Young Adults/Adults: Suffering from depression (including treatment resistant depression), OCD, generalized anxiety disorder, PTSD, social anxiety disorder and eating disorders.
Seniors: Ketamine is an option for treating anxiety and depression in elderly folks allowing them to find peace and joy during their Sunset years. Also it can be helpful for caregivers dealing with fears, rumination, depression and anxiety surrounding end of life issues.
In person KAP is my preferred modality. It offers the healing quality we call Prana that is felt with face to face in person contact.
Telehealth may be a better fit for those who are outside of Santa Barbara County, don’t have a ride home or are unable to leave home. I am offering concierge, at home, psychotherapy sessions to prepare, dose & follow up with integration psychotherapy (once you obtain medicine from your MD).
Please reach me by text or call (323) 362-2177 if you would like more information.
Our world has changed overnight, and each morning we awaken to a new world with completely different parameters. With each passing day, more unthinkable closures arrive. Just a few months ago, we’d never heard of social distancing or flattening a curve; today, they infuse our every conversation. A few weeks ago, we’d never dream of shutting schools. Today, schools may be remote or closed indefinitely. This winter, we were arguing about Presidential candidates and Oscar nominations. Now we are recalibrating voting, rationing diapers, and publicly fighting over toilet paper.
In my training as a therapist, one of my most important learnings was on grief. I’d always thought grief was reserved for death, but John W. James in his book “The Grief Recovery Handbook (2009) defines grief as “the conflicting feelings caused by the end of or change in a familiar pattern of behavior.”
Allow me to add the loss of our “normal” social life as we’ve known it.
Friends, what we are dealing with right now is grief. Whether or not we have actually lost anyone. Whether or not we know it.
Every single citizen is facing an end or change to their familiar patterns. We all have routines deeply engrained in us that are wrestling to survive. We love our morning coffee and drives to work. We relish our lunch dates and happy hours. Churches and temples and mosques keep us grounded. Gyms and yoga centers keep us healthy. Entertainment keeps us social and laughing. Planes keep us seeing the world.
All of that is on pause.
And I don’t know about you, but I have many conflicting feelings about this. I am grieving.
Swiss-American psychologist Elizabeth Kubler-Ross was a pioneer of grief work in the late 1960s. Working with terminally ill patients, she tracked their process of grief into 5 non-linear stages. Her work, and the subsequent work of grief theorists, provide us keen insight into our individual and communal grief journey. We need each other as never before, and we need a framework to guide us through.
While all stages of grief are a normal part of the human process, some stages of grief are costly, or even deadly, to controlling this pandemic. Cue Denial.
1. Denial: Denial is the first stage of grief and it is our greatest protector. We need denial; our minds can only process so much at once. It lets us digest information in waves, breaking down a tsunami into manageable tides.
For me, my pandemic denial went like this “Oh, there is a virus happening in China… Oh wait, Korea and Italy… Now, it’s in Seattle. I have family there… But it’s not bad, it’s like the flu…Oh wait…”
At some point, denial breaks and different kinds of questions erupt. Malcolm Gladwell, in his book “Tipping Point,” writes that every movement has a moment that turns the tide. We will all look back and remember the very moment when this virus hit our souls, when Covid-19 became real and we could no longer deny its magnitude. Our friends, our family, our cities, our government, and the world are all emerging past denial at various tempos. Social media, pseudo-science, and our fierce allegiance to faith and political groups have either hastened or slowed these tipping points. But at some point, denial collapses, and we need it to, as denial in a pandemic is deadly.
2. Anger: Once denial fades, all the feelings we’ve been denying arise. Anger often surfaces first, as it’s more comfortable than sadness or fear. Anger points fingers, assigns blame, asks hard questions. It rants on Facebook, it causes arguments, and in the recesses of night, turns to God and asks, “Why?” Anger is existential. It looks to the root and demands justice.
I’m angry at my loss of freedoms. I once could fly my 72-year old Mother out to see my baby. I now can’t. I once had a 40th birthday trip planned for my spring break. I’ve canceled and lost money. I once could go to the gym, to work, and do basically whatever I wanted. Those freedoms are halted, and I grieve their loss.
I’ve found myself angry at friends: “Why is _____ still going out? Why won’t _____ heed advice? Why isn’t _____ government doing more? Why didn’t ____ act earlier?” When I came out of denial, my loved ones still in denial became my first easy target. My youngest and oldest friends have gravely frustrated me, reminding me (once again) of my utter lack of control in life.
Friends, anger is part of the healing. Anger reveals the intensity of our love and our unreserved desire to fight for our beloveds. Anger is the undercurrent of activism, revolutions, and hope for change. There is a great deal to be angry about.
Anger is imperative to grief as it builds a bridge to others. This may seem counterintuitive — how can anger at others connect me to them? Because anger has a stickiness. It has a structure. When I loathe someone or something, I am bound to them in fury and fury ignites action.
Living at home in close quarters with family can also heighten fury and its copartners, anxiety, and irritation. Even with the most loving spouse or child, we are not accustomed to non-stop time with them. Each family member likely will have different boundaries and beliefs as to how contagious this virus is, leaving one family member ready to quarantine for life and the other comfortable with frequent outings — yet another cause of friction. The death of our personal space is new. No longer do our minute choices just affect ourselves. All of this must be renegotiated.
3. Bargaining: Bargaining is the stage of grief where desperation emerges. We start bartering with ourselves or God or time.
In bargaining, there are lots of stills. I can still do this… I can still do that… Ultimately, the only still left to face will be ourselves. One week from now, social patterns we are doing today will further become extinct, and we may cling to stills. And as a country, we all need to sit still for a moment.
The gift of bargaining is how it reveals our addictions, even the healthy ones. Our addictions to work, busyness, media, happy hours, socializing, traveling. This is bargaining’s dance, walking the tender line between fear and freedom.
We don’t want to live in fear. Fear lowers the immune system, and we need ours robust. But I also must recognize that refusing to live in fear means the hiatus of certain freedoms, which is extra challenging for me: I like adventure sports. I waited until 40 to start a family. I volunteered abroad working in the murder capital of the developing world. I launched my career in an “unsafe” NYC neighborhood.
But we are dealing with a different type of risk right now and soon the stillness will settle in, one way or another, and we must find ways to embrace it.
4. Depression or Sadness: After we bargain and quiet ourselves, the weight of loss arrives. Life may feel like a whirlwind or fog. Tears or numbness may creep. The news may seem hopeless. People you know may start getting sick.
It’s okay to feel the weight of that. It’s imperative actually.
Social isolation is wary on the body and soul. Humans are not designed to live in bubbles away from each other. If I didn’t hug and hold my baby every day, she wouldn’t thrive. Adults are no different.
There is no cure for sadness. Embodiment is the only way through. Grief may arise in headaches, sleeplessness, guilt, aches. Let it pour through you and pass. The sadness will come in waves, as all of these stages will. These stages are cyclical and with each new loss, we may jet back to denial. Trust the process. There is hope on the other side.
And by all means, if the sadness becomes too overwhelming, please seek help. Phone a friend. Hug those in your home. Online therapists are ready and waiting to help. Hotlines are available. No one is truly alone.
5. Acceptance: At some point, social distancing may become “normal.” Acceptance does not nullify the pain of loss nor does it make the loss okay. When we lose something dear to us, that is never okay. Acceptance merely allows our souls to stabilize a bit. We can face our new daily realities with more grace. We find our new groove. We find ways to stay virtually connected. We readjust, knowing that some days will be tough, others will feel light, and all feelings (from rage to laughter) are welcome.
Finding ways to survive and thrive in this experience will call on all of our creative juices. Where we ask, “What do I have to offer in this new reality? What can I give from my home office or bedroom? What meaning can I bring to those I love?” If you teach, teach. If you sing, wail out your balcony. If you mother, hug your child close. If you father, do the same. Cooks, make meals! Sewers, make masks! Doctors and farmers and grocery store workers and nurses and social servants, keep pressing on in hope!
Everyone, write letters to those you love and tell them why they mean the world to you.
We all have a fountain inside us that can offer hope.
Acceptance recreates the world. It gifts us back our personal choice and control. Acceptance brings gratitude, a deep appreciation for the miraculous gift of life. And if you are reading this from a personal device and have shelter, food, and health, then there is SO much to be grateful for. We may not have our “normal” life. We may not be near everyone we love, but we still have love.
Trust this grief process. Do your part. Stay home not only to protect yourself but to protect others. Everyone is somebody’s son or daughter or mother or father or grandma or grandfather or beloved. Let’s all grieve and rise together.
***Post-publication disclaimer: If you find yourself feeling all of these in the same day, or even hour, that is very normal. Be patient with yourself. Find safe ways of denial escapism, such as indulging in a funny movie. It’s okay to have a few hours each day where you just laugh; it’s good medicine. We are all in this together. Be gentle. Be kind. Be safe. Be well.
Can I see you if I don’t live in Santa Barbara? YES! If you live in California, we can meet over a HIPPA compliant and secure server from your smart phone or computer (with high speed internet). The Simple Practice Telehealth has an App which is easy to download for free. If you don’t want to download it, you can access the session from your web server via the private link I will send you (after establishing yourself as my client). This is a wonderful addition to mental health services since you don’t need to leave the house to obtain quality psychotherapy.
Bonus for Using Telehealth
Increased access Approximately 123 million Americans live in an area with limited access to healthcare. Telehealth can play an important role in these communities by increasing accessibility
Reduced cost Nearly all research suggests Telehealth saves money when compared with traditional approaches to providing care. For clients, this often means lower transportation costs, less time missed from work, and less money spent on child care expenses.
Better client experience Telehealth eliminates the time wasted traveling and sitting in the waiting room.
Same-level client care In clinical study, no client outcome difference was found between Telehealth appointments and face-to-face office visits.
Yolanda works within the format and is guided by Emotionally Focused Therapy with Couples.
As a therapist, I am extremely excited about the work of Susan Johnson, PhD. She’s a professor of clinical psychology at the University of Ottawa. Her work with people who were in pain, suffering a huge emotional drama inspired her to create a therapeutic modality called Emotionally Focused Therapy or EFT. This is a strength-based perspective of bonding. Her belief is that emotional bonding is a part of our basic survival. She feels that is one of our deepest human instincts and that we need a safe emotional connection with our partner. Her work began focusing on emotional bonding and helping people get out of pain when they connect with their attachment figures.
Using former theorists work such as John Gottman, John Bowlby, and Philip Shaver, as a stepping stone, she has built a new way of treating the couple. Her development of the adult bonding process created a huge therapeutic boon and the invention of EFT. I like this work because it talks about the dance that couples do which is normal but not healthy. She gives us ways to create loving relationships within safe attachments. She is inspired to train therapists to help couples understand that they have strengths and can begin to talk about their dance and move towards a healthier pattern of relating.
We use this therapy modality because it integrates the neuroscience with attachment theory. Our brains are wired for love and safety. Any time we perceive some sort of rift in our close relationships it is alarming and dangerous because losing our connection to our loved one jeopardizes our sense of security. This primal fear triggers the amygdala, the part of the brain that senses fears and we become hijacked. When people become angry or withdraw from one another it exacerbates the fight or flight response. EFT helps people come back closer together.
Couples come and learn the answers to questions such as “are you there for Me?” Another question couples want to know is, “can I count on you?” One of the most primal questions we want to ask her partners is, “if I call, will you come?” Becoming a couple that is intimate is a process. Couples that have been together six weeks or 60 years can benefit from EFT.
Yolanda can help you to define what your “Raw Spots” are, teach you to repair the bonds that may have been damaged and work towards having a closer and calmer relationship. Since emotion and bonding are universal, it is a cross cultural therapy and works with all couples including those who are educated/non-educated, gay/straight/bisexual.
**Synthesized from the article called Emotionally Focused Therapy with Couples – the social work connection by Lynn K Jones, DSW, Social Work Today.