Therapy on the Cutting Edge

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

In this podcast, Patricia Papernow discusses her experience as both a stepparent and a parent in a stepfamily, and how this led to first a dissertation on stages of development in becoming a stepfamily, and then a life-long interest in studying and working with stepfamilies. She discusses how stepfamilies are different from first time families, particularly regarding the time and space for the couple to develop their attachment and build some common ground and the challenges children face in stepfamilies. She describes the 5 major challenges for stepfamilies: 1) insider/outsider positions, 2) children’s needs, 3) stepparents and biological parents polarizing around parenting tasks, 4) the other biological parents/ex-partner being part of the family system, and 5) navigating creating new shared rituals. She offers concrete, evidence-based guidance about what works (and what doesn’t) to meet these challenges.​ Patricia Papernow, EdD is well known for her books Surviving and Thriving in Stepfamily Relationships, Becoming a Stepfamily, and, with Karen Bonnell, The Stepfamily Handbook From Dating, to Getting Serious to Forming a “Blended Family,” ​as well as the author of dozens of articles and book chapters about “blended families.” Dr. Papernow is a systems and trauma-trained clinician with a special focus on working with families through the divorce and recoupling process. She is a renowned educator teaching about stepfamilies all over the U.S. and the world. She is also the recipient of the 2017 award for Distinguished Contribution to Family Psychology from APA (American Psychological Association).

In this episode, Phil discusses his career and his early experience with EMDR and how this became a focus of his work as he went on to become an EMDR trainer. He discusses the controversy around EMDR, and its mechanisms of action, and issues related to research and funding. He discusses his theory on how EMDR works, and talks about the technique he has developed called the Flash Technique. He discusses how he has found this technique to be extremely effective in helping clients to effectively process trauma, even faster than traditional EMDR. Phil Manfield, Ph.D has been licensed as a Marriage and Family Therapist since 1975. He has authored or edited five books about psychotherapy and the use of EMDR, including: EMDR Up Close: Subtleties of Trauma Processing, EMDR Casebook, and Extending EMDR: A Casebook of Innovative Applications. He has taught in the US, Canada, Australia, South America, Europe, Asia and the Middle East. Currently, he is the Northern California Regional Coordinator for the EMDR International Association.

In this episode, Dr. Palfy discusses how her work in law enforcement, specifically investigating and arresting child sexual abusers, led her into a career of psychology. She discusses how when we think of childhood sexual trauma, we often think of women, although 1 in 6 men were sexually abused prior to age 16. She explains that of those that were abused, only 5 in 1,000 go on to disclose their abuse, thus giving a sense that this doesn’t happen to boys and may be missed when working with men. She discusses some of the differences between abuse of boys and women including societal norms of men being protectors (the man of the family) so not telling, fear of being seen as gay or as someone who will inevitably be a child abuser, worrying that they somehow wanted the abuse as males anatomy responses physiologically different during abuse, and ultimately society not making a place for males to be vulnerable, and instead dismissing or shaming them for being too sensitive. We discuss her work in helping others to understand male experiences of abuse, so that clinicians can be more aware of seeing that this may be part of the reason men are struggling and help them to address their trauma. Kelli Palfy, Ph.D. is a psychologist and author, who first started her career as an RCMP officer that specialized in sex crimes. Today, Dr. Palfy works with first responders, male survivors of sexual abuse, and people who are bullied in the workplace. Dr. Palfy authored the book Men Too: Unspoken Truths About Male Sexual Abuse which is based off of her own research and experience in the field.

In this episode, Joel discusses his work as a police officer, and his decision to become trained as a psychologist, in hopes of making an even greater impact on the people he arrested. Joel discussed his work in Crisis Intervention, working with homeless populations and the training of police officers to work more effectively with mentally ill citizens. He discusses his work with the West Coast Post-trauma Retreat where he works with first responders in an effort to prevent suicide. Suicide is the leading cause of death for first responders and more officers die from suicide than all other factors combined. He explains the reticence of first responders to engage in mental health treatment, and the challenges police officers have in finding a supportive clinician. He and I discussed the murder of George Floyd, the effect on the relationship between police officers and the community, and the subsequent impact on police officers. He discusses the psychological impact of the riots that followed Floyd’s death. We also discussed the dynamics that may have played into the lack of action of the other officers at the Floyd incident. We discuss the research of The Milgram Shock Experiment and the Stanford Prison Study where “normal” individuals acted in ways that most would have said they would not have acted but did so in relation to context and authority. Joel discussed his most recent focus on building resiliency in police officers, and training them as part of the Police Academy, as well as training seasoned officers in connecting to their meaning, influenced by Victor Frankel’s book, Man’s Search for Meaning. He explained that they also teach the difference between compartmentalization, which is necessary and adaptable on the job, as opposed to suppression, which could lead to bottling up and later spilling over of emotions which could affect a responder’s personal and professional life. Joel Fay, Ph.D. is a retired police officer who proudly served the force for over 30 years and made a career change, obtaining his Doctorate in Psychology. He now has his own private practice, is the lead clinician for West Coast Post-Trauma Retreat (WCPR), and is the co-founder of the First Responder Support Network, where he is currently the Clinical Director. He also teaches Crisis Intervention Training across California, is the co-author of Counseling Cops, and the author of many articles about emergency service stress. In his private practice, he specializes in working with emergency responders from many different organizations. Dr. Fay has received many awards for his amazing work, including the California Psychological Association 2007 Humanitarian Award and the American Psychological Association 2012 award for Outstanding Contributions to the Practice of Policy and Public Safety Psychology.