Showing all posts tagged support

Your Devotion to Healing

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Your Devotion to Healing

We all want to know how people feel about us. Most of us want to know how our therapists feel about us. “Does he think about me in between sessions?” “Does she think I’m smart? Funny? Doing a good job?” “Does my therapist like me?” I think of clients often, both past and present. In fact, I think of our work together and how I’ve received immeasurable benefit from knowing each and every client.

 

Every single day I’m aware of the gifts of this profession. I’m deeply thankful and appreciative to be in a position that allows me to make contact with so many different members of my community. I’ve wanted to write a thank you letter to past and present clients for some time, but I’ve been fearful that I couldn’t express my gratitude as clearly as I’d hoped. I decided that it’s better to try than to stay silent.

 

We start out as strangers. You call or email, looking for help with your pain and suffering, questions, and frustration about your situation. Sometimes you’ve been suffering for years. Other times your discomfort is recent.

 

I know how hard it is to make that first contact, to come in for the first few sessions, before we’ve established a connection. You feel a mix of trepidation and cautious optimism. You’re afraid I might judge you. You’re afraid of stigma. You’re afraid there’s nothing anybody can do to help you, that you’re beyond hope, but you’re not ready to give up just yet. Thank you for your fight.

 

You show up and share your history, parts of yourself. You answer my questions. Little by little, you start to let go and engage in the process. You fight against the urge to clam up when you’re visited by self-judgment and fear. Sometimes you win. Sometimes the urges win. You keep trying. Thank you for your persistence.

 

I am awe-struck by your courage. You’ve been through so much life. We live in similar worlds so, I know that you’re working against years of people telling you to suck it up, that your pain isn’t a big deal, that there is more pain, worse pain out there, and that you’re lucky. I know you tell yourself this, too. But there’s a small part of you that doesn’t believe it. Thank you for your courage to hold onto this small part.

 

You come to our sessions when you don’t feel like it, when you’re thrown around by life, when you’d rather finish that work project or Netflix show or go out with friends. You come to our sessions when you’ve got a million responsibilities, when you’re afraid to face your feelings, when you’re embarrassed about what you shared last session. Thank you for your commitment to this work.

 

Somehow, you push through your own self-judgments, fear of judgment from me, discomfort, and you bring your authentic self. You allow yourself to ask revealing questions. You face your vulnerability and insecurity. You tell me what makes you feel joy, loneliness, hate, fear, and rage. Thank you for your authenticity.

 

For these and so many other reasons, I am inspired by you. You remind me that, while life is undoubtedly a painful experience, it is also wonderful. You remind me that it’s better to take chances instead of staying grounded in fear. Thank you for your inspiration.

 

You have changed me. I’m not the same person I was before I started this work. You have inspired me to become more self-aware, more patient, more curious, more direct. You’ve inspired me to learn and to embrace my vulnerability, to live more authentically. You’ve taught me to stop getting angry at people for being who they are and instead be curious. You’ve taught me to look and listen more closely and more compassionately. I would not be who I am today without our work. Thank you for changing me.

 

It is an honor and privilege to work with all of you. I hope my words and actions demonstrate my gratitude for you. Thank you for all you share with me.

 

Love and Be Loved,
Natalie

 

 

I am a licensed mental health professional serving Portland, OR. 97205.

What Is Gender

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What Is Gender

Gender is confusing. It’s often used and understood as a synonym for sexual genitalia. Consult any dictionary, and you’ll see. And while, in our culture, both terms are inextricably linked with one another, they are different. They’re associations with one another (and our staunch adherence to them) have proven oppressive and dangerously limiting.

For some, it’s never an issue; they’re born, they are raised as the sex they were assigned at birth, identify with that sex and its associated gender, and it’s all good. For many others, it’s not so easy. Some of us feel confined by the limits of our current conceptualization of gender upon which our society has agreed and enforced for generations.

Even in places where people self-describe as open-minded and accepting, a cis man wearing a dress is assumed to be in costume, and a femme or high femme woman with fully grown out leg hair is a spectacle.

Gender is a construct, and we have agreed that being masculine means one thing and being feminine means another. Many of us who disagree with this construct do so while following the rules. We feel that we are following these rules against our wills. When people do break free and live authentically, however outside the norm, they are mocked, isolated, bullied, attacked, and even killed.

For years, in the Trans community, “passing” has been a goal. Some want to pass in hopes of feeling in alignment with who they know themselves to be. Some want to pass to look and feel like and be accepted as a “real” man or woman. (Please note that I am absolutely simplifying this concept.) This is a testament to the generations of patriarchy, toxic masculinity, sexism, and misogyny that inform our culture. Men must “look like men, ” and women must “look like women.” To this day it’s still an issue of safety as MTF (male-to-female) people are the most targeted members of our community. (And MTF People of Color make up a substantial portion of that group.)

Obviously, this is not true for every Trans person. There are plenty of people in the Trans community for whom passing isn’t much of a goal, and there are many who’ve found more peace and happiness after transitioning. Happiness is a universal goal, and many eventually find it after they have transitioned. (Most people don’t find immediate fulfillment; transitioning is often a long and arduous process during which a person can face various types of rejection and self-doubt. Years of managing the stress brought on by denying oneself, living in fear of being rejected for living authentically compounded by the stress of letting go and allowing oneself to transition is an enormous undertaking.)

But there is a whole group of people who identify as Trans and don’t want HRT (Hormone Replacement Therapy) or surgeries. Some Trans people want HRT but not surgery. Some want some of the surgeries but not all and don’t want HRT. Some FTMs will never look the way we’ve been conditioned to identify as male, and some MTFs will never look the way we’ve been conditioned to identify as female. Most of us assume that when someone transitions they’ll start behaving and presenting in a way that our culture affirms as masculine enough or feminine enough.

We have decided what is masculine and feminine, which characteristics are ok to swap and which are definitely not ok. Straight men can have long hair, but they can’t wear makeup. Women can have buzz cuts and abstain from shaving body hair, but they’d better be Lesbian. Our culture puts an incredible amount of pressure on its members to conform to its rules and has assembled a loyal and persuasive army of militant enforcers who are always more than willing to defend these rules.

In response, so much dangerous adherence to these limits is the notion of being gender-fluid. Gender fluidity is gaining momentum. A lot of people don’t feel they should have to comply with a certain presentation based on their genitals. So they don’t. They identify and present however feels most authentic to them. They don’t ask for permission. They don’t appease. People who are gender-fluid have looked at the gender, and sexual constructs created by the dominant groups in our culture and have opted out. They are creating a safer, more inclusive culture where we are not defined by our presentations or ruled by binaries and either-or options.

I’m often asked about “detransitioning” and how common it is. This is a complicated subject and will take time and commitment to discuss. If you have any questions about what I’ve written or would like to discuss detransitioning, please contact me. I’d be more than happy to talk about this with you.

 

Love and Be Loved,
Natalie

How Do I Know If I Need Therapy?

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How Do I Know If I Need Therapy?

“So about how long should it take until I feel better?” “How long do you think I’ll need therapy?” “How many sessions should I expect to attend before my problem is solved?” I have asked all of these questions during time spent on the other side of the couch. I know what it’s like to want concrete answers and expectations met. Everyone wants a sure thing in the face of so much uncertainty.

Therapy is not exactly a sure thing. Surely, it can and does help, but it’s not as simple as basic input of time and results yielded. Results depend on client honesty (with themselves and the therapist), right fit with a therapist, client’s commitment to the work both in and out of the therapy office, and right fit with whatever therapeutic modality is used.

Therapy is almost never a quick fix, but there are quicker-fix type/brief therapeutic modalities available. Whether or not these protocols are right for someone depends on a lot- personality, history, diagnosis, whether or not a person has experienced complex trauma. Even in the best of scenarios, it still requires the practice of skills through time to maintain results.

Under the psychotherapy umbrella, there are five really (really) broad categories we use to organize treatment strategies:

Psychoanalysis and Psychodynamic Therapy:

Makes the unconscious conscious, insight oriented. Emphasis on client-therapist relationship. Brief therapy model (20 session maximum) is not the rule, but is available for single-incident trauma like an attack, rape, catastrophic event, targeting a single life shift.

Examples of Psychodynamic Therapy: Jungian, Dream Work, Attachment-based

Often used for: Increasing self-compassion, improving self-concept, self-actualization, mood disorders, relational problems, trauma, developing insight to identify and manage internal conflict, shifting external locus of control to internal locus of control, couples, families,

*Psychoanalysis: Multiple times per week. The therapist is a blank slate onto which client projects their beliefs and experiences. Relies heavily on free association.

 

Behavior Therapy:

Focuses on conditioning new behavior. Uses brief therapy model.

Examples: Applied Behavioral Analysis, Aversion Therapy, System Desensitization

Often used for: Phobias, Addiction, Anger issues, Impulse control problems, self-injury

 

Cognitive Therapy:

Focuses on changing thought pattern. Uses brief therapy model.

Examples: Rational Emotive Behavioral Therapy, Cognitive Behavioral Therapy

Often used for: Phobias, Addiction, Schizophrenia, Bipolar Disorder, Suicidal ideation, Anxiety disorders

 

Humanistic Therapy:

Focuses on cultivating personal accountability and reaching highest potential. Emphasis on free will. Uses both brief and long-term therapy models.  

Examples: Gestalt, Client-Centered, Transpersonal, Solution-Focused, Adlerian  

Often used for: Improving self-concept, self-actualization, improving communication with others, cultivating self-awareness, shifting external locus of control to internal locus of control, couples, families, existential crises  

 

Integrative or Holistic Therapy:

Often referred to as “Eclectic Therapy.” (Some practitioners will basically fight to the death in disagreement over whether or not Integrative is also Eclectic.) Uses various modalities depending on what is indicated for each client. One therapeutic modality combines various features of the previous four categories. Uses both brief and long-term therapy models.  

Examples: EMDR, Narrative, Cognitive Behavioral, Dialectical Behavior, Internal Family Systems, Gottman Method, Transactional Analysis

Often used for: All of the above

 

Some people prefer to see the same therapist for various issues they’d like to target while others seek out a different specialist to treat each issue. There’s no right way to do this, just whatever feels like it’s working for the client. Some clients come with an agenda and leave when their goals have been reached. Some stay for a while after because they like having a professional to talk to who’s all about them. Plenty of people try therapy and find it difficult to give themselves over to the process, take a more passive route to treatment, get frustrated and give up. Sometimes this is because traditional psychotherapy is not a good fit for them right now, maybe ever. There are so many other great therapeutic options. Traditional psychotherapy is not the only way to heal or feel better.

 

I know it’s overwhelming to look for a therapist and decide which kind of therapy would be best for you, especially when you’ve been dealing with a problem for years, and you’ve finally decided to take the plunge and ask for help.

 

If you describe the issue and a little bit about yourself, many of us will be able to direct you in the right direction. There are plenty of therapists who won’t do this because they are sure that they can handle it regardless of their training and orientation. While I would like to believe that this is mostly the exception rather than the rule, it happens. If you feel too overwhelmed or busy or exhausted to educate yourself on various therapeutic tools and modalities, remember that you can interview multiple therapists at a time to see who feels like the best fit for you. (You can also do this regardless of your stamina to self-educate.) Once you start seeing a therapist, you can audition us. If you’re not feelin’ it for some reason, you can switch. It’s ok not to like your therapist or to like them, but feel like they’re not actually helping you. Therapy is an investment, and you have the right to switch providers at any time for any reason. If you’re feeling like you need to discontinue treatment, I usually recommend addressing this with the therapist; sometimes it just takes a little direct communication to shift things. Even if you don’t plan on continuing your work with the therapist, honest feedback is good for both sides.

 

If you’d like to talk more about this, please email me or call and I would be happy to answer any questions. This is one of my favorite subjects!

 

Love and Be Loved,
Natalie

Black Lives Matter

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Black Lives Matter

As a practitioner in the helping profession, it is my job to help people thrive. None of us can truly thrive if groups of us are being singled out, mistreated, attacked, harmed, and killed. The Black members of our communities continue to experience this.

 

It is my responsibility as a member of this community, health practitioner, and white-presenting person to use every platform I have to address issues of injustice and inequity in my community to communicate that this community cares about what happens to you and we will fight alongside you for your rights and your lives. Racism oppresses, harms, and kills.

 

Yes, all lives matter, but here in the United States, Black lives specifically are historically and consistently undervalued. It does not devalue anyone’s life to say that Black lives matter. If it offends you or is uncomfortable for you to hear the phrase, “Black lives matter,” consider the reasons why a group of people in our community feels like they need this movement. Consider why this movement is criminalized. What must their experience be like if they are so vocal about this movement? One group is saying, “All lives matter,” while another group is saying “Stop abusing and killing us.”

 

White people are often afraid to talk about racism. Many of us feel uncomfortable around it and silence ourselves. Our silence is unacceptable and is a very real, harmful symbol of our agreement that some lives are more important than others. It is a clear sign of our privilege that we are afraid to have uncomfortable conversations about race while Black people are afraid for their lives. As people who hold privilege, it is our responsibility to talk openly about racism and how we can work to eradicate it. It is our responsibility to keep learning and unlearning, growing and changing, and to be better for our community members who deserve our respect, our voices, and our solidarity.

“I Love My Kid but Hate Parenthood.”

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“I Love My Kid but Hate Parenthood.”

A while back, I wrote a post directed toward parents who regret parenthood. And I don’t just mean sometimes. I don’t mean that “Ugh, I hate this part,” feeling. I mean the whole thing, the conflict of loving their children but hating the entire process.

I’ve received a lot of feedback about it. Many people were grateful and expressed that they’d been feeling alone with their guilt and regret. Feelings are complicated, people are complex, and our culture is still learning how to accept and hold all of this. My message was that it’s ok to regret or hate parenthood, that it’s ok not to feel as though you were cut out to be a parent whether your kid is 3 months, 2 years old, 6, 10, 16, 22, or 27 years old. It seemed to resonate with a lot of people.

There’s a theory developed by Donald W. Winnicott called “The Good Enough Mother.” It was developed in the culture of the 1950s which is why it only refers to the mother. It’s more complicated than the title suggests, but basically, he tells us that parents should slowly titrate the soothing to their children’s frustration, that parents should slowly and methodically transition from immediately meeting a child’s needs to letting the child self-soothe and learn how to get their needs met. But that’s not all. Upon further study of his theory, we find that Winnicott talks about the dangers of chasing perfect parenting. He cautions that striving for perfect parenting does a real number on developing brains.

Over the years, I have seen a lot of parents, families, and children. I’ve seen parents who wanted children from the time they were children, parents who somehow found themselves suddenly parents, and parents who figured they’d want kids some day, so they had them. A significant amount of these parents realized that they didn’t like being parenthood. Not only was it different from what they’d envisioned; it turns out the whole thing (or much of the thing) felt completely contrary to everything they wanted.

These parents have struggled with regret, guilt over the regret, anger over what they feel they’ve missed, and angst over how this might impact their children. (Although, there have been some parents who swapped their angst and guilt for denial.)

These parents need to hear that they don’t have to love parenthood to love their kids.

There are a million reasons not to love parenthood- poverty, any and all of the –isms, trauma, lack of a support network, disliking our own children, resenting the responsibility and experiencing it as an unwanted burden.

If you are a parent who regrets or hates parenthood, you’re not alone. You deserve compassion and respect. I know it’s taboo to regret something society tells us is the pinnacle of love and value and meaning. If you would like therapeutic or referrals for adjunct support, please call or email me.

 

Love and Be Loved,
Natalie

Regretting Parenthood- It’s OK

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Regretting Parenthood- It’s OK

Time out. I want to take this time to address something that seems to be kept under fairly tight wraps:

For those of you who find yourselves in this taboo circumstance and in case you aren’t met with enough reassurance about it, I want you to know that it’s ok to regret parenthood. It’s ok, and it’s more common than you might think. You can even feel overwhelming love for your children and still regret having them. It’s ok if it feels like this is something more than the typical “Sure, I miss some things about my childfree days, but if I had it to do over again, I’d choose parenthood every time.”

It’s ok to regret parenthood even if you wanted children more than anything in life. It’s ok if you weren’t sure about or were staunch against ever having children, had them, and now regret having them. It’s ok if you vacillate between enjoying parenthood and regretting it. It’s ok. You’re not a bad person. And you’re not a bad parent.

For years, I’ve witnessed the oppressive guilt and shame that accompanies some of those who come in for support, for a safe place to reveal their regret for becoming parents… and it is one of the most courageous things I have ever seen, people who are honest about something that much of society says they should experience as the pinnacle of humanity. We need to make space and give support to this honesty.

The problem is not how you feel or that this is your experience. The problem is with the lack of support. If your feelings are not welcome, where are can you take them? Is it a sustainable solution to deny them or stuff them or disown them or…?

Over the years I’ve heard people in various stages of parenthood describe both their regret and their guilt and shame about their regret, people who have young children, adult children who have gone on to have their own children, and every stage in between. Parents who are close with their adult children, who love their children (and grandchildren) very much, share their regret about becoming a parent. One doesn’t negate the other; you can enjoy your children, love them, share a tight bond, and still feel that parenthood isn’t for you.

It’s ok that it’s not what you expected, and you wish that you had made a different choice. Again, your feelings about this don’t make you a bad person or a bad parent. They are not a reflection of your strength of character. It’s ok that you have feelings of resentment about the change or loss of your identity. You are not alone, and you are not wrong for feeling this way.

I think this next part is pretty obvious, but just in case it’s not, I am not advocating that a regretful parent tells their children that they made a mistake having them or that they clearly demonstrate these feelings through their behavior. That will add to the regret.

I’m saying that it’s ok to have your feelings and that you have a right to express them to trustworthy friends and family. You have the right to receive support and love from your circle. These are crucial aspects of feeling as good as possible about your parenting job.

There are plenty of people who feel that becoming a parent is the apex of their lives, and this is so, so beautiful. But there is no less beauty in someone who, for varying reasons, finds themselves in a parental role, feels that this was a huge mistake, and has the courage to speak up, get support, and do the best they can. It’s ok. You’re not wrong. You’re still a good person. There are plenty of reasons to explain why you might be experiencing this and not one of them has anything to do with being defective or “bad.” Let’s figure out what this feeling is all about.

If you would like to talk more about this, please contact me. I would love to connect with you.

You can call me at (415) 794-5243 or email at natalie@nataliemillsmft.com.

 

Love and Be Loved,
Natalie

Relationships: Cure vs. Comfort

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Relationships: Cure vs. Comfort

The revolutionary physician, Hippocrates, encouraged us to “cure sometimes, treat often, comfort always”.

This is relevant not only for health practitioners but humanity at large. Sometimes we can cure pain; we can often alleviate some of its negative impacts, and we can always comfort one another in its midst.

About ten years ago, I was talking with a close friend about the various difficulties we have encountered in relationships. She mentioned feeling a lot of fear about her current relationship. As she talked, I tried to find some strategies for her to try. I wanted her to feel better. She kept telling me how scared she felt, and I kept throwing what seemed like helpful approaches at her feelings. Eventually, my brave friend trusted me enough to speak up for herself. She said something like, “That’s not helping! I don’t need you to try to make it better or tell me all the things I can or should do. I need you to let me know I’m not alone. Just be with me in it.”

The lesson my friend reinforced for me is incomparable. Although my impulse was to take away her pain or change it somehow, I realized that this impulse was for me, not her. I felt helpless, so it didn’t feel like enough to empathically be with her in her pain; I wanted to fix it. I’m grateful to my friend for her courage, for knowing what she needed and telling me.

I see this a lot in relationships. One person has a problem, and the other person wants to fix it, to cure it. Sometimes this is a realistic option. Sometimes there are things one member of a relationship can do to alleviate the suffering of their loved one. If it’s a relatively simple solution like being more attentive to their responsibilities or being more sensible with shared finances, it’s easier to identify a clear cure.

Other times, there are manageable ways of sharing the burden, ways of treating a loved one’s suffering. This can look a lot of different ways depending on what the problem is. For some people, a slight change in communication can help them to feel better. For others, treatment of the problem might be a little more amorphous.

Ultimately, what doesn’t fail, the thing everyone wants regardless of what’s hurting, is comfort. We want to feel like we’re not alone in our hardships, that we have love and support and a sense of safety in the uncertainty.

I’ve found a useful (and simple) way to offer comfort to a loved one is to ask, “What can I do to help you?” Sometimes they know exactly what I can do, and sometimes they don’t. When they don’t know, I tend to stay away from suggesting a swarm of options. Unless there is an obvious suggestion, a barrage of propositions can feel overwhelming for the other person, almost like an entirely new dilemma.

It’s ok not to know what to do. It’s enough for you to wrap the ones you love in your comfort.

 

Love and Be Loved,
Natalie