Home: Of the Earth

This November, MHT is participating in the Miry’s List Friendsgiving Fundraising Drive. The money goes to programs that support refugee families that have been resettled in the United States. In tandem with these efforts, our clinicians are writing posts reflecting on what home means to them.

Meditating on what “home” means to me stirs up a lot of feelings - sadness, pain, grief, fear, disappointment - just to name a few. Having moved homes frequently throughout my childhood and into adulthood, I always felt a strange knot in my stomach when someone would ask about my home or where I'm from; like there was so just too much too explain. As I’ve come into more stable footing and appreciation for the lessons I have learned through all of my moving around, I realize that to me home has always been a place within me. It’s a place that I often find through my connection to the Earth. When I am feeling at home within myself, my body literally feels connected to the ground beneath my feet, and I will imagine all the layers and elemental compounds of the Earth all the way to it’s core, while also tuning in to the shimmering rays of light or the movement of the air, all the way up to feeling the life that I am given by the sun. I come to feel at ease and grateful in the comfort I can take in my own breath and my own aliveness. I feel safe within myself and more eager to connect with the other earthlings living on this beautiful planet.

I trust in nature’s wisdom even through its death and destruction. As storms pass and seasons change, maybe even climates change, I am reminded of how complicated and tumultuous a place called home can be. Amidst the chaos and uncertainty I take solace in knowing that I am a person of the Earth and that I belong here. I hope we can all stay attuned enough to the moods of the only home we really have in this universe to do our part to conserve what we can for future generations of earthlings.

“When I am feeling at home within myself, my body literally feels connected to the ground beneath my feet, and I will imagine all the layers and elemental compounds of the Earth all the way to it’s core, while also tuning in to the shimmering rays of light or the movement of the air, all the way up to feeling the life that I am given by the sun.”

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HERE'S HOW YOU CAN PARTICIPATE IN FRIENDSGIVING WITH US:

Give! Visit our Miry’s List campaign page and make a donation. It's that simple and no sum is too small. Truly.

Follow! Be sure to follow us on Instagram and our blog throughout the month of November. We will be reflecting on what it means to be welcomed, received, and known.

Share!  Help us spread the word. You can do this by sharing our social media posts or links to our Miry’s List Friendsgiving Fundraiser page.

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A little about Miry’s List:
Refugee families come to the United States seeking a safe haven from violence and persecution in their home countries. They leave behind family and friends, as well as virtually everything they own. Many Americans, seeing these families in their communities, wonder: What can I do to help? Miry's List provides a mechanism for people to directly help new arrival refugee families with the things that they need to get started in their new lives – from diapers to beds to cleaning supplies and toiletries. To learn more, visit miryslist.org.

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Erika Mitchell, MA, is a Registered Associate Marriage and Family Therapist #109385, working under the professional supervision of Michelle Harwell, PsyD, LMFT 50732. Erika specializes in helping her clients bring mindful, attuned awareness to their sensations and emotions.

Spirituality as Process

Maybe you, like me, sometimes wonder what spirituality really consists of. How can anyone really understand or know this realm of reality that transcends, but is inseparably involved with, the material? My thought is it’s not quite knowable. Or maybe better put, it’s not ‘master-able’ by our methods of knowing. It’s the kind of thing that can’t be all-the-way understood or written about comprehensively in a textbook.

And yet, there is something concrete about spirituality -- that is, it seems that a full-hearted seeking after spiritual life, truth, and goodness does bring about significant change over time. Sometimes in quiet ways inside of individuals and sometimes in powerful and surging ways that had seemed impossible.

My own life has felt rather upended by my spiritual experiences at certain times. To be honest, that is probably what I most want -- and simultaneously am most afraid will happen. There are also times my spiritual life has felt dry, so dry it’s made me think, “What if this is a desert, and all those memories of abundant, vibrant liveliness were only ever mirages?”

“Maybe you, like me, sometimes wonder what spirituality really consists of.
...My thought is: it’s not quite knowable.”

Lately I’ve been considering a new thing, for me, regarding spirituality. And that is the importance of “process over content.” (We talk about this quite a bit in therapy training. It’s a foundational goal of therapists to learn to pay attention to the pattern of things that are playing out, rather than attending only to those things that are explicitly named or spoken about in the moment). 

Applying this to my own Christian spirituality has meant learning to pay attention not only to the words of Jesus on the topic of spirituality, but also to his process -- the overall pattern of life he lived out as an example of cultivating a spiritual life. His times of solitude, service, prayer, fasting, and teaching are all different parts of the important picture of his spiritual process. As I’ve reflected on this, I have been challenged to be honest with myself about my own spiritual “process.”  What are my patterns of action and inaction? What do my actions show my spirituality is really about? To put it to a sciency metaphor that appeals to me: What’s the “center of mass” of my way of living? The answers to these kinds of questions left me feeling discontent and hungry for more in my life. That turned out to be a transformative place to start.

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Allison (Allie) Ramsey is a Licensed Marriage and Family Therapist Therapist who works with individuals on a broad range of issues, including anxiety, depression, relational challenges, faith integration, divorce, and aging. 

Failure: An Expected Guest

“...losing taught me freedom. ”

When I was in college, I was a sprinter (for you track fans out there, the 400m dash was my main event). Many, many training sessions, pairs of shoes, taped feet, and ice baths later, one of the most valuable things I gained was getting used to failure.

I’m actually pretty competitive, so don’t be misled into thinking I don’t care about winning. (Ha!) But while the drive to win taught me discipline, confidence, and focus, losing taught me freedom.

Regular public failure required me to develop a sense of security beyond success, and once I had it, I was able to freely find the edge of my capacity and risk stepping beyond it.

In my post college years, I have looked back on my experience with failure in athletics as a season of “training wheels.” The risks and failures I ventured into in that season had few real world consequences.

“...I was able to freely find the edge of my capacity and risk stepping beyond it.”

These days, I find that my failures often carry a much bigger ripple effect, affecting the lives of those I care about. It’s challenged me to again develop a sense of security beyond perfection. Really, no system that depends on me to be perfect is very secure, though I think it can have that illusion. “If I could just perform perfectly, things will be alright in my own life and the lives of those I care for.”

But really, things became much more secure when I got honest with myself and others about the reality of failure as part of my existence and my best efforts to help. That honesty allowed me to think of responding to my own failures as part of “normal life.” Not something to be rigidly prevented or defended against, but allowed in as an expected guest.

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Allison (Allie) Ramsey is a Licensed Marriage and Family Therapist Therapist. Allie works with individuals on a broad range of issues, including anxiety, depression, relational challenges, faith integration, divorce, and aging. 

The Rhythm of Candor

Candor is synonymous with truthfulness, honesty, frankness and bluntness. I tend to surf candor as oppose to always deep diving. Why is that? I value candor in specific contexts such as, health care and academics. When the stakes are high then candor feels caring. When the conversation turns to my friend’s new haircut, candor feels narcissistic. I am willing to soften my opinion in order to spare another’s feelings so, I guess that makes me an advocate of the little white lie. Some might argue that I am narcissistic for thinking my opinion holds that much weight. Others may argue that anything but radical candor does not allow for growth or authentic relationship. I think it is a balance – a relational dance that we all engage in. If we are attuned then we may discover our rhythm is different from our partners, friends and co-workers.

“...it is a balance – a relational dance that we all engage in. If we are attuned then we may discover our rhythm is different from our partners, friends and co-workers.”

Consider candor versus the little white lie and children’s sports teams. For preschool age children, most team activities are not competitive. No one keeps score and “everyone’s a winner.” This team philosophy carries on until the early school age years where children begin to compare themselves to their peers. The preschool bubble bursts as, children figure out they may not be, for example, the fastest. As children age, coaches and parents provide more feedback about the game. The most developmentally appropriate coaches will speak to where the team worked hard and where they could have worked harder. Children need to experience a sense of mastery before being able to process where they might improve.

As a mother, I carefully choose my words. This does not mean that my children do not hear my truth. I simply aim to deliver my truth in a manner they can developmentally digest. Words hold power. What I say as a mother can propel my children forward or cripple their sense of self. In order to be an agent of change, candor needs to be delivered with preparation and caring. Telling a child “the truth” will only help them grow if they are prepared to receive it. I am also careful to consider their truth might be different from my own. Helping my children connect to their own voice is often more powerful then looping and repeating my own truth.

So, when do we utilize a white lie and when do we speak with candor? Words become weapons when fueled by distressing emotions. Candor, even radical candor has a time and place but it is important to remember that, delivery, relationship and self-regulation all matter. If those are not in play then maybe a little white lie is developmentally appropriate.

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-Laura MacRae-Serpa, MFTI, CCLS has special interests in supporting children and families navigating adoption and the challenges of chronic illness.

Clinical Candor: An Interview with Dr. Karen Maroda

M: I'm at the tail end of my analytic training and I’ve become fascinated by how my mind has shifted in the process of training. How in love I am with this process, this way of thinking but how inaccessible it feels to the masses. I don't think it has to be. My idea with my newsletter and blogs, similar to analysis, is how can we think more complexly about simple ideas and think more simply about complex ideas. Karen, I think you excel at this. You have a great ability to speak about ideas in a really clear and approachable way. Before we jump into the idea of candor, can you give us an idea of how you got interested in psychoanalysis.

K: My mother, who we did not have a college education, was naturally psychologically minded. She would observe our emotions and if it wasn't clear to her what I was feeling or why, she would inquire. She would say, “Well, Karen you seem a little down or you're not as lively coming home after school. Did something happen?” She always knew of course. She was very intuitive. She was just asking, “did I want to talk about it?” So, in a sense, my mother was psychoanalyzing me from the time I was young and inducting me into the whole notion that you don't just accept what someone says at face value, that you should trust your feelings. I think that my mother introduced me to the whole notion of trusting my emotional intuition and that asking someone about what they were feeling was an expression of love.

K: It’s been life pursuit, a way of being. I was speaking in Indianapolis a few months ago and I was pleased to hear a candidate talk about psychoanalysis not simply as a profession, it’s a calling. It’s a life.

Dr. Karen Maroda

M: Yes! I had this experience when I was developing as a young clinician where I would get around analysts and I couldn't always keep up with the terminology used but their minds were so alive to me. They had this spontaneous quality. It reminds me how you shared the origins of the word candor is candid which evokes a sense of freedom and spontaneity. There was a flexibility and freedom to explore, play and reflect that was more than the sum of its parts. And I could just feel the difference between their mind and my own. It's a way of thinking and being that that evolves overtime...

In your paper on counter-transference, you talk about how clinicians, by our nature we are often empaths. We feel, we care, we listen but we are not very good at being direct or honest both clinically and in our lives.  How do prepare your client for the role of honesty in therapy?

K: Well, most people don't really understand what an analytically-oriented treatment looks like. I tell them the three basic rules are: they have to show up, they have to be as open as they reasonably can be given that no one is completely open, and they have to pay. (laughs)

M: (laughs) Good basics.

K: Then I usually explain about transference. That any of their feelings toward me are not out of bounds. Anything that comes up and particularly anything that's repetitive that they're feeling either positively or negatively toward me is important for them to express.

M: This idea of having candor, of being direct, the fear is, in speaking up, you might shut the client down. How do you negotiate this: keeping lines of communication open given that generally the analyst is in a position of some kind of power?

K: The idea is there’s candor and then there’s candor.  You know what I mean?  You don't just blurt out anything that you may be thinking which is like, “Boy, was that a stupid thing to do.”

M: Right, right.

K: So I take a moment to gather my thoughts and think about how it fits in the context of the person. I seek to complete the analytic task to gain perspective on their behavior historically and currently. But you know if somebody did something really stupid then I am more likely to say, “Well, it seems to me that this behavior had a pretty bad outcome for you. You know, probably not one of your finest moments.” (laughs)

M: (laughs)

K:  I use humor a lot. It cuts the tension. I'm agreeing that they screwed up without saying you're screwed.

M: I'm thinking about this on two levels: what are you trying to create within your client through the use of candor; what are you hoping that they bring into their lives through this process? The other part I'd love to hear more about is, the fact that our patients don't just want empathy, or I should say, sympathy, they also crave sincerity. There's relief when we can speak directly to all parts of the self, even negative ones.

“Being authentic without being insulting or cruel. Finding a way to constructively give feedback, whether positive or negative. So the positive isn’t too over-stimulating or generate too much expectation of a repeat performance. The whole notion of not waiting until your own feelings are so intense that you have trouble managing them and being in control of them when you’re talking. It’s easier to be honest when you’re in control of how you feel. Most people white knuckle it.”

K: Absolutely. I think people want feedback. Particularly, as I wrote in “The Power of Countertransference” if they are seeking it, then I don’t understand why you would not be responsive to a direct request for feedback. I think where we get into the delicate issue is when you're not sure, or when the patient is provoking possible feedback but not asking for it directly. Then you have to explore it and make a decision which may or may not include asking them if they want feedback. I think it's a no brainer when the patient is literally saying I want to know what you are really thinking or feeling about me?

M: Yeah, yeah.

K: For example: most of my clients become much more successful as a result of their treatment and they want to know am I going to resent them? Especially if their parents were very competitive with them. If they are too successful will I try to destroy them, take it away?

M: So what do you think benefits your clients in being able to ask you those questions in terms of their growth and development?

K: I think it gives them a tremendous confidence in their own intuition because I think one of the greatest contributions of neuroscience and the whole notion of unconscious to unconscious communication, is that clients already know what we are feeling. We already know what they’re feeling. I think the art is to determine, ultimately, what's most beneficial to actually discuss to get to the bottom of what’s going on. What's important to the work and what isn't. Will some of our ideas, notions shut down the patient experience, I think inevitably yes! That's the nature of relationships, whether it's analyst and patient or mother and child or spouse. There are ways you just cannot relate to someone else or you can't promote it.

M: A client having to contend with the real you rather than just feeling it.

K:  You know, I successfully treated someone with severe borderline personality disorder. That was where I first experimented with expressing rage. She thought everything was somebody else's fault. She would talk about her husband and blame the poor guy for everything. He was responsible for every feeling she ever had. She wanted me to endorse that. That he wasn’t sufficiently empathic but he was!  He martyred himself for her, whatever it took. She really needed somebody to stand up to her.

M: You made a comment about our culture not leaving room for negative emotions. I see this an an epidemic in parenting. We've got the hover parent generation where parents can't give feedback to their children or they have to sandwich it with so much goodness. To me, it's about emotional clarity, right? Sometimes it's not about positive or negative. It's about being clear with emotions and our intentions.

K: Yes. Being authentic without being insulting or cruel. Finding a way to constructively give feedback, whether positive or negative. So the positive isn’t too over-stimulating or generate too much expectation of a repeat performance. The whole notion of not waiting until your own feelings are so intense that you have trouble managing them and being in control of them when you're talking. It’s easier to be honest when you’re in control of how you feel. Most people white knuckle it. Neuroscience shows us that negative emotions are rarely outside of our conscious awareness. (They are felt and known even if not explicitly acknowledged). So we need to talk about it….

M:. You alluded to something earlier that I’ve been processing for a while, personally. I have a tendency at to be effusive with my language, you spoke to how we can say something positively in a way that is not too overstimulating.  Candor is about being clear in feedback. I have an awareness  of my tendency to slant towards hope and it has impact. Not always negative but I have to watch it. The truth is I have these little awareness all the time in session and I think ‘bookmark’ I need to go back to that. But how often do we, have the internal candor to take a deeper look?

K: Bookmark is a great word. That’s the beauty of the whole analytic approach. You bookmark it and you're curious about it. You don’t just blurt it out to the patient. You bookmark it and think about it. You wait to see, is this more about me or more about the patient. Because transference is repetitive, it will always come up again, and you don't have to figure it out in the moment.

M: So, what I hear is with candor, there's a certain amount of measure. Working towards an internal space that is curious. Curiosity to pay attention to the tiniest movements inside, an internal honesty that translates to a clinical (relational) honesty. 

So with enactments, there can be a dishonesty there. I mean, of course, we fall into things but I think you're putting more onus on the clinician to pay attention. 

K: Absolutely, and I think that if you look at the literature most of the enactments are not positive, they’re negative. But if you have transcript of sessions you would see there are just as many positive enactments as negative going on, but we don't yet care about those. Because those generally are not disturbing the universe of the relationship. (laughs)  I will notice with a patient that I really like or admire we do this little mutual admiration thing, you know? It is a sense a form of acting out. A little flirtation, something.

M: This is where the awareness comes in. How much of that is unconscious to the analyst?. There's a part of you that's just feeling good and maybe another part has the passing thought..I wonder if this is something?

“Be thoughtful, of course, but be courageous. If you have any anxiety when you’re practicing, that’s good...Take risks. If you’re never afraid and you’re just offering soothing, comforting things you’re probably not giving the person everything that person really needs.”

K: Right, it depends. If it’s happening too often (repeating) then it's like OK, well, wait a minute.  The enactments that we talk about in literature are mostly negative ones. I have yet to talk to a therapist where they were not aware of some negative feelings before the enactment. An enactment comes typically after an impasse that’s lasted a minimum of days if not a weeks or months. The impasse is broken by an enactment or treatment is destroyed by the enactment. I think that since I started using self disclosure regularly I have almost no enactments. I currently have one patient I have regular enactments with on a regular basis because she cannot accept negative emotions mine or hers. She simply won't allow for an emotionally honest exchange. You cannot eliminate enactments with everyone.

I think if you are sitting harboring negative feelings and thinking about them, no treatment is taking place. That’s why my new line I'm going to be using a lot in my next book is, “what is the analyst’s fiduciary responsibility to the patient? (laughs) What is clinically beneficial and to what extent are we stealing their money? When we sit white knuckled and think ‘this guy is a pain in the ass.”

M: Well, it’s another aspect of coasting in the counter-transference right?

K: Yes, like what you were saying about parents being overly effusive or overly positive. Therapists do this too. They try to be super positive or uplifting and affirming. Of course we want to do that to a point but that's not really what most people come to treatment for. Most people who have a lot of positive attributes and good relation skills get reinforcement in the world. They come to us to help them work through the obstacles and the negative behaviors that they can't work out anywhere else and the pain.

K: Right. I was thinking about submitting a presentation to Division 39, “Did Winnicott kill psychoanalysis?”

M: (laughs) Oh no!

K: Of course I’m tongue and cheek but we are so enamored with good enough mother which is about always being positive,  always being the cheerleader. I think most therapists are so masochistic and they allow patients in small and large ways to be abusive towards them...

M: Yeah I thought that that is what is revolutionary about your paper. In the first paragraph you talk about why as therapists we're drawn to this profession to help but simultaneously you are calling out our own masochism.  The way we feed off our ability to hold pain in the service of someone, to contain, soften…

K: To be saint like.  We're so overly invested in ourselves being the perfect mother to all of our patients. As if  the perfect mother is somebody who would just lie down, puts up with everything. It’s not.

M: Well, thank you for jumping in with me to explore the concept of candor and your clinical practice. Your mind is so alive. It’s been a pleasure.

K: You know, I end my most of my lectures with this:  Be thoughtful, of course, but be courageous. If you have any anxiety when you're practicing, that’s good.

M: Ah! I love that.

K: Take risks. If you're never afraid and you're just offering soothing, comforting things you're probably not giving the person everything that person really needs.

Karen Maroda, PhD is a clinical psychologist in private practice in Milwaukee, Wisconsin and a board certified in psychoanalyst by the American Board of Professional Psychology. In 2012, she was elected Fellow status by the American Psychological Association for her contributions to psychology on a national level. She is also a Fellow of the American Academy of Psychoanalysis. She has been in private practice for over 30 years and lectures nationally and internationally. She is the author of three books, several book chapters, and numerous journal articles and book reviews. She is passionate about the change process and has made it her life’s work to innovate psychodynamic techniques, making the process more interactive and collaborative. 

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Michelle Harwell, MS, LMFT is an expert trainer, respected speaker, and licensed therapist in trauma and attachment. She is noted for her specialization in areas of development, attachment, trauma, and neuroscience, and her ability to communicate complex topics with clarity and humor. Michelle is currently completing her PhD in Psychoanalysis from The Institute of Contemporary Psychoanalysis. She received her BA in English Literature from University of Oklahoma, MA in Theology from Fuller Theological Seminary, and MS in Marriage and Family Therapy from the Fuller Graduate School of Psychology.
 

Skiing Between the Trees

     Approximately 25 days ago I had the unfortunate experience of skiing knee first into a tree. Did I say approximately? I meant exactly. How do I know the number of days, you ask? Because not a single one has gone by that I have not physically felt the ramifications of this accident nor has the voice in my head whispering her cruel messages of self-doubt and humiliation given me a respite.

“To admit that I need to slow down, however, in some way conveys that I am not, in fact, invincible. And I would really like for you to go on thinking that I am.”

     That’s life though, isn’t it? Right when we feel as though we have found our groove and know how to masterfully navigate the path we find ourselves on, we hit a tree; or a rock, patch of ice, branch, mogul, etc. Roadblocks come in all forms, really. It is in these moments that I am especially terrible at taking the advice I so frequently share with my clients, “Slow down, take care of yourself, listen to the messages your body is sending to you.” It sounds so nice, right?

     To admit that I need to slow down, however, in some way conveys that I am not, in fact, invincible. And I would really like for you to go on thinking that I am. 

     For so long I believed that my self-worth and productivity had a symbiotic relationship. The advancement of one was inevitably linked to the progress of the other. But then I hit my first patch of figurative ice, fell flat on my butt, and learned that I was incapable of over-producing my way back onto the slopes alone. You better believe I put up a hell of a fight trying to ram those skis back on though. Eventually I got there, but only after accepting the hand of another skier that happened to cross my path.

     Inviting someone into the journey of getting back on your feet after a significant wipe out can be altogether terrifying. It requires vulnerability and a willingness to let yourself be seen from a fairly unattractive angle. But from that vantage point also comes the grace of a new perspective. One that may remind you that we are beautiful because, not in spite of, our scars, and that we just might be able to avoid a few of those trees if we pause for long enough to look up and marvel at what is right in front of us. 

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Cresson Haugland MS, MFT Intern has worked in both the community mental health and private practice settings and has extensive experience working with families in transition, couples, adolescents, and individuals. 

Pay No Attention to the (Wo)Man Behind the Curtain

They say a blog is born every seven seconds. Actually, I just made that up…but it sounds about right. I have hesitated for years in creating a blog for that very reason.  The thought goes something like, "with all the voices out there, do we really need yet another blog cluttering the interwebs?" Honestly though, that just sounds like fear talking. I think underlying my question is a deeper, more personal one which is, will my voice matter? Will the thoughts and viewpoints expressed here be heard, considered, respected? And maybe therein lies the value of this blog.

“ As therapists we often sit behind the proverbial green curtain, like the all powerful Oz, we listen, take in, then interpret and advise but rarely do our clients get to peek behind the curtain and gain a glimpse of our own humanity.”

As therapists we often sit behind the proverbial green curtain, like the all powerful Oz, we listen, take in, then interpret and advise but rarely do our clients get to peek behind the curtain and gain a glimpse of our own humanity.

The truth is any therapist worth their weight is deeply aware that they are engaged in the same human struggle you are. In fact, the good ones know that this is what gives them the depth to understand you and sit with you in your struggle for as long as it takes.

Now I’m not saying you’re going to get the juicy details of the inner workings of me or my team's lives, you wish! Trust me it’s not that juicy…What I think we can offer is entry into the human experience; what we see, what moves us, impacts us and causes us to wrestle.

So I would like to introduce to the world the birth of a blog, our little blog. A place where this small group of women therapists can share our minds and engage with you in a dialogue about the human experience.

-Michelle Harwell, LMFT

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Michelle Harwell, MS, LMFT is an expert trainer, respected speaker, and licensed therapist in trauma and attachment. She is noted for her specialization in areas of development, attachment, trauma, and neuroscience, and her ability to communicate complex topics with clarity and humor. Michelle is currently completing her PhD in Psychoanalysis from The Institute of Contemporary Psychoanalysis. She received her BA in English Literature from University of Oklahoma, MA in Theology from Fuller Theological Seminary, and MS in Marriage and Family Therapy from the Fuller Graduate School of Psychology.