Situations that trigger a call for assistance with couples counseling are generally described as a need for improved communication, chronic conflict, lack of physical or emotional intimacy, or a desire to better understand the impacts of past trauma. Therapeutic work can evolve into tackling more specific long-standing disappointments in emotional and physical intimacy. Disconnection is often exacerbated incrementally by increased responsibility with children, aging parents, and cultural differences, among other …
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The therapeutic modality developed by Francine Shapiro and referred to as eye movement desensitization reprocessing or EMDR, when embedded in the context of a wider lens, focuses on specific events and feelings with a view to overarching goals. We become who we are in a relationship, and specifically in our earliest relationship with a primary caregiver who shapes our worldview before we can give this active consideration. Subsequently, we develop …
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In 1987, Francine Shapiro went for a walk and discovered eye movement desensitization reprocessing (EMDR) as a therapeutic technique for traumatic experiences with lasting impact. Some thirty years later, with a substantial body of research confirming its efficacy, the mechanism of action remains a mystery. However, the treatment has expanded to focus on chronic pain, addictions, attachment trauma, among other areas. So, what is EMDR exactly? First and foremost, like …
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I’ve been conceptualizing this for several years now – ideas about what I would like to do with perspectives from my long-time practice as a physician and those always developing as a psychotherapist. I love both; each brings a unique skill set and way of being in the world, and I am well-immersed in the confusions one has for the other. I am an adult therapist with a deep love …
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It was some time into practice before I understood how being a therapist contributes to one’s own growth. I found this assurance from my best mentors rather mysterious. Sure, I’m a better listener, but what did they really mean? From my vantage point now, it seems obvious, and it is more than being attuned. On the surface, it is about being able to hear stories of suffering and watch someone …
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We went into medicine to help people, and now we struggle with feelings of betrayal. We sacrificed so much. While our cohort in college went on to graduate and earn an income and start families, we continued with medical school, an all-in venture financially and personally, demanding all of our time, efforts, and attention. Then we trained. And trained some more. And then, finally, we went to work. We took …
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I have heard from more than one retired anesthesiologist about becoming aware of the weight of the pager after it is relinquished. I imagine other physicians engaged in critical care, trauma (physical and emotional), other emergencies, and obstetrical care might have heard similar descriptions. Have I left anyone out? We do a pretty good job of negotiating chronic professional anxiety at a subacute level. In fact, we are so accustomed …
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Some forms of trauma are obvious: natural disasters like earthquakes, floods, fires, being physically assaulted, wrongfully terminated, becoming suddenly very ill. Trauma is divided into so-called big T and little t experiences, but the distinction is misleading.
While physical assault (big T trauma) can lead to serious sequelae such as loss of a sense of safety, chronic hypervigilance, post-traumatic stress disorder (PTSD); a dissolved intimate relationship, being bullied, being emotionally or …
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Therapy is a treatment intended to heal a disorder. That’s the medical perspective anyway, and it’s not wrong, but it’s maybe only part of the picture. Therapy frequently begins by addressing a primary complaint or problem in a collaborative relationship that grows over time. And during that time, while the client is assessing trustworthiness, the clinician continues to work towards an effective therapeutic alliance. How this exactly occurs depends a …
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Initially, after completing my master’s degree, I felt a bit lost. Being very busy, juggling different roles, focusing on areas of interest to the exclusion of other areas of life has long been my comfort zone. The stillness of having completed an intensive project while working full time would have been challenging enough. But in the middle of a pandemic, I found myself wandering around my house, confined, without a …
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They say you learn a lot from your clients. Not in anesthesia, where I frequently feel great empathy for my sick patients and their families. Our connection in the peri-operative environment is too short-lived for this, I believe.
But in therapy, where the relationship is both critical and deeper, and where I have more recently turned my attention, I have come to appreciate that observation personally. I specialize in “burnout,” that …
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