Therapy on the Cutting Edge

In this conversation, Lisa Bloom, PsyD, and Silvina Irwin, PhD, two experts in Emotionally Focused Therapy, share insights on integrating sex therapy with couples therapy. They discuss how attachment impacts sexual relationships, using compelling research like Harlow's monkey study. The duo highlights key concepts from Emily Nagosky, such as the Dual Control Model of Sexual Response, and the importance of addressing sexual concerns within couples therapy. They also explore how physical intimacy serves as reassurance, advocating for practical touch exercises to enhance connection.

In this episode, Paul discusses how his seeking connection with other African-American clinicians in the Emotionally Focused Couples Therapy (EFT) community, in order to translate the EFT approach into his and his colleagues experiences with their African-American clients, lead him to write his book, Emotionally Focused Couples Therapy with African American Couples: Love Heals. He discussed how attachment in African cultures and other collectivist cultures are different from our traditional sense of child attaches to mother, and in recent years, child also attaches to father. Instead, he discussed how in a more collectivist culture, child attaches to community, and other villages may be the responsive attachment figure while the mother is working on the farm, or the grandparent, and how this was extended as African Americans were brought to the United States in slavery, families were broken up, and others took in children who were not there and children attached with the adults they were enslaved with. Paul discusses working with couples, within an attachment framework, and how cultural humility is a significant aspect of the work with others, whether of a similar race or culture, or different, as his cultural experience and racial identity can be a different experience than one or both partners of a couple he might be working with who are also Black. He discussed the three levels of cultural humanity, which is knowing about general issues that affect the group that one is working with, the diversity of experiences within that group, and ultimately, the self as therapist, and the therapists’ cultural experiences and how that impacts their thinking. His goal in writing his book was to promote clinicians needing more information and understanding of culture, and adjusting clinically to the realities of unique stresses and threats to African American love. Paul Guillory, PhD is a psychologist, and Associate Professor at the University of California, Berkeley in the Clinical Science Program, Psychology Department. He is a certified Emotionally Focused Couples Therapy therapist and certified EFT supervisor, and an EFT Trainer-in-Training. Paul is the author of the book, Emotionally Focused Therapy with African American Couples: Love Heals, and is the former chairperson of the Northern California Community of Emotionally Focused Therapy. Paul was the psychological consultant to the Oakland Raiders professional football team and the National Football League for 14 years, has been a consultant to the Sacramento Kings professional basketball team, and is a selected provider for the National Basketball Players Association. He has also served as Director of the Center for Family Counseling in Oakland California for 10 years, and has been in private practice in Oakland, California for over 30 years.

In this episode, Celia discusses how her experiences of growing up as a child of immigrant parents who fled Eastern Europe to Argentina, and then her own experience of immigration to the United States has lead her into a career in working with systems, both at the family level, as well as the community and large cultural level of systems. Celia discusses how her interest in the family system grew out of her own experience of moving from a couple to a family, and experience in a psychodynamic program that was very pathologizing of the parent and a focus on the attachment and transference with the therapist. She discussed training with some of the most influential family therapists. We discussed a training she had done some years ago, called One Size Doesn’t Fit All, and how important it is to not just transpose a U.S. model of therapy, based a a two parent nuclear family, to all clients. She discussed the tools (1 & 2) she developed using her MECA model, and looking a multigenerational households, siblings raising children, community raising children, and discussed there is great variation within cultures, and needing cultural humility, as well as understanding that social justice is separate from cultural competency in diversity. She discussed her article on Centering the Voice of the Client, which came out of her work at Harvard Medical School, where she did process research on the elements related to collaboration using a Shared Decision Making model. We discussed the elements of collaboration: sharing the agenda setting, balance of talking time, tentativeness rather than absoluteness, collaborative meaning making rather than diagnostic expert labeling, and co-constructing behavioral tasks. Celia Falicov, Ph.D. is a clinical psychologist and family therapist in San Diego, California. Celia is the Director of Mental Health Services at the Student-Run Free Clinic Project of the Department of Family Medicine at University of California, San Diego. She is also a past president of the American Family Therapy Academy (AFTA) and has published numerous books and articles, including: Family Transitions: Continuity and Change Over the Life Cycle, Cultural Perspectives in Family Therapy and Latino Families in Therapy, and Multiculturalism and Diversity in Clinical Supervision with Falender and Shafranske.

In this episode, Ryan discusses his career as an Interventional Psychiatrist, using neuromodulation treatments for clients who are not responding to medications and therapy. He discusses the use of TMS (transcranial magnetic stimulation) which is FDA approved for both depression & OCD and often turned to after multiple antidepressants have not been effective. He discusses how TMS stimulates brain circuits through magnetic pulses, manipulating activity in areas of the brain and stimulating neuroplasticity in specific pathways. He describes how clients often report feeling less reactive, as the process may help balance the connections between the limbic system and the prefrontal cortex, increasing cognitive control and emotional regulation. We also discuss ECT and Ketamine which are other treatments provided through his organization, Mindful Health Solutions, as well as his training in Psilocybin and MDMA assisted therapy, which are not currently approved outside of research settings in California. He discusses how each of these interventions can promote brain changes like neuroplasticity, and how it may be beneficial to pair these interventions with therapy concurrently. He discusses the applications mainly for depression and OCD, but we also touch on and speculate about how brain stimulation & psychedelic treatments could be used to treat a variety of disorders, such as PTSD, borderline personality, ADHD, Social Anxiety, and substance abuse/dependence. Ryan Vidrine, MD is a Board-Certified Psychiatrist who specializes in the treatment of OCD and related anxiety Disorders. He started his career in neuroscience and moved into psychiatry with a particular interest in the field of Interventional Psychiatry and Neuromodulation for treatment resistant conditions, which includes the use of ECT, TMS, ketamine/esketamine, and deep brain stimulation. During his residency training, Ryan worked in the UCSF OCD & Anxiety Specialty Clinic, developing expertise in the diagnosis and treatment of the full range of anxiety disorders, approaching patients from an Acceptance-Commitment Therapy (ACT) framework, which focuses on patient values as the anchor and impetus for behavioral changes. He is currently Director of OCD and Anxiety Services at Mindful Health Solutions and an Assistant Clinical Professor in the Department of Psychiatry at UCSF School of Medicine. Additionally, he completed training through the CIIS Psychedelic Therapy and Research Program in San Francisco, CA.

In this episode, I speak with Shana about her work with adults with Obsessive Compulsive Disorder at UCLA’s intensive treatment program. We discuss Exposure with Response Prevention, the effective, evidence based treatment for OCD, as well as Shana’s experience with the Obsessed tv series on A&E. We discuss how I use clips of her work with one of the clients and how impactful that reality tv show has been in helping clinicians understand ERP as well as helping clients see what effective OCD treatment looks like. Shana discusses the changes in content of OCD and particularly the “harm to others” obsession that has attached itself to the social justice movements of the #MeToo movement, Black Lives Matter (BLM) movement and other social issues where OCD patients obsess about saying the wrong thing or bumping into someone, and thus causing a micro or macro aggressions. We discuss how clients with OCD are the least likely to harm someone, which is why in the second episode of Obsessed, she has her client whose fear is that she will kill someone against her will, and has that client hold a knife to her throat in session and sit with the distress of the ability to kill someone, and the new learning taking place that interrupts the thought-action fusion of OCD. Shana Doronn, LCSW, PsyD is a licensed Clinical Social Worker and Doctor of Psychology in the UCLA OCD Intensive Treatment Program. She received her MSW at USC and her Psy.D. at University of San Francisco. Dr. Doronn frequently presents on OCD and related disorders in workshops and symposiums throughout the country. She was also a featured therapist on A&E’s reality documentary “Obsessed” from 2008-2010. In addition to her current work in the OCD Intensive Treatment Program, Dr. Doronn also treats patients with OCD and other anxiety disorders in her private practice in Los Angeles and Orange County.

In this interview, Rachel Walker explains how trauma-informed psychotherapies like EMDR, Parts Work, Attachment Theory, and Structural Dissociation work better in collaboration than they do alone. She discusses her journey to this realization, and the integrative treatment model which she developed and now practices as a result. This model, which Rachel teaches throughout the United States, moves beyond any one treatment modality to focus on the ways in which ALL trauma-informed therapies overlap. Her work illuminates the bigger picture, helping clinicians and trauma survivors alike to be more oriented within the treatment, and clearer about every aspect of the healing journey - from assessment, to goal setting, to pacing, to the application of interventions. The roadmap which she has developed provides a trauma-informed treatment progression that keeps the healing moving forward, regardless of the level of trauma and dissociation. The end result is a process that can be consistently relied on to work, leaving both therapist and client feeling more hopeful, collaborative, and empowered in the treatment and healing of complex trauma and dissociation. Rachel Walker, LMFT is a trauma-informed psychotherapist and EMDR Approved Consultant practicing in Oakland, CA. She is the winner of CAMFT’s Mary Reimersma Distinguished Clinician Award for 2021 for her innovative contribution to the field of trauma treatment. She has created an in-depth trauma training for mental health professionals called, 'At the Crossroads of Trauma Therapy', which integrates theories and interventions from many of today’s most effective trauma models. Rachel is also the founder and creator of the online platform, TraumaRecoveryStore.com which provides simple tools for improving trauma treatment and promoting the self-healing process. She has written and designed numerous treatment tools for therapists and clients, including the Trauma Recovery Guidebook for Therapists and the Trauma Recovery Handbook for Survivors (in English, Spanish, and Icelandic). Rachel’s therapeutic training began in the arts where she learned to apply play, metaphor, creativity and spontaneity to the work. Her deepest and most heartfelt desire is to inspire trauma survivors, and the therapists who treat them, to hope! With perseverance, patience, curiosity, and human to human contact—recovery is absolutely possible!

In this interview, Marco discusses how he was invited to do a study on EMDR, to understand the neurological mechanisms behind the processing of the trauma. He discussed his career being a MD and a neuroscientist interested in memory. He discussed using EEG to measure what was happening in the brain during bilateral stimulation during EMDR. He explained that they were able to determine that the delta waves that were being evoked during EMDR were similar to the delta waves exhibited during sleep, and he discussed how sleep is so significantly connected to processing of memory. He discussed the processes of trauma and the mechanisms of action for EMDR. Marco Pagani, MD is a nephrologist trained in internal medicine from Jackson Memorial Hospital and attended medical school at the University of Miami School of Medicine. He has been working in neuroimaging since 1990 and has over 30 years of experiences. He works for the Italian Research Council called Sayonara. His interests are primarily in the neurobiology aspects of EMDR and in neurodegenerative disorders. He has treated Chronic Renal Disease, Nephrotic Syndrome, and Acute Renal Failure during his time as a Doctor of Internal Medicine. He has many publications regarding EMDR including Eye Movement Desensitization and Reprocessing and Slow Wave Sleep: A Putative Mechanism of Action and Neurobiological Correlates of EMDR Monitoring – An EEG Study.

In this episode, Rona discusses how her work as a nurse conducting parenting classes led to her hosting a radio show to reach a wider audience of parents about safe and effective parenting methods, and how to better understand your child. She emphasizes how knowing the temperaments of both the child and the parent are key for successful parenting and better understanding of the child. She discusses how to resist pathologizing everything your child does, and explores the concept of a wide range of normal in childrens' behavior. Rona explains the idea of how better parenting is really about identifying your own triggers as a parent, and how you must work on yourself in order to be the best parent you can be. Rona Renner, RN, author of Is That Me Yelling?: A Parent's Guide To Getting Your Kids to Cooperate Without Losing Your Cool, had a wide range of experiences in health care before being trained by Kaiser Permanente to be a temperament counselor, which she has continued to use as a foundation for her work facilitating parenting groups and classes for over 30 years. She has also spoken at numerous national conferences on children’s temperament, ADHD, and other parenting concerns, as well as provided consultation for medical professionals and teachers on learning differences in India and Africa. Rona is a current host of About Health on 94.1FM KPFA, and has been a guest expert on national television segments on CNN and 20/20. She founded both Childhood Matters and Nuestros Niños, and was the radio host of Childhood Matters for ten years.

In this interview, Steve discusses his path to working in the field of mental health after growing up in a family where his father suffered from misdiagnosed bipolar disorder, but it was never discussed due to doctor's orders. He discusses his book about growing up in silence and stigma, "Another Kind of Madness: A Journey Through the Stigma and Hope of Mental Illness", and his interest in working to overcome mental stigma. We discuss his research on ADHD, and how the MTA study was one of the largest studies looking at medication and treatment. We discuss the behavioral interventions that are helpful to children and families where ADHD is present. Additionally we also explored his work in the book, the "ADHD Explosion: Myths, Medications, Money, and Today's Push for Performance", and the issues of under and over-diagnosis of ADHD. This also leads into the conversation about ADHD and gender, and Steve discusses his research in the BGALS study, looking at how ADHD appears in girls and women, and the longitudinal research. Finally, Steve talks about his work with programs to run stigma reduction groups in high school, when beliefs are being developed, and having speakers series and other method to address stigma in a real world way, and his work with Bring Change to Mind. Stephen Hinshaw, Ph.D. is known for his work in developmental psychopathology, clinical interventions with children and adolescents, and mental illness stigma. He is currently a Professor of Psychology at the University of California, Berkley and the University of California, San Francisco. Dr. Hinshaw has authored over 370 articles and chapters as well as 12 books, including, Another Kind of Madness: A Journey through the Stigma and Hope of Mental Illness , The Triple Bind: Saving our Teenage Girls from Today’s Pressures with R. Scheffler, and The ADHD Explosion: Myths, Medications, Money, and Today’s Push for Performance. Dr. Hinshaw’s research efforts have been recognized by many awards including the James McKeen Cattell Award from the Association for Psychological Science (2016) which is the highest award to honor a lifetime of outstanding contributions to applied psychological research.

In this episode, I speak with Steven Friedlander, Ph.D. about working with families involved with “high conflict” divorce, as well as parental alienation/parental rejection situations. Steven discusses his career and how his work led him to researching and writing about parental rejection/parental refusal, and his approach for this work. He described the different roles that clinicians can play in helping a family where there is a great deal of conflict and discussed the Special Master/Parenting Coordinator role, the co-parenting role, child custody evaluation, and the therapist role. He explained the complexity of researching the effectiveness of treatment for families dealing with rejection/refusal, as well as differentiating between a parent who may be acting in a way to alienate their child, and a case where there is no clear evidence for alienation, but seemingly brought about as a by-product of the enmeshed parent. Steven Friedlander, Ph.D., is a clinical psychologist with a special expertise working with families when a child is refusing or resisting contact with a parent. His most recent publications have focused on post-divorce disruption of family relationships, and interventions designed to resolve those problems. Dr. Friedlander facilitates consultation groups for other professionals which focus on interventions with families when a child resists/refuses contact with a parent, and parent coordination in high conflict families. He previously served on the Board of Directors of the California chapter of the Association of Family and Conciliation Courts (AFCC-CA) from 2005-2014. Dr. Friedlander is Clinical Professor Emeritus in the Department of Psychiatry, University of California San Francisco t