2024 Continuing Education

This 14th year of business was a mixture of delving into some new content; reviewing the basics; and specialized training. I love the variety of sources to inspire my work–and the challenge to tailor experience with each particular client.

I went to a workshop about “divine” and “shadow” femininity and masculinity earlier this year. As a therapist and sex therapist, of course I’ve been analyzing relational and internal energies for my whole life. I see some real limits to associating energies with gender and am committed to fluidity and curiosity. At the same time, the lens of “divine” feminine and masculine is an interesting way to highlight qualities that someone of any gender can incorporate into life, with or without a partner. I’m also fascinated by the shadow aspects. While some religions may prescribe gender roles, they are silent on the shadow side–the problematic ways that gender roles hurt people. In this other framework, divine femininity relates to deep strength in vulnerability, creativity, radiance, acceptance, presence, compassion, timelessness, and flow. Toxic or shadow femininity is associated with hyper-etiquette, passive aggression, manipulation, gossip, perfectionism, false humility, covert competition, and/or helplessness. Shadow (or “toxic”) masculinity, as many of us know, relates to violence, aggression, entitlement, hostility, impulsivity, bravado, and being caviler. Divine masculinity is protective, providing, initiating, activating, adventurous, focused, grounded, and direct. Anyone can have any of these traits. The shadow sides of each relates to how people cause harm and/or unconsciously sabotage themselves. This framework is one of a thousand that can help us self-assess our growth edges and practice them with ourselves and in relationships.

Another workshop I took this year was back to basics: Interpersonal Psychotherapy (IPT). It’s a comprehensive treatment theory for depression, anxiety, and trauma that involves assessing and treating 4 domains: interpersonal disputes, role transitions, grief, and interpersonal deficits. Intervention techniques include communication analysis, interpersonal inventory, role playing, assertiveness training, and building social support. I also studied an Interpersonal Process Approach book (different from IPT) with a supervisee.

For sex therapy, I attended the AASECT national convention again. This year’s workshops included:

  • The Room Nextdoor: Neural networks and Sexuality (with Emily Nagoski, author of Come As You Are and Come Together)
  • The Fight for LGBTQ Rights in an Age of Fear-Based Politics (with Representative Zooey Zephyr)
  • Black Male Sexualization (with Yamonte Cooper)
  • Intersex Narratives: Navigating Identity, Advocacy, and Sexual Health (with (Pidgeon Pagonis)
  • Navigating Intimacy with Autism
  • Reimagining Menopause and Beyond: A Journey of Empowerment and Clarity
  • Sexual and Reproductive Reality of Breeding Kinks
  • Centering Latinidad in Sex Education, Counseling, y Therapy
  • Assessing Sexual Dysfunction and Preventing Early Onset Psychosis

Additionally, I started learning how to combine two of my specialties. I took a course in combining EMDR and Ketamine-Assisted Therapy. It helped me sharpen both skill sets and develop a couple protocols for combined treatment. Both EMDR and Ketamine-Assisted therapies may help tap into unconscious material and enhance neuroplasticity. This is a treatment option for some people with depression and trauma.

I also completed my last year coordinating trainings with the Queer Affirming Therapist Guild and attended the American Academy of Psychotherapist conference (previous blog post). It’s been a great year!

Behind the Scenes

I’m recently back from the American Academy of Psychotherapists Institute & Conference. It’s always a reliable time of growth and development and this year was no exception. I talk about it frequently because no one else from KC attends this event–and I think it’s the best continuing education I receive. Imagine groups of 12 psychotherapists sitting in a circle for days on end discussing nothing but their feelings and reactions “here and now.” You get the idea! We engage vulnerable self-disclosure and extend both kindness and direct feedback (because YES these are not mutually exclusive). It’s amazing how our lives intersect; wonderful the transference and defense mechanisms we untangle.

We have large group processes as well, and experiential workshops. We built trust and wailed together in grief. We engaged holotropic breath work. We explored internal wounds, aggressor impulses, and options for growth/resolution/integration. Thank you AAP!

New Clients

Greetings! I have a short waitlist for new clients. If you are seeking a counselor who practices in one of my specialty areas and it’s not an emergency, feel free to contact me! I can give you an estimated time frame.

New Office Location

My office is upgraded as of January 22, 2024! Those who know me know this search has been a year in the making. In the end, I’m collaborating with one of my favorite healing spaces: Arbor Vitae!

Arbor Vitae is only 5 blocks from my current office. It also houses 4 yoga studios; a float spa; saunas; a cold plunge; multiple massage therapists; an acupuncturist; and other healers. There’s also a cafe on site. The building has more plants than some retail nurseries!

Arbor Vitae translates to “tree of life” and is also the name of the white matter in the brain that processes sensory and motor information. I look forward to seeing you there!

Beliefs about Growth & Change

Here are the nuts and bolts–what I think I know about change and resilience

  • The capacity to fully experience both pleasant and unpleasant experiences is key. A wide Window of Tolerance is healthy.
    • Avoidance and denial are only useful short-term survival strategies. Are you able to fully experience and express your unpleasant experiences in real time? Or the soonest appropriate time? This is what grief processing is all about. If the pain is not honored, it may be waiting in the wings to surprise you and project itself into even more situations down the road. Take your devastation seriously (yet don’t act impulsively). Acceptance and meaning develop out of emotional truth (both pleasant and unpleasant truths).
    • Less discussed is Positive Affect Tolerance. Positive affect tolerance is the ability to fully embrace pleasant experiences (love, joy, success, etc). Many folks harbor unconscious fear when a pleasant experience presents itself because they are bracing themselves from future disappointment and pain. They would rather control their experience than ride the emotional highs and lows. This emotional numbing is an understandable strategy yet ultimately limits internal and external connections.
  • Grief is a part of life. If you want to minimize the expense of therapy in your healing journey, you may want to do some serious grief journaling
  • Identify the emotional longing underneath your disappointments, frustrations, and desires. What are you truly longing for? It may not be in line with your initial words or assumptions. For example, if you’re overtly wanting sex, you might be longing to play, be cherished, or to connect. Once you clearly identify your deep emotional longing, you can generate additional approaches.
  • Congruence is vitality. Congruence means authenticity; we can be respectful without masking. Therapy may be a low-stakes opportunity to increase your genuine self-expression, a key ingredient for both autonomy and intimacy.
  • When magic happens in therapy, it’s usually around a Corrective Emotional Experience. If a client is repeating any unconscious patterns or assumptions, I do my best to respond in a way that is helpful, yet goes off-script from the pattern. Relational dynamics that are experienced earlier in life sometimes become expected, maybe even facilitated, unconsciously. The corrective emotional experience can open doors that may increase relational options outside of therapy. This kind of exploration is a huge part of what makes therapy different from other relationships, like friendships or colleagues.
  • Projections. There are a million things I could say about projections. They can wreck havoc on relationships or, if brought to awareness, can be useful in self-development. Recognizing projections can lead to healthy vulnerability and communication. Everyone makes projection errors. When we recognize projections, we can practice self-compassion and repair.
  • Inner child. Self-parenting is cheesy but real, valid, and often necessary. Neglect is gradually healed by taking the inner child seriously and responding with appropriate, consistent self-care (and community-care if you can find it). Our younger selves can be attended to in the here & now.

2022 & 2023 Continuing Education

Here’s a quick list of my studies the last couple years…I love my job!

(My year with the Integrative Psychiatry Institute is included in prior posts, skipping it here)

SUPERVISION

  • Clinical Supervision: Ethics & Effective Practice*
  • Ethical Frameworks for Multiple (Dual) Relationships

SEXUALITY

  • Minimizing STI Stigma with Inclusive Education
  • Building Queer Families: Conception, Emotional & Legal Issues, and Resources^
  • Sex Positivity: what it is and isn’t
  • Issues & Clinical Implications around BDSM/Kink and Non-Suicidal Self-Injury*
  • Sex & Consent in Contemporary Youth Culture
  • Decolonizing Mental Health & Sexuality through Irreverent Comedy
  • Sex after Sexual Assault
  • Pelvic Floor Health and Vitality: from Pain to Pleasure*
  • Trauma-Informed Assessment of LGBTQ+ Youth^
  • Emerging Trans: Therapists’ Role in Supporting TNB Young People^
  • LGBTQ+ Older Adults: Strategies and Recommendations^
  • Non-Monogamy/Polyamory Panel^
  • Rewiring Trauma through Kink^
  • Gender-Affirming Letter Writing for Clinicians^
  • Play Therapy with LGBTQ+ Youth: Caring for the Child, Collaborating with the Parent^

EMDR

  • Easy Ego State Interventions*
  • EMDR & Mindfulness*

OTHER

  • Ethics of Self-Disclosure
  • Suicide Prevention
  • Grief & Bereavement in LGBTQ+ Communities^
  • Borders & Walls: Facing the Other*
  • Differential Diagnosis with DSM 5*

*Longer events, ranging from 4 hours through 4 days

^Events I volunteer organized speakers for the Queer Affirming Therapists Guild

Ketamine-Assisted Therapy: Procedures and Safety

After graduating from the Integrative Psychiatry Institute this May (250 hours of education), I’ll be offering ketamine-assisted psychotherapy, starting in July. I’m supporting other local therapists and their clients, offering brief treatment that augments their current work. A round of ketamine-assisted psychotherapy with me would include:

  • a consultation with you and your primary therapist
  • medical screening with a physician (referral available) who would prescribe you the Rx if indicated
  • Counseling/preparation meeting(s)
  • a 3 hour medicine meeting (the last hour we talk/process)
  • a follow up integration meeting within 2-3 days of the medicine meeting
  • consultation and referral back to the primary therapist and any additional resources
  • additional rounds if indicated

Safety:

Ketamine therapy is not for everyone. I have seen it effective for treatment-resistant depression and obsessive-compulsive disorder. Manic or hypomanic states, personality disorders, and/or a history of psychosis contraindicate ketamine. Ketamine involves altered states of consciousness that can increase client vulnerability and projection. I’ve heard of misuses. For the safety of everyone:

  • I follow best practices in the field (from my clinical training as well as the Big Tent community and the Jules Evans substack)
  • medicine meetings are videotaped and securely stored according to HIPAA protocols
  • I do not touch clients
  • there is no communication between client and therapist between meetings, except to schedule meetings, or in case of an extreme emergency
  • clients are welcome to bring a calm, quiet support person observe medicine meetings
  • All ketamine treatments are conjunct with psychotherapy (this is not necessarily true of IV clinics or “underground” practitioners)

I’d be happy to answer any questions! julia@juliacounseling.com

2021 Continuing Education

I attended and organized many programs this year. LMK if you would like to discuss!

I attended:

  • Sexual Development and Attitudes of African American Women
  • Sex and Sexuality in the Muslim Community
  • More than Medicine: Alternative Treatments for ADHD
  • Sex Therapy with Religiously Conservative Clients
  • Inter-generational Transmission of Trauma on Adult Sexual Intimacy
  • Couples After Pregnancy: Intimacy & Sexuality
  • Racial Literacy: Racial Stress in Therapeutic Relationships

I also organized events through the LGBT Affirmative Therapists Guild. I facilitated the event & discussion and other professionals presented on the following topics:

  • Hormone Therapy with Transgender Clients (medical provider panel)
  • Weight Stigma
  • HIV+: What Therapists Need to Know
  • Lesbian-Affirming Client Care
  • Reflections from LGBTQ Community Members

2020 Continuing Education

Here are some workshops I attended since my last update:

  • Pros/cons of forgiveness after trauma
  • treatment planning
  • suicide assessment
  • treating dissociation with EMDR (with Dolores Mosquera)
  • restoring sexual development via body-based therapies (with Dr. Nan Wise)
  • practicing during Covid-19: ethical & risk management
  • Black & White therapeutic dyads (with Dr. Laurie Paul)
  • developmental impact of shame
  • negotiating racial stress within a therapeutic relationship (with Dr. Howard C. Stevenson)
  • roots of self-sabotage
  • religious trauma: negative effects of purity culture
  • gender expansive & Non-Binary clients
  • sexual taboos within the Black community (with Christina Wright, MPH)
  • intimacy & sexuality after pregnancy (with Dr. Stephanie Buehler)

I also started a new EMDR Certification process through EMDR-specific supervision