I will be at the new location starting August 1, 2011.  My telephone number and email address will remain the same. 

659 Cherry Street, Suite 108
Santa Rosa, CA  95404
707-527-9822

For the last five years, I have focused on grief with an emphasis on catastrophic losses due to suicide, homocide, sudden illness, accidents, or multiple deaths.  I am most experienced in the area of suicide loss because of my own personal experience (my mother took her own life) and because I volunteered as a grief counselor at the Marin Suicide Prevention and Community Counseling Center before becoming a licensed therapist.

Group counseling can be very effective in healing from grief.  It is helpful to share your experience with others who can identify and relate to what you are going through, especially with suicide loss which still carries some stigma.

I also address grief and loss in individual therapy.  Please call me at 707-527-9822 to learn more about the group or to schedule an individual session.

And I just can’t stop thinking about it.

The details are pretty horrific.  A fifteen year-old girl was unrelentingly tormented by nine other teens who in concert threatened, assaulted, insulted, and humiliated her publicly and in private — at school, online, and via cell phone — for over three months.  Then after a particularly bad day of abuse, she went home and quietly hung herself. 

As a civil society, we are left to wonder how something so terrible and seemingly preventable was allowed to happen.  Where were the adults whose job it is to protect children from physical and mental abuse?  And why did the school staff not adequately respond to her cries for help as well as to the complaints of her mother? 

Equally as important, why did no adults step in to protect those bullying teens from themselves and their very worst instincts?  (Yes, I mean protect.  These are still young people susceptible to influence). No one called them to account or pointed out that their actions were not only cruel, but shameful — and reflect very poorly on them and their environment, as their families and school have since learned.

Only now that they are facing serious legal consequences might some of those teens experience anything close to remorse.  I find it deeply disturbing that they did not have such feelings at the time they learned of their victim’s death.  Quite the opposite it seems.  Even after her suicide, the harassment continued on Facebook.  According to one news account, one of them actually posted “accomplished” on her memorial page.

The death of a young person is a particularly tragic event and we as mental health professionals, parents, and teachers, need to do all that we can to understand and prevent teen suicide.  Depression or other underlying mental illness is almost always a factor, but depression can be caused and exacerbated by painful circumstances such as bullying, humiliation, physical and sexual abuse, and loss.  That is why it is essential to address both the feelings of the depressed individual and any related causes.  Had this been done, this vibrant young girl might still be alive today.

Our stories, good and bad, can be powerful indicators of how we feel about ourselves and our lives, but if you pay attention, you will notice that they shift with time.  There may be different emphases, new information, or new interpretations with each telling.  Or an important story suddenly isn’t anymore and we no longer relate to it in the same way.  This shows us that even though events belong to the past, our stories remain dynamic and can define who we consider ourselves to be in the present. 

Our stories, based in fact and subjective memory, though powerful, can be limiting.  The  gift, however, is that we always have the ability to re-examine, learn from, and relate to our past in more constructive ways.  Psychotherapy is one means of doing just this:  examining the stories that are active in our lives and shifting our perspective to allow for greater and more positive possibilities.

The good news about depression is that it is very responsive to treatment and can be well managed even if recurrent.  Studies have shown that people get the best results when treatment is multi-faceted and includes some combination of psychotherapy, behaviorial changes, and when warranted, antidepressant medication. 

Therapy helps clients identify the issues that are contributing to the depression as well as finding tools to counter the distorted and negative thoughts that characterize depressive thinking.  Behavior changes can include just about anything that improves functioning, but some good examples are:  reducing (or eliminating) drugs and alcohol, getting regular exercise, eating well, and developing a mindfulness practice (like tai chi or meditation).

Anti-depressant medication has high efficacy rates and can be very helpful.  Depression is often caused or at least exacerbated by a biochemical imbalance, frequently a deficiency in the neurotransmitter serotonin. 

Of course, the bad news about depression is that it can be dangerous, even deadly when it is severe.  The nature of the disorder is to impose a negative and hopeless view that a person suffering from it mistakenly accepts as the truth.  Common symptoms may include sleep disturbance, over or under-eating, negative thinking, guilt, irritability, lack of interests or pleasure, suicidal thoughts, frequent crying, or emotional numbness.

If the depession has lasted more than a few weeks or is getting worse, then I encourage treatment.   Often, therapy is enough to provide immediate relief, but as stated above, the most effective treatments involve a more holistic approach. 

For a list of books I recommend about depression, visit my page Resources: Recommended Reading.

First, there is silence and usually my client smiles with recognition.  She (or he) knows exactly what I’m getting at.  When the answer comes, we are both taken by the clarity and kindness of the advice offered.  “You deserve better,” she might add, or “Don’t take it so hard.  We all make mistakes.” 

It is so common for us to view a situation with compassion when it isn’t our own.  We reserve the greatest understanding for others, perhaps even more for those who aren’t our relatives or very close associates.  That’s why the example of a “good friend” can be so helpful.  But even so, my clients will share with sadness that it is “different”  for them.  Somehow, they “have to be better” and this is rich territory for us to explore. 

However, as my clients learn to listen to and strengthen this understanding and kind self, they are better equipped to counter the self-critical inner voices that fuel depression and anxiety.  Cultivating positive “self-talk”  in this way is more than saying affirmations.  It really is a means of tapping into an inner wisdom.

In my teaching, I emphasize taking practical steps to promote mental fitness and mental health as we age.  In fact, this is relevant at any point in our lives.  The earlier we start, the better.  Scientific studies have shown that physical exercise, mental challenge, emotional well-being, good nutrition, and social engagement are all factors in having and maintaining a healthy brain.

I recently wrote an article about the Brain Gym I helped create with my colleagues at Primrose.  For those who are interested in learning more about the brain fitness field and options that are locally available, I invite you to read this article in the 2010 Winter Issue of Sonoma Medicine, the magazine of the Sonoma County Medical Association.

An analogy can be made to the human psyche.  Even in moments of darkness: of uncertainty, sorrow, fear and despair, there are glimmers of light, all that has sustained us to this moment and the promise of brighter days to come.  And still, sometimes it can be so hard to remember that we are loved, worthy, and capable, and that things can — and will get better.

In these frozen moments, it can seem that this is all there is or will ever be.  It is a good time to remember that, like the seasons, hard times and difficult emotions will pass.  They are a part of the human experience, not the entirety of it.  Sometimes our pain leads the way to greater knowing and deeper resolve. 

The darkness of night is also a  positive force, a necessary time of rest, withdrawal, and rejuvenation.  Time to reflect and to dream.  This portion of Michael Sheffield’s poem, “Winter Solstice” reminds us of the truth of this:

All creatures sleep and wake and sleep
Enjoying rest from daylight’s busyness.
Relax, renew your tired self.
Restore your soul.

And this remember all the year
The mountain needs the valley
To appear
So high.

(From:  Sheffield, Michael. “WINTER SOLSTICE.” 17. ReVision Publishing, 2008. Psychology and Behavioral Sciences Collection. EBSCO. Web. 21 Dec. 2009.)

After Memorial Hospital closed its inpatient psychiatric unit in April 2008, I spent six months working weekend shifts in a local emergency room evaluating patients and arranging psychiatric hospitalization when necessary. I found it disheartening to send our local residents to hospitals outside of the county. I knew how difficult it could be on patients and their families to be hospitalized so far from home. Finding an available bed was not always an easy task, either. Patients sometimes waited days before being transferred to an appropriate facility. I felt that I was working in a broken system, trying to band-aid together the best solution possible.

It was difficult to understand how a county as large as ours could not have inpatient psychiatric care other than the few available beds at Psych Emergency Services. Some of our local leaders tried to place a positive spin on the situation by stressing the expansion of community and peer-based services funded by the Mental Health Services Act at the same time the local psych units were closing. Though I applaud a prevention model of care and community-based services, I do not believe that they alone are sufficient, especially when emergencies arise.

As a Marriage and Family Therapist who has had clients in crisis and who has worked on an inpatient psychiatric unit, I am greatly relieved that a psychiatric hospital will be opening in our community in the near future.

Feeling appreciated is a universal human desire and feeling unappreciated is an all too common source of hurt and dissatisfaction in many people’s lives.  Too often, husbands and wives feels unappreciated by their spouses, parents by their children, children by their parents, or employees by their employers, and so on.  Sometimes the lack of appreciation felt is due to a perceived slight or misunderstanding.  But sometimes it is caused by a very real lack of acknowledgement, which can lead to feelings of self-doubt, hurt, and resentment.

In a 2005 study in positive psychology (a young branch of psychology that emphasizes strengths and virtues in individuals and communities),  Mitchel G. Adler and N.S. Fagley of Rutgers University concluded that people who felt appreciation had a greater sense of well-being than those who did not.  “Appreciation was significantly related to life satisfaction and positive affect, even after the effects of optimism, spirituality, and emotional self-awareness had been statistically controlled.” (Adler and Fagley, 2005). 

In short, it appears that having appreciation makes people happier. And it is fair to say that feeling appreciated also contributes to happiness by making people feel valued, which adds to self-worth and purpose. 

Giving thanks is clearly a win-win for all.