
  • Abuse
  • Communication issues
  • Passive Agression
  • Jealousy

Fixing broken relationships is hard work. It takes commitment from both parties and a willingness to openly explore the problems and possible solutions that will enable you to move toward the relationship you both desire.

You too can have the relationship you desire. Call me at (303) 444-2003 to schedule an appointment.

Having the Support of Community

Support communityWhen we think of factors that influence our physical and mental health, we often think of diet and exercise. The missing piece of this puzzle is social connectedness and community. Listed in “40 Developmental Assets” developed by the South Fraser Valley Regional Child & Youth Committee in partnership with Fraser Region Community Justice Initiatives Association, are elements of community. If it is instrumental in healthy development in children, wouldn’t it serve people of all ages?

Living to Age 90?

Health status checklist excellent checked for people in communityI was listening to NPR (National Public Radio) a few weeks ago when I heard the report of a study that talked about the effects of community on peoples’ health. For people who have a supportive community, the rate of heart attacks and stroke decreases; blood pressure is lower. In my reading of January’s Reader’s Digest, I came across a story about a Greek island where people are 2.5 times more likely than Americans to reach the age of 90 and men are 4 times more likely than American men to reach the age of 90. The article bespeaks their diet and schedule. It mentions visiting with friends each day but, unfortunately, does not mention it as a factor in longevity and health. I think the author missed the proverbial boat.

We are Social Beings

Most of us turn to family, friends, clergy and others when we’re having a hard time. People are designed as social beings. Pascal Vrticka, a Social Neurologist, said in an article in the Huffington Post: “We are, so to speak, biologically hard-wired for interacting with others, and are thus said to be endowed with a “‘social brain’.”

Friends having coffee can offer the support of community

Increasingly, in our American society, we are becoming more isolated. When you go to the large grocery chains, there are numerous check-out stations where we no longer have to talk to anyone. We can do all of our grocery shopping without having a social interaction. And the prevalence of on-line shopping is increasing. We can look for what we want, get additional information, find sales and purchase our items. All without having a conversation with anyone.

Sociologists House, Landis and Umberson quote the following in their recent study:

Recent scientific work has established both a theoretical basis and strong empirical evidence for a causal impact of social relationships on health. Prospective studies, which control for baseline health status, consistently show increased risk of death among persons with a low quantity, and sometimes low quality, of social relationships. Experimental and quasi-experimental studies of humans and animals also suggest that social isolation is a major risk factor for mortality from widely varying causes. The mechanisms through which social relationships affect health and the factors that promote or inhibit the development and maintenance of social relationships remain to be explored.

Depression and Isolation yourself and being/feeling depressed can happen in either order. Someone who is depressed often isolates him or herself; someone who isolates him or herself can start feeling depressed. This can definitely be seen with the recent weather patterns. Many people who ended up staying at home for days because of the recent storms say they “need to get out”, they feel like they have “cabin fever”.

How to Find Community

Many of my clients have “increasing my support system”, meaning friends and community, as one of their therapy goals. If you are feeling bereft of community, think about what you enjoy or used to enjoy. Find a group that does that:

  • 32267212_mIf you like hiking, find a person or a group of people who like to hike.
  • If you like knitting, contact a knitting store and see if they have any groups that get together in their store.
  • If you have a spiritual connection, perhaps visiting a faith community to see if it could help meet your needs.
  • The internet can be a wonderful resource for “meetup” groups. Go to to see what options are available. If you don’t see a group that interests you, you can start your own meetup group.

Dr. Christiane Northrup on her recent PBS special said supportive communities enhance our immune systems. Think, “Community is Immunity!” Community supports our physical health, our mental health, our spiritual health and our relational health.

If all of this is overwhelming or you just need help, call me at (303) 444-2003 to schedule an appointment.


PTSD: A Day in the Life

How Trauma Can Have a Lasting Impact

Imagine waking up in the morning and not feeling rested, or not remembering your drive to work. What if your relationships change because you are not who you were? What if every time you heard a certain sound or you drove by a certain area you had a flashback or panic attack?

Traumatic events can have a serious and lasting effect on our lives. If not treated, these debilitating after-effects can last a life time. The best treatments involve re-processing the trauma and it’s manifestations. By re-processing, I don’t mean talk therapy in which you relive the event again and again. This type of exposure treatment is unnecessarily re-traumatizing. My preferred therapy technique to treat PTSD and trauma is Brainspotting. But more on this in a minute, first lets explore a possible day in the life of someone suffering with PTSD.

PTSD Symptoms:

In our example, let’s talk about Cindy who survived a car accident. Married with children, Cindy now struggles with the very real symptoms of PTSD.

Waking/Sleep Issues

PTSD A Day in the Life picture of tired woman holding head

Cindy is tired so much of the time.

Cindy wakes up tired most days. She often has problems falling asleep and staying asleep through the night. But as a mom with kids, she doesn’t have the option of calling in sick. Because she is often tired, she finds herself being inpatient and sometimes yelling at them. Before the accident, she was better able to regulate her emotions and not feel as stressed.

By the end of the night, Cindy is exhausted. Unfortunately, sleep issues beget sleep issues. The more anxious she becomes about falling asleep, the harder it is to fall asleep. Her brain is switched on when it is time for it to calm down for sleep.

Interactions with Others

A day in the life of ptsd and trauma. kids playing and jumping on a bed.

For someone suffering from PTSD, normal play can be too much and kids don’t just get to be kids!

We talked about Cindy’s interactions with her kids in the morning, but another problem associated with her PTSD is her reaction when her kids play in a normal, exuberant manner. For most people, this is not an issue, but for Cindy, it is loud. The sound is overwhelming and Cindy is constantly telling them to be quiet.

The lasting effects of her PTSD is also impacting her adult relationships. She has withdrawn from her family and friends because she doesn’t have the energy to deal with them. Her family and friends don’t understand. They think “it’s just in her head” and can’t understand why she just doesn’t “just get over it.”

Cindy’s husband notices that she isn’t the person she used to be. In fact, it seems like her personality has changed. The emotional filters that everyone has when they feel an emotion no longer works as consistently as they did before. When Cindy feels angry, she yells–which happens often as she is so often over-stimulated. Their sex life is non-existent which increases the tension between them.  Because her brain is working so hard to heal, there are times it looks like “the lights are on but nobody’s home.”

Difficulty Concentrating and Executive Function Challenges

PTSD woman overwhelmed with choices at grocery store

Simple tasks can become overwhelming challenges.

Big projects now seem to be too much for Cindy. Breaking them down into doable pieces, prioritizing, sorting and setting goals used to be so easy. Now, these executive functions take to much effort. Even using a recipe can be a challenge. Most people can easily go back and forth between the ingredient list and the instructions. For Cindy, this is a monumental challenge. Even reading for pleasure has been effected.  Now she has to measure how much information is on a page; otherwise, it can be too overwhelming.

Similar Triggering Experiences

Part of PTSD is that similar experiences or sensations can trigger flashbacks. These can take the form of:

  • Situational – Experiences like driving around town can be a powerful trigger for those who have been in car accidents.
  • Noises – Loud bangs, screeching tires and even noisy children can trigger flashbacks.
  • Scents – Our sense of smell is the strongest for bringing up past experiences. Unfortunately those experiences aren’t alway happy!
  • Music – Certain songs or types of music can cause powerful associations that are triggering for some people who suffer from PTSD.
  • Touch – The startle response it so primed in people with PTSD even a light touch can cause a strong adverse reaction. People who have been physically or sexually abused can be very sensitive to touch.

People who are triggered feel like they are going crazy, they wonder if they will ever feel normal again and if this will ever stop. Because your brain links memories, thoughts and experiences and your mind/body/spirit knows what it needs to do to heal, Brainspotting can be a powerful treatment option for reprocessing the emotional load associated with the traumatic memory. A basic tenet of Brainspotting, is that you have the innate ability to heal.

What Helps – Strategies for Coping with PTSD

Planning for your energy is important. What was so easy before the trauma now can take monumental effort and energy. What you eat and drink plays an important role. “Food is fuel” is a discussion I often have with trauma survivors. Foods that converts to sugar quickly are not your friend. While the body may want quick energy (so it craves sugar), planning ahead and eating well for yourself will work much better in the longer run.

Exercise is imperative. Even if all you can manage is 5 minutes of walking, it will help your nervous system and your mood. All of what I mentioned previously can effect your mood. Depression and/or anxiety easily creep in. Natural light is helpful. If you are indoors all day, sit by a window for at least some of the day. It can help with depression.

Hand rising out of water indicating the need for those with PTSD to seek professional helpGet professional help. A good nutritionist can help with food and supplement suggestions to support the healing your body is doing. A psychotherapist who specializes in trauma can assist you in moving from merely surviving to thriving. It is important to find a therapist who does more than talk therapy. Explore things like Brainspotting, Somatic Experiencing, EMDR and other mind/body modalities.

For Those With PTSD – The Days in Your Life Can Get Better

The effects of PTSD are pervasive. They decrease the mind’s ability to organize and process information. They hamper the nervous system’s ability to regulate stress. As we’ve seen, PTSD negatively impacts relationships. These can even affect one’s ability to hold down a job.

Cindy felt like she was on the outside of normal looking in, but after seeking treatment, she felt heard and understood, she reprocessed her trauma, and she is now able to enjoy the sounds of her children’s rambunctious play.

If you have questions about PTSD or would like to explore Brainspotting, please call me at (303) 444-2003.

Additional Reading:

Brief Therapy

Solution Oriented Therapy is a type of Brief Therapy designed to focus on people’s strengths. It is about the “here and now”, rather than focusing on your past. You can focus on a single problem and actively work to resolve it.

Solution Oriented Brief TherapyA good example is fear of flying. Sometimes, phobias are based on a past trauma. Many times, the origin of the fear is not evident. By using Brainspotting to reprocess the trauma, you can successfully overcome your fear.

Brief Therapy is often misunderstood as time limited. In Solution Oriented Therapy we:

  1. Set measurable, realistic goals
  2. Determine where we are now
  3. Work toward achieving your goals
  4. Periodically, we assess progress and adapt as needed

I like to call this adaptive therapy. We are flexible in how we view the problem and in working toward your goals, adapt as needed.

While I like this Bob Newhart video as a humorous take on therapy, Brief Therapy isn’t quite this brief:

If working with someone who uses Solution-Oriented Therapy sounds interesting to you, call me at (303) 444-2003 to schedule an appointment or ask questions.

Talking About End of Life Decisions

“Two things are certain in life. . . death and taxes.” Most everyone has heard this quote and either chuckled or groaned.  I attended a presentation recently about “The Conversation Project” whose goal it is to inspire people to talk with their loved ones about their desires at the end of their lives. None of us knows when we are going to die so it is best to having these conversations early and more than once.

I Don’t Want to Deal with Death

Some people have the mistaken belief that if they don’t think about it or talk about it, they won’t die. Most humans have a need to feel in control. Death is one of those things in life over which we have little control.

End of Life – Things to Talk About Now

Photo of two distressed women difficult end of life healthcare decisionsWho will make your healthcare decisions if you are unable to make them yourself?

 What will making those decisions do to those you love? 

How will it effect their relationships if they don’t agree with each other?

The only way for you to have control over your the decisions made if you become incapacitated is if you have a Living Will or Medical Power of Attorney (aka Healthcare Proxy or similar terms). These are both documents that legally designate your decision-makers if you are ever in a situation in which you are unable to do so for yourself. It is important to designate 2 or 3 people (Put them in order. More than one is important in case your designee is unavailable). You need to have regular conversations about your wishes. Be specific about your desires. If your proxy knows what you want, it is a much easier decision, and your loved one(s) can be at peace knowing s/he has followed your wishes.

Advanced Directives – Who Will Be Responsible? What Will Be Done?

photo of woman in hospital bed with person holding a living will in the foregroundLiving Will

A Living Will is a Type of Advanced Directive. It is a document that dictates your desires if you are unable to do so yourself. It gives written legal instructions regarding your medical care preferences. The Living Will can address the administration of life sustaining procedures.

Medical Power of Attorney

A Medical Power of Attorney, also called a Healthcare Proxy, designates a decision maker who will act on your behalf and in accordance with your wishes. This is why it is so important to talk about your desires. You should also designate alternates in the event that the your first choice is not available. This is the most important document to complete!


Do Not Resuscitate (DNR)

dnr2A Do Not Resuscitate order, commonly called a DNR, is an advanced directive medical order that directs medical personnel not to resuscitate in the event that the breathing ceases or the heart stops beating. It is a decision only about CPR. It does not include decisions about pain medications or nutrition. Unlike a Living Will or a Medical Power of Attorney, which are typically drafted by an attorney, a DNR is a form discussed, completed and must be signed by your doctor.

Please note, if you call 911 and there is no DNR in place, Emergency Medical Personnel must perform CPR. Here is a great article that discussed this issue.

If The Worst Happens

Completing the documents above and discussing your wishes with your love ones can protect you from worst case scenarios.

  • If you haven’t legally designated someone to make these type of health care decisions for you if you are unable, then who will? It could be a person or persons who are completely unrelated to you and don’t even know you.
  • Without advanced directives you may lie there in a vegetative state while your loved one go through a lengthy and costly legal process to establish guardianship and take control of your healthcare.
  • If you haven’t designated a proxy (and ideally more than one) to make decisions, your family members may not agree which could cause unresolvable family problems.
  • You may be resuscitated against your wishes.
  • You could only be partially resuscitated. If the heartbeat starts again but your are not strong enough to breath on your own, a machine called a ventilator may be employed to move air in and out of your lungs indefinitely.
  • You could be in a persistent vegetative state with no one able to override the decisions of healthcare professionals.

How to have a Conversation About End of Life Decisions

Here are some conversation starters:

  • What do you think about growing older?
  • What do you think about dying?
  •  What matters most to you at the end of life?
  • What can you not imagine living without?
  • What do you value most?
  • Who do you want to be the primary and secondary decision makers?
  • What would be worse than death?
  • What do you fear about dying?
  • What would be a good death?
  • How involved do you want you loved ones to be?
  • How long do you want to receive medical care?

If you are uncomfortable dealing with these issues, I can help. We can meet privately in your home or my Boulder office to explore your feelings and wishes on the subject. Then, when you are ready, I can help create a safe environment for you to communicate your wishes to your loved ones. For more information, call me at (303) 444-2003.

Hospice Resources

Hospice care focuses on comfort, care and quality of life for people in the final phases of life. Hospice care can be done at home, in a hospital or in a separate hospice care facility. National Hospice and Palliative Care Organization has a website with resources to help in choosing a hospice.

Robin Williams Suicide – Dealing with Depression and Bipolar

Robin Williams dies of suicideRobin Williams suicide brings to the forefront the serious issue of depression.

On Sunday August 10th, Robin Williams was found dead in his home in Mill Valley California. The official cause of death has been called “death by asphyxiation” according to Lt. Keith Boyd, chief deputy coroner for Marin County Sheriff’s Office.

Mr. Williams’ personal assistant found the 63-year-old actor clothed, with a belt around his neck in the bedroom of his home in Tiburon, California, Boyd said. He was found in a slightly elevated seated position. Williams also had recent “superficial cuts” on his wrist and a closed pocket knife with possible blood on it was found on the floor near his body. Toxicology reports are pending.

The actor’s publicist, Mara Buxbaum, told ABC News that the actor had been battling “severe depression of late.” Williams has reportedly been seeking treatment for depression. It was also reported the Williams had recently undergone rehab.

I, along with the rest of the world am shocked and saddened by this artistic genius’ untimely death. How do we make sense of this high profile suicide?

Suicide and Depression or Bipolar Disorder

There have been reports that Robin Williams suffered from Bipolar Disorder, a condition in which sufferers experience cycles of mania and depression. Whether he suffered from Bipolar depression or unipolar depression, the fact is that he suffered greatly.

A normal reaction to suicide is, “How could he do this to his family?” Having worked on a mental health center crisis line, I know that he probably wasn’t thinking about his family. His pain was so great, and he battled it for so long; he may have just wanted the pain to end.

In addition, people tend to equate success and wealth with happiness. Depression doesn’t discriminate. It can besiege anyone regardless of their economic or social status. It also greatly impacts the family. Symptoms of depression include:

  • Depressed mood
  • Trouble falling asleep or staying asleep
  • Sleeping too much
  • Loss or increase in appetite
  • Difficulty concentrating
  • Anhedonia or no longer enjoying activities previously enjoyed

Depression isn’t experiencing just one of these symptoms and it isn’t just for a day or two. Depression is an illness that people can battle for a lifetime. It’s important to note, there is a difference between human response to sad or troubled events and depressive disorders. Grief can also look like depression.

If you experience these symptoms for an extended period of time, you may benefit from professional help. People who experience severe depression may have thoughts of suicide. This doesn’t mean they are going to act on them, but they do need to seek professional help.

Update on Robin Williams’ Suicide!

It has recently come to light that Robin Williams was suffering from Lewy Body Dementia and had been diagnosed with Parkinson’s Disease. For more information, here are some resources on this condition:

Are you Triggered By Robin Williams’ Suicide

Many of us have experienced the suicide of a friend or loved one and have been triggered by the news stories of Robin Williams’ suicide. If you are feeling anxious, depressed or are in need of support, call me at (303) 444-2003. I can help you work through your feelings and regain your equilibrium.

Suicide Prevention Resources in Boulder County

Sadly, Colorado is among the top ten states with the highest suicide rates in the US. Here is Boulder County, there are a number of resources for suicide prevention:

You Don’t Need To Live With Depression and Pain. How I Can Help:




A Case Study in Brainspotting

Brainspotting (BSP) is a non-verbal method of treating trauma and other stuck energy issues. Since initially learning it in 2007, I’ve used it with many clients. Almost everyone has experienced good effects from their reprocessing. Here is the story of one such case. The client’s name and identifying information has been changed to protect her confidentiality. A note about physical health issues: many people who have experienced abuse somatize their trauma. “Stuck energy” can manifest as physical issues.

Brief History

Sara was a middle-aged woman who was referred to me so I could help her deal with some of her health issues. She relied on supplemental oxygen round-the-clock and dealt with pain and other health issues on a regular basis.  When she was much younger, Sara had been in a facility to work on her eating disorder.


After being in touch with her doctors so that we were all on the same page, we did a genogram (a family tree “on steroids”) so that I could understand her family, health, relationship, addiction, and abuse history. I learned that Sara had an extensive history of physical, sexual and emotional abuse, from some of her family members and her ex-husband. With people who have survived abuse and are suffering from PTSD and other related symptoms, I often start with helping them access and strengthen their resources.

Because of Sara’s extensive abuse history, our first “target” in BSP was “a time when she felt good in her body”. She looked at me like I was crazy and told me she couldn’t think of a time when this was true. I asked her to close her eyes and think about a time when she felt good about her body. She was able to come up with a time. We brainspotted that as a target. At our next session, I asked Sara what she’d noticed during the previous week. She shared that she started setting limits with her mother, something she said she had never done before. In ensuing weeks, she shared more instances of setting limits and boundaries with those around her. She was enjoying being able to take care of herself in this way. All from only one session of brainspotting.

Over our time working together, Sara and I brainspotted a number of times, including abusive situations. When we ended therapy, Sara no longer needed to use oxygen and many of her physical ailments had gone away. Her doctor was astounded. Sara said this was so much better than her in-patient experience dealing with her eating disorder. In fact, she said that BSP had helped her compulsions around food.

Brainspotting TreatmentSteps for a Typical Brainspotting Session:

  1. I explain brainspotting and answer any questions
  2. I ask the client if s/he wants to try brainspotting; if yes, we continue
  3. Client puts on headphones with biolateral sound (sound that alternates brain hemispheres)
  4. We define a specific target (the issue we’re going to work on) for that session
  5. On a scale of 1 – 10, we rate the resource or distress of target
  6. I notice where clients eyes are drawn or help client find brainspot
  7. I “Hold the space” and stay attuned with client
  8. If the client is not talking about what s/he is noticing, I check in with him or her
  9. When it’s time to end the Brainspotting session, I help the client come to a good stopping point if s/he is not already there (help client de-intensify what they’re feeling)
  10. We process the BSP session and talk about what to expect in the upcoming week
  11. At our next session, I ask the client what s/he has noticed

Brainspotting doesn’t necessarily end when the session ends. Like a computer program, the processing can run in the background for hours, days or, sometimes, weeks. It doesn’t interfere with your life. Some people may notice the on-going process until it is completed; other’s do not.

During the check-ins after brainspotting sessions, clients often share stories of how their lives have changed. People have talked about emotional improvements, abatement of physical symptoms, and even changes in relationships.

If you are interested in learning more about Brainspotting or to schedule an appointment, please call (303) 444-2003.

Treating Flood Related Trauma in Lyons

Treating flood related trauma in lyons coIn September 2013, many of us on Colorado’s Front Range and nearby mountain towns experienced a flood we will always remember. As the rain came down, little did we know the impending impact on our lives and our communities. We saw the stream waters rise, the streets flood, and damage to our homes and businesses.

Being active in the Boulder community, I’ve spoken to many people who now get “triggered” when it rains, especially with the monsoons we’ve gotten in the past month. Most of what I’ve heard is fear that floods will happen again. People talk about their hearts racing, flashbacks, sleep disruptions and more.

Resilience in the Face of the Flood Tragedy

In addition to the challenges, we also saw the resilience of the human spirit as our communities came together as we worked on cleaning up the devastation. While helping a friend, I experienced strangers coming to her door to see if she needed help. They came back and brought food, fans and a caring smile.

Self Help for Treating Flood Related Trauma

I’m often asked what people can do feel “normal” again. Some suggestions to connect to your own resilience:

  • Exercise is important. It helps release brain chemicals that will help you feel better.
  • Eat well: whole grains, protein, fruits and vegetables.While sugar can provide temporary relief, it alters your blood sugar and makes things worse after the initial relief.
  • Expose yourself to natural light. If you can’t go outside, sit by a window.
  • Get support from family and friends.
  • Get professional help if needed. Therapy, including Brainspotting, can help.

Therapy for Treating Flood Related Trauma

I recently treated a client who went through the flood while her husband was out of town. She was left alone to care for three young children. As a result of the flood, she had a number of lingering symptoms. She felt:

  • Overwhelmed
  • Anxious
  • Depressed
  • Sleep deprived

She was experiencing flood flashbacks and felt very out of control. This level of anxiety was driving her to question everything in her life.

We began using Brainspotting to deactivate the trauma, but leave the memories intact. The key is to remember traumatic events without reliving the experience emotionally. After just one session of Brainspotting, her flashbacks went away, her sleep increased, and she was less anxious. She was no longer depressed and overwhelmed and was able to look at her life more clearly.

It’s OK to struggle with uncomfortable feelings, especially when events like heavy rain storms occur. It’s also OK to seek professional help. As a result of the trauma, some people feel on edge all the time. Other people are blindsided by powerful emotions and physical symptoms triggered when it rains.

If you want help working through your flood experience, call me at (303) 444-2003 to schedule an appointment.