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Surviving sexual assault

5/6/2023

 
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Last month there was an initiative to raise more awareness about sexual assault. At least one in six men have been sexually violated (1in6.org), and experts say that the number is probably even higher because men are less likely to report when they have been sexually assaulted or raped.
 
According to 1in6.org, it takes a man an average of 22 years to speak about his experiences as a survivor of sexual violation. Society conditions men to remain silent, and to hide their vulnerability.  If a man were to report his own sexual violation, this might be viewed (by some) as a direct contradiction to this conditioning.  This might mean a man might not recognize himself as a survivor of sexual violation, or he is too ashamed to report it, or other people might not believe him.
 
Another issue is that society often interprets men’s behavior through the lens of aggression or anger, rather than an expression of distress, including a sign that they have experienced trauma. This is further complicated when people confuse sexuality and sexual violence, assuming sexual violence is sexual act rather than an act of violence. As a result, many people fail to appreciate the number of straight men who are a survivor of sexual violence.
  
If you have experienced sexual violation, or you know someone who has, you might feel emotionally numb, or you might be stuck in hypervigilance, which means you are easily startled or quick to get angry or upset. Here is a little more on each of these concepts –
 
Emotionally numb – Another term for this is dissociation. To survive the experience of sexual violation, your brain might have shut down for a moment.  It did what it needed to, otherwise the experience might have been overwhelming. The trouble is, the danger has now passed, so you need to reconnect with your emotions, your thoughts, and your body.  With the help of a trained professional, such as a psychotherapist, you can learn some grounding exercises, to become aware of your whole self.  It is important to know that you have not necessarily become emotionally numb forever.  It was a survival mode that should, with the right help, become a temporary state.
 
Hypervigilance, easy to become startled or get angered or upset – If you were sexually violated, your body probably went into fight or flight mode.  Your sympathetic nervous system kicked in, sending the blood pumping around your body, and readying your body to fight or flee.  The trouble is, you were not able to get away, and so your brain and body are still stuck in that fight or flight mode, stuck in hypervigilance.  It is as if your brain and body have unfinished business, leaving your brain on edge, and causing you to jump at even the slightest sudden noise, smell, touch or thought.  You are still ready for attack, long after the danger has gone. 
 
All of this can have an impact on your intimate relationships, your sense of trust of other people, the way you work, your concentration levels, your sleep, and your appetite.  It is also a constant drain on your body.  You may deal with it by isolating yourself or trying to keep things under excessive control (which, in turn, leads others to tire of you, dismissing you unkindly as a ‘control freak’).   You may even engage in substance abuse, as a way of escaping this constant sense of panic.

What can help
Talking to a trained professional, such as a psychotherapist, is an important step to take.  With the help of a psychotherapist, you will do three things –
  1. Establish safety – This might include the need for deep relaxation and grounding exercises, to activate your parasympathetic nervous system, so your body is not permanently fixed in ‘fight or flight’ mode.  There are numerous relaxation and grounding exercises available (for free), so it is down to personal preference, but my favorites include Progressive Relaxation, The Four Elements, mindfulness exercises such as Loving Kindness Meditation, and the Three Minute Breathing Space.  You can find these on my Audio Therapy page.
  2. Retell the story of your sexual violation from a position of control, allocating responsibility to the perpetrator.
  3. Reconnect with society, including friends and family.

There are different types of psychotherapy available, and one particularly effective approach for trauma is Eye Movement Desensitization and Reprocessing therapy (EMDR).  EMDR is recognized as an “A” level of treatment for trauma, recommended by the World Health Organization and the National Institute for Clinical Excellence. 

There are other types of therapy, and most will focus on your thoughts, emotions, and bodily sensations.  It is important to include work on the body, as that acts as a bridge between your thoughts and emotions.  You hold a great deal of your trauma in your body, causing all sorts of physical symptoms including stomach cramps, constipation, migraines, and nausea.

No matter what approach your therapist takes, it is essential that you look out for your negative, self-critical voice.  If you are the survivor of sexual violation, and you are carrying shame, this critical voice will be turned up to full volume.  Work with your therapist to turn down the volume on this critical voice, replacing judgement with understanding.  Understand that your thoughts, emotions and body may have done all sorts of things to survive the sexual violation.  For example, you might have engaged in escapist behavior, such as denial or substance abuse, or you may have lashed out (at others or yourself) with the rage that you were feeling.  Understand that this was what you had to do to survive.  These might not have been constructive coping mechanisms, but they were all you had to survive, and now is the time to replace these with more helpful coping mechanisms.

I hope you found this useful. Please get in contact if you need to discuss any of this.

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC

Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917

Conspiracy theorists, extremism, and intolerance

4/29/2023

 
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What do COVID vaccinations, the assassination of JFK, and the moon landing all have in common? They have all been the subject of conspiracy theories. And there are plenty more. According to research carried out by Pew Research Center, more than half of Americans have heard of QAnon, one of the better-known conspiracy groups of recent times. For as many blog posts, updates on Instagram, and TikToks, there are as many variations in the perception of reality. This is a good and bad thing. On the one hand, it is healthy to think critically about the information we are given. On the other, we can end up straying too far from common sense, putting us and others in danger
 
A sense of belonging and identity
Conspiracy theories, extremism, even intolerance, can all give someone a sense of belonging and identity. This is especially so if someone accepts those conspiracy theories, extreme views or intolerance from friends or family members. Our emotions serve as a significant motivator for our behavior, and if the choice is between rejection of those views or a sense of belonging, often we will choose a sense of belonging. As psychology professor Arie W. Kruglanski points out, one of the appealing factors of extremism is the “ideological narrative—the story a terrorist group tells to justify its actions,” justifying the actions according to “group values.” Group values can give someone a sense of belonging or identity, and that can be quite attractive when someone has low self-esteem, or they feel isolated.
 
Our fear of uncertainty
When we create conspiracy theories or we hold extreme views, we claim to know "the truth", whether or not we have the evidence to back it up. We prefer this false sense of certainty because our brains are hardwired to fear uncertainty. For our predecessors, uncertainty posed a significant threat: It meant that we might not survive the night, we might not know where we would find food or shelter, and we might not know whether that beast was going to devour us. In the twenty-first century, we still fear uncertainty with the same sense of mortal dread, and so some of us would prefer to cling to the certainty of conspiracy theories or extreme views, rather than embrace that uncertainty. This is especially true if we have survived trauma. Research shows that we are more likely to adopt black-and-white thinking to avoid the uncertainty we fear.
 
A growth in technology
Before the cell phone and social media, conspiracy theories might have been a problem confined to small ripples in social circles. But every post, like and retweet transforms these half-baked ideas into verified authority. We haven’t got the time to verify every last piece of information, so we rely on information from others, and, as a result, we can quickly drift from any semblance of reality. And if we were just talking about us adults, that’s one thing, but as Helen Lovejoy said in the Simpsons, “Won’t someone please think of the children!”. According to the United Nations, the internet is one of the main strategies used to recruit children to extremism, and the same can be said for conspiracy theories.
 
Pandemics = Conspiracy theories, extremism, and intolerance
It is no coincidence that we are examining conspiracy theories as we emerge from a pandemic. History shows us that conspiracy theories, extremism, and intolerance thrive during times of crisis and upheaval. Most pandemics followed this pattern, whether it was the cholera epidemics between the 1830s and 1860s or the 1918 influenza pandemic which killed fifty million worldwide. As Ervin Staub points out in The Roots of Evil: The Psychological and Cultural Origins of Genocide and Other Forms of Group Violence, acts of extremism such as genocides “often arise under conditions of acute societal uncertainty.”
 
Distress tolerance, and rebuilding a sense of belonging and identity
So what to do about all of this? If our fear of uncertainty is keeping us reaching for conspiracy theories, extremism and intolerance as much as our quick fix of social media, we need to learn how to reduce the distress associated with uncertainty. Your brain is an amazing flexible tool, so it can relearn as much of what it has learned already. This includes learning to tolerate uncertainty. Sometimes this can follow a basic exposure approach, where we identify uncertainty in our daily life, and then adopt a mindful approach as we breathe through the discomfort of it. That way, our brain can learn that this is survivable. 

You can also identify where you might have made assumptions to fill the gap of uncertainty, checking the facts and challenging some of those black-and-white thought patterns. In addition, you can identify other ways to develop a sense of belonging and identity, ways that are more constructive than conspiracy theories, extremism, and intolerance. 
 
I hope you find all of this helpful. If you have any questions, get in touch.

​Chris Warren-Dickins LLB MA LPC
Explore Transform LLC

Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917

#ConspiracyTheories, #Extremism, #Intolerance, #Polarization, #MentalHealth, #Depression, #Anxiety, #Stress, #Self-Esteem, #Counseling, #Psychotherapy, #FindATherapist, #Ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor

Setting boundaries

4/23/2023

 
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At Explore Transform LLC, we focus on anxiety, depression and trauma. These can have a significant impact on our relationships, so it is important to set aside time to continually monitor the health of our relationships, and the skills we apply to them. One such skill is boundary-setting.

​In a relationship you bring your own baggage.  You may feel more easily triggered, or scared, or angry, in certain situations that are beyond the control of your loved one(s). When it comes to your emotions, there are no rights or wrongs.  You feel how you feel, but it is how you act on it, and how you communicate those emotions, that counts.  This is where boundary-setting comes in.  Boundaries help you to establish the space within which you can - 
  • Feel your emotions
  • Communicate those emotions
  • Work out how your emotions might be causing conflict within your relationship
  • Negotiate with your loved one(s) what you are going to do about that

One approach to all of this is to use DEAR skills to set boundaries with love.  DEAR skills were developed by Marsha Linehan, who created Dialectical Behavior Therapy (DBT).  Here is a quick three-minute run-down on using DEAR skills to set boundaries with love -
  • Describe your perspective fully, without making assumptions about the other person’s perspective.  Simply describe what you see.
    • This is an example of using your Describe skill - You saying to your loved one(s) "I see your shaking fist and I hear your raised voice, and this seems to me an expression of anger"
    • This is not using your 'Describe' skill - Saying to your loved one(s) "You are angry and I know why"
  • Express your feelings clearly and in a non-accusatory way
    • This is an example of using your Express skill - Saying to your loved one "Although I still love you, I feel scared when you raise your voice and shake your fist near me.  You can express your anger around me, but I wonder whether there is another way for you to do that and still feel heard"
    • This is not using your Express skill - "You wanted to intimidate me so you are doing everything you can to harass me"
  • Assert your boundaries without apology and without dilution.
    • This is an example of using your Assert skill - "I hear that you may not see it my way, but I wanted to share how scared I felt, and this is the way I view it"
    • This is not using your Assert skill - "Perhaps I am wrong, and perhaps it is silly to get scared when you don’t mean to do that"
  • Reinforce - Engage with the other person so they see the benefits of the boundaries you are trying to set, and the potential cost of continuing without these boundaries. For example, ‘I love you enough to be willing to share how I feel when you do that, and I am concerned if we continue like this, I might retreat even further from you’.  There are no threats and no value-compromising promises.
    • This is an example of using your Reinforce skill - "When I feel scared, I am unable to show you my full self, and I am unable to show you the full amount of love I have for you"
    • This is not an example of using your Reinforce skill - "If you don’t change, I will leave"

If DEAR skills are new to you, start slowly.  Try one or two parts of it the next time you need to set your boundaries with love.  

But that's not all...

When you try to set boundaries, the relationship can be strained for a while. If this is the case, consider the following ten tips to nourish your relationship -

  1. Eye them up - Remember the intense intimacy of eye contact.  Cell phones get so much more attention than our loved ones, so try glancing up to catch that twinkling eye that once held your attention for so long.
  2. Numero Uno - Third parties (friends, family members, and neighbors) can offer a temporary distraction or additional insight, but your primary go-to person should be your significant other (or others if you are in a polyamorous relationship).
  3. Don’t Make Your Insider(s) an Outsider - You may have friends or relatives who have seen you through the ups and downs, who know a whole repertoire of inside jokes to share with you, but that does not mean that your significant other(s) should feel like an outsider.
  4. Professor of Our Intimate Other(s) - Over your years together you need to work hard to learn what keeps your intimate other feeling safe and secure.  This inevitably changes over time, with new challenges such as a new career, new stages in parenting, and a flipping pandemic to keep you on your toes.  But to show that we are willing to learn about each other is a fantastic first step in love and trust.
  5. Learn the Rules of Fight Club - In our intimate relationship we will fight, and that is okay, provided we follow mutually agreed-upon rules of fighting.  Such rules are likely to include physical or verbal abuse (and what exactly that means), but it might also include certain no-go areas that are either too sacred or too painful.
  6. Learn the Rules of Fun Club - Just as much as we need to fight well, we need to remember how to have fun.  With our careers and kids, families, and friends, it is so easy to forget the fun we can have in our intimate relationships.  Even if we have to schedule a time for pure old fashioned frolicking, do it!
  7. Pace Yourself - The frantic pace of life can take us away from our intimate other(s).  Now and again it would help to slow down the pace and just notice each other.  This can be as simple as touching each other’s hands and noticing the warmth.  There are various mindfulness exercises that can help with this, and the key point is to just notice (in a non-judgmental fashion) whatever comes up, not to try and change anything.
  8. Top and Tail the Day - No matter how busy things can get, try and establish some sort of ritual to start and end the day together.  Even if it is to turn the lights off together before you go to bed, or share some cereal in the morning.  Life is short, and you will look back on those simple moments with fondness.
  9. A Wealth of Health - It is easy to focus on finances, particularly in this economy, but taking care of each other’s health is equally important (not least because you cannot continue to work and earn without your health).  Checking in on each other to make sure they are keeping up with regular health checkups, including eating healthily and exercising, can be another opportunity to connect with each other.
  10. A Safe Space - I saved this one for last, and I view it as the most important one.  True intimacy can only be achieved when we know that we are safe.  It is physically impossible for our brain to truly enjoy intimacy and sensuality when we are in a fight or flight mode.  As a result, we need to create an environment in our relationship that fosters calm and safety.

I hope you find all of this helpful. If you have any questions, 
get in touch.

​Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917

Shame, guilt, and the bidimensionality of trauma

4/21/2023

 
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“I was walking around with it, and I didn’t even realize it was trauma. I always assumed trauma was something a war veteran experienced or the survivor of a plane crash. I didn’t realize that my sh*tty childhood amounted to trauma, this thing that stuck to every part of my life and muddied everything I touched. I thought it was me; I thought I was fundamentally flawed, miswired even, and there were times when I felt hopeless. This made it so hard to reach out for help, and to truly believe that I deserved help, let alone that anything could help me.”
 
As a psychotherapist working with trauma, I hear this a lot. Although it is getting better, we have spent too many years underestimating the prevalence of trauma. If you think that it can arise as a result of adverse childhood experiences or other chronic situations where we are constantly denigrated, such as racism, homophobia, transphobia, or discrimination due to our socio-economic status or immigration status, you can see how prevalent trauma might be.
 
When we have experienced trauma, when our coping skills have been overwhelmed, this can lead to changes in the functioning of our brain. Trauma changes us in terms of our hopefulness for the future, but also how we interpret the past, something I refer to as the bi-dimensionality of trauma.
 
In his interview with Dr Andrew Huberman, psychiatrist Dr Paul Conti explains that we attach meaning to memories, and that meaning is colored by our emotions. At the time of the trauma, we might not believe that we are at fault or powerless, and if we are a small child, we might not even have the ability to hold such beliefs. But over time, as we look back, we can start to interpret the trauma that way. As a result, we anticipate the future with a sense of futility or powerlessness.
 
We can see the effects of trauma in how we behave, in our mood, in our sleep patterns, and physical health but getting help can be difficult when guilt and shame are such an integral part of trauma. In an interview between Dr Huberman at Dr Conti, Huberman asks why guilt and shame are hard-wired in our brain. From an evolutionary perspective, Dr Conti explains that if a bad thing happens to us, it helps to remember that bad thing, so we avoid it in the future. If a saber tooth tiger attacks you, it serves you well to remember to avoid saber tooth tigers. The limbic system in our brain has various functions including affect, and affect helps to initiate behavior to help with survival. Shame is an aroused affect and so it is a strong deterrent, so it can keep us vigilant and act more defensively. This all makes sense when we were fleeing saber tooth tigers, and when our lifespan was much shorter. But in this modern world, we are living much longer, and witnessing so much more, so this constant influx of trauma has a negative impact on the brain over a longer lifespan.
 
Dr Conti explains that the trauma inside us that leads to guilt and shame is reinforced by three processes -
1.     It serves as a punishment because we believe we deserved it; this is a negative way that the brain makes us try to do better.
2.     It serves as a distraction from deeper or more painful emotions.
3.     If we think of something awful that might happen, that tricks us into believing that we can somehow control the future. For example, I know I will fail.
 
To heal from trauma and break from this shame and guilt, we need to find ways to think of ourselves differently. Dr Conti suggests this could be something as simple as journaling. I love writing, whether it is fiction or non-fiction, it really helps me to interpret and re-interpret things I have experienced. In the same way, this is why talking to other people, including a therapist, can help. This process helps with trying to gain distance, developing compassion, but also understanding why certain things are a certain way.
 
However…
 
As Dr Huberman points out, it can be hard to give up that punishment, distraction and control when it creates arousal that we can apply for gain. To this point, Dr Conti explains that we mustn’t take a limited view of gain; for example, we might end up working hard and reaping financial gain, but we might lose a great deal in our personal relationships.
 
Trauma, and the associated shame and guilt, can be hard to manage without professional help, although this is not impossible. If you feel that you do need professional help with this, please reach out so you can have a free, confidential telephone conversation with me.
 
Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917
​
#Trauma, #Depression, #Self-Esteem, #Counseling, #Psychotherapy, #FindATherapist, #Ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #MentalHealth, #Anxiety, #Stress

Spring roundup

4/19/2023

 
Here is a collection of our recent blog posts.

We hope you find these useful.

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917
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Get beyond your depression

4/15/2023

 
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​Negative thoughts, persistent flattened feelings, explosive anger, irritation, withdrawal, over-eating, tears, under-eating, over-working, a disconnection from your loved ones, an excessive use of social media, an inability to enjoy the things that usually give you enjoyment…
 
The list could go on.
 
But what is this list? These could be signs of depression, and as you can see from this list, depression comes in many different forms. For some, there is a withdrawal from the world, and yet others might push themselves harder, engaging more with the world, even though they feel flattened and hopeless inside. Ever heard “You can stand in a room full of people and still feel alone?”. Well depression is as tricky as that; it is hard to spot if you only look for the stereotypical signs of sadness or withdrawal.
 
One thing that does help to identify depression is knowing the person involved. As a psychotherapist, I get to know my clients and learn what their usual patterns are, whether that is introverted or extroverted, whether they tend to feel nourished spending more time with their family or engaged in their work, and then I can see if depression has taken hold, because usually these patterns will change. I also want to know whether this is a significant issue, usually of at least two weeks, or whether it is just a temporary dip.
 
Depression can be particularly difficult because you can get trapped in a depression cycle. When you feel low, you assume there will be a negative outcome with the things that usually make you feel better, and so you don’t engage in those activities, and this makes you feel worse about yourself. Your self-talk can become more negative, referring to yourself as a ‘failure’ and ‘worthless’, and it is particularly concerning if hopelessness becomes pervasive.
 
If we look at other challenges to mental health, for example Obsessive Compulsive Disorder (OCD), there is, at least, an escape clause: For example, if we touch the door frame four times then our obsessive thoughts dissipate. With depression, however, there is no such escape clause because we are stuck in a double-bind where we assume there will be a negative outcome, and we assume we are inadequate in most situations.
 
Given the links between self-harm, suicide and depression, it is important that we prioritize care for depression. However, depression is sometimes viewed in a negative light, and some have even referred to it as a weakness. The opposite is true. Recognizing depression and seeking help for it is a sign of strength. It is also important to understand that your body and mind often respond for a reason.
 
In my psychotherapy practice I use Polyvagal Theory to help people visualize depression as the dorsal vagal response, or rather the shutdown, at the bottom of the nervous system ‘ladder’. When we learn this, we can also understand that there are other parts of the nervous system, further up the ‘ladder’, and so we can use breathing exercises and tapping to move out of the dorsal vagal state, into a more connected ventral vagal state. This can only occur when our nervous system sense cues of safety, so it might take some time for you to learn to trust the therapeutic relationship and feel safe enough to flex in and out of these various states.
 
All of this might seem a little unclear, but when we put this in action, you might notice some wonderful changes in your body and mind.
 
If you have any questions about this, or depression generally, get in touch today.

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917
​
#Depression, #Self-Esteem, #Counseling, #Psychotherapy, #FindATherapist, #Ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #MentalHealth, #Anxiety, #Trauma, #Stress

Assertiveness, without being an ass

4/15/2023

 
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I love being a psychotherapist and parent because of the overlap: As I help clients to navigate life’s challenges, I grow and learn as a parent, and vice versa. One of the growth areas that offers a continuing opportunity for reflection is assertiveness.
 
We live in a world with other people, so we are continuously trying to strike a balance between the needs, emotions and experiences of others, and how that impacts our own needs, emotions, and experiences. To lean too much one way, and we become passive, acquiescing to every other person’s needs rather than respecting any of our own. If we have leaned too far this way, we might have been called “a people-pleaser” or “an appeaser.” If we had the misfortune of falling under the spell of someone abusive, they might praise us for our passivity, saying that we are “easy to get along with” or “no drama.” The trouble is, to live a life of pure passivity is not sustainable. If we go too far the other way, we might risk becoming aggressive. This is where we can only see our own needs, emotions, and experiences, without any care for others.
 
So how do we strike a balance? Assertiveness is the sweet spot between passivity and aggression. Sometimes it is useful to visualize it holding two hands out: You can hold your own needs, emotions, and experiences as valid, whilst also holding the other person’s. Both are valid, and the real work is trying to negotiate a middle ground or overlap. Sometimes you will not find that area of compromise, and you have to decide which way to lean and weigh up the consequences of that choice. And sometimes you do not have the choice or freedom to exercise assertiveness (for example, if you are in a work environment where you need to keep your job to pay the bills).
 
It is widely recognized that certain skills are useful to keep a balanced, assertive approach. For example, becoming comfortable with saying no, using short sentences without a need to overly explain your reasoning, and calmy repeating your point in the face of resistance. I always like to use the imagery of a tree swaying gently in the wind of resistance; you are flexible, hearing what they have to say, but remaining firmly rooted in the moment.
 
So, we know that assertiveness falls in the middle of two extremes, but what does that look like in reality? -
Assertiveness is not aggression – Aggression is an attempt to dominate others without respecting their rights or boundaries. Example: “I will leave you if you work late tonight.”           
Assertiveness is not passivity – Passivity is a failure to communicate one’s needs or to allow others to encroach on your boundaries.  This could be the result of fear, or an inability to assert one’s rights, but it could also be an attempt to manipulate someone. Example: “Fine, work late, see if I care” (when they really do care).
Assertiveness is an ability to hold your own needs, emotions, and experiences as valid, whilst also holding the other person’s – Example: “I feel lonely when you come home late from work.”



I use Polyvagal Theory to help my clients understand their behavior, emotions, and bodily sensations. I have spoken about this theory in other articles, so here is a link to a quick recap. From a Polyvagal perspective, if we are not assertive then it might be because our nervous system is picking up cues of danger. In response, we might fight, flee or freeze, or we might shut down. In other words, we might use the sympathetic nervous system (if our nervous system senses that we can overcome or escape the danger), or we might switch to a dorsal vagal response, which means to go numb or blank-minded if there is no escape. There is also the fawn response, in other words, we hope to appease (or submit to) the aggressor to escape the danger. None of this is assertive.
 
To become assertive, we need to feel safe to do this, or, in other words, we need to be in a ventral vagal state. There might be many reasons why we do not feel safe, and some of those reasons might not reflect present-day reality. For example, if a work colleague, or teacher or friend reminds us of an overbearing caregiver from our childhood, we might become ‘triggered’ by this association and lose the ability to exercise our skills of assertiveness.
 
We can learn how to put ourselves in the best position to use skills of assertiveness by doing two things –


  1. Learning what our triggers are. We all feel more or less assertive in different circumstances, and so if we are hijacked by adverse experiences from our past, we need to identify these potential triggers. One of the best results of this learning process is that you are taking the first step to distinguish the past from the present. For example, when you are around that work colleague, teacher, or friend who reminds you of an overbearing caregiver from your childhood, you can gently remind yourself: That was then, this is now.
  2. Learning how to bring our nervous system into a ventral vagal state. The vagus nerve runs over the lungs and heart to the brain, so that is why we emphasize breathing exercises, or butterfly taps, as just a couple of techniques. 
I hope you found this useful. If you need to clarify anything, please let me know.

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917
​
#Assertiveness, #Relationships, #Counseling, #Psychotherapy, #FindATherapist, #ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #MentalHealth, #Depression, #Anxiety, #Trauma, #Stress

Psychotherapy and speech therapy

4/14/2023

 
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As a psychotherapist I regularly help people when they are struggling with anxiety, depression, and trauma. It is important to look at why we might be suffering in this way, but it is also important to get help with the practical things. When we get anxious or depressed, and when we are experiencing the fallout from trauma (whether you are in the shutdown response, free, fight, flight or fawn), it can be hard to think straight, and so a psychotherapist can help you to problem-solve until you are able to do it one your own again.

One example of this problem-solving can be finding the right professionals to help you and your family. In this video I talk to Laura Grube about when you might need the help of a speech therapist, how trauma impacts speech development, and what you can expect out of speech therapy.

​If you have any questions about this, please do reach out to us.

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917
​
#Counseling, #Psychotherapy, #SpeechTherapy, #EMDR, #FindanEMDRtherapist, #EMDRTherapy, #EMDRTherapist, #TraumaTherapy, #FindATraumaTherapist, #HealingFromTrauma, #FindATherapist, #ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #MentalHealth, #Depression, #Anxiety, #Trauma, #Stress

When psychotherapy meets neurology

4/12/2023

 
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When do you see a psychotherapist, a licensed professional counselor, or a neurologist? In this video I talk to Dr Olga Noskin, neurologist at Neurology Group of Bergen County, and Dr Noskin specializes in vascular neurology. 

In this video you will learn that there is a great deal of overlap between our differing professions, particularly because we both deal with the brain and how it impacts how we function in the world. We need both professions to work together to help someone manage the physiological and psychological impact of their neurological complaints.

Have a look at the video and let us know if you have any questions. Dr Noskin and I would be happy to answer them.
​
​Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917

#Neurology, #EMDR, #FindanEMDRtherapist, #EMDRTherapy, #EMDRTherapist, #TraumaTherapy, #FindATraumaTherapist, #HealingFromTrauma, #FindATherapist, #ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #Counseling, #Psychotherapy, #psychology, #MentalHealth, #Depression, #Anxiety, #Trauma, #Stress

Gender identity: A broad spectrum

4/10/2023

 
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If you need to talk to someone about anxiety, depression or trauma, and you are gender queer, transgender, or non-binary, you need to make sure that you are opening up in a safe environment. There are some professionals who might claim to be accepting, but the reality is far from true. I have been on the receiving end of professionals who let their personal biases leak out, making crass assumptions and pathologizing people because of their own lack of experience.
 
Some people who are reading this might have questions about gender identity, either because they are exploring their own identity, or they know someone who is.

As a result, let’s answer: What is gender identity?
 
Gender identity?
In the words of Gender Spectrum, gender identity is 'our internal experience and naming of our gender. It can correspond to or differ from the sex we were assigned at birth'.

Gender identity is not a binary concept, this is simply how we have understood (or oversimplified) gender. The reality is that gender identity exists on a spectrum, and this can include people who are transgender, cis gender, non-binary, gender queer, and other gender identities. 'Because we are provided with limited language for gender, it may take a person quite some time to discover, or create, the language that best communicates their internal experience. Likewise, as language evolves, a person’s name for their gender may also evolve. This does not mean their gender has changed, but rather that the words for it are shifting.'

'Each dimension of gender is informed by our unique intersection of identities, experiences, and personal characteristics. We are more than our body, gender identity and gender expression: we are also our race, ethnicity, class, faith, sense of geographic place, family history, and more.

​Our gender is personal because, while we share some of these aspects of self with others, the way that all of these identities, influences and characteristics come together is unique to each of us'. Read more here https://www.genderspectrum.org/quick-…/understanding-gender/


What is cisgender privilege?
If someone’s gender identity corresponds to the sex they were assigned at birth, this is known as cisgender. To identify as cisgender means that you live with cisgender privilege, whether you are aware of this or not. Cisgender privilege means that you do not have to endure the overt and covert discrimination experienced by many people who are not cisgender (for example, people who are transgender, non-binary, or gender queer).
 
Cisgender privilege means you can assume you will not be denied work, a home, healthcare, a place to worship, a family to love, or your personal safety, because of your gender identity. Cisgender privilege means that you don’t have to remind people (even your loved ones) of your pronouns, and/or your name (for example, you are not dead-named).

Seemingly innocuous moments in everyday life can symbolize cisgender privilege, which basically assumes a binary construct of gender identity. Examples of these everyday moments are set out below:
  • You fill out a form and it asks you to tick the box ‘male’ or ‘female’.
  • Your friend is pregnant and holds a gender reveal party with ‘Pink or Blue?’ on every single decoration, including the cake and balloons.
  • You attend a graduation ceremony where seating or required outfits are distinguished based on sex: Dresses for ‘women’ and suits for ‘men.’
  • There are only two bathrooms, one labelled ‘men’ and one labelled ‘women.’
  • The same goes for other public facilities including locker rooms in gyms and changing rooms in clothes stores.
  • Waiting to board a plane, the airline announces that only women and young children can board first.
  • There are role models in the media and in the political arena who are cisgender.
  • There are rites of passage, public ceremonies, and other traditions based around the binary concept of male and female.
  • You register your child for a sports class and the instructor asks your child to get changed in the girl’s locker room, and join the girls group 
 
To pretend that there are only cisgender people in society is to pretend that parts of our population do not exist. To do this is offensive, and it can leave a lasting impact on someone’s mental health.  “40% of transgender adults reported having made a suicide attempt, and 92% of these having attempted suicide before the age of 25” (Trevor Project). In addition, 86% of transgender individuals reported sexual or physical assault. Here are some accounts from a Human Rights Watch report:
 
“Alexander S., a 16-year-old transgender boy in Texas, said: I started getting a lot of anonymous people telling me to kill myself, that it wasn’t worth living. I called the school and told them what was going on and they didn’t do anything.”

“It was “like a little mental pinch” when teachers used the wrong pronouns. “It doesn’t seem like a big deal, but eventually you bruise”, 17-year-old transgender student in Utah.”
 
So, the biggest cisgender privilege is to live a life where you are less likely to commit suicide, and less likely to experience sexual or physical assault.

Less obvious forms of discrimination include microaggressions, which are everyday slights, snubs or insults that communicate hostility (whether or not they are intentional). GLAAD ran a photo campaign to highlight this issue. Here are some examples from that campaign –


  • Jacob, who is gender queer, was asked “When are you going to really transition?”
  • Tyler, who is agender/queer, was told “you need to shave if you’re trying to look like a girl”
  • Tiq, a trans man, was told “I would never have known you used to be a girl”
  • Shane, a trans man, was told “You understand what it’s like to be a woman”
  • Seven, a transgender man, was asked “Did you transition because you thought you were an ugly girl?”
 
If we are to truly understand the concept of privilege, we cannot stop at gender identity. For example, a white transgender man will experience white privilege that a black transgender man will not. As the American Psychological Association points out, each of our “social identities contributes uniquely and in intersecting ways to shape” how we experience and perform our lives (APA Guidelines, 2018). In turn, this has an impact on “relational, psychological, and behavioural health outcomes in both positive and negative ways”. In a future article, we will look at other forms of privilege, including white privilege.

In the meantime, we will close with some tips on how to address cisgender privilege –
- Raise awareness about the privilege of being cisgender.
- Stop making assumptions about people’s gender identity. If in doubt, and it seems appropriate, ask. If not, use ‘they’ rather than ‘him’ or ‘her’.
- Normalize the concept of identifying gender, including a person’s pronouns, and include your own pronouns in your email signoff.
- Gender identity is a personal matter. How you identify, and how much you share that with another person, is up to you.

I hope you found this useful. Please get in contact if you need to explore this more.
​
Chris Warren-Dickins LLB MA LPC
Pronouns: (they/them/theirs)
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917
​
#Gender, #GenderIdentity, #Transgender, #NonBinary, #GenderQueer, #Anxiety, #Depression, #Trauma, #FindATherapist, #ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #Counseling, #Psychotherapy, #psychology, #MentalHealth

Understand your trauma responses

4/10/2023

 
When you work with an experienced psychotherapist, they will help you understand that certain behavior, emotions or bodily sensations can be signs of a trauma response. Often we identify trauma responses as fight, flight, freeze and submit responses -
 
  • Fight – You once could not protect yourself.
  • Flight – You were once trapped.
  • Freeze – You once could not move or cry for help without the risk of abandonment.
  • Submit – You once could not say no or set boundaries and still be accepted.
 
When we learn to identify the trauma responses, this can also help us to understand where these originated. This can then take us once step closer to healing from trauma, because we can identify how the circumstances have changed since we experienced that trauma. For example –
 
  • Back then, you could not protect yourself because you were young and small. Now, you are an adult with independence.
  • Back then, you were once trapped in a household with an abusive parent or sibling, but now you are free.
  • Back then, you could not cry for help or move without the risk of abandonment by your caregivers, but now you are in a healthy relationship where you can express your emotional needs.
  • Back then, you were not permitted to set boundaries, but now you have respectful relationships.
 
To heal from trauma involves helping your nervous system to sense that the trauma is in the past, and you are able to feel the present safety. You can distinguish past from present.
 
If you would like to explore this further, get in touch.

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com

+1 (201) 779-6917
​

#EMDR, #FindanEMDRtherapist, #EMDRTherapy, #EMDRTherapist, #TraumaTherapy, #FindATraumaTherapist, #HealingFromTrauma, #FindATherapist, #ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #Counseling, #Psychotherapy, #psychology, #MentalHealth, #Depression, #Anxiety, #Trauma, #Stress

The stunned silence of an anxious mind - Three years on

4/10/2023

 
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Three years ago, when I wrote The Stunned Silence of an Anxious Mind, we were full throttle into a pandemic. Because there was so much uncertainty, there was so much anxiety, and I struggled to keep up with the demands of my psychotherapy practice, while also trying to keep my young children healthy and balanced.
 
Three years on, and the mental health of the United States has not improved. Rates of anxiety and depression have increased from one in ten adults to four in ten adults, and part of this is due to the increase in intolerance and discrimination. We only need five minutes to scroll through the news headlines to see examples of this.
 
Anxiety and depression, whether or not fueled by intolerance and discrimination, can make your self-esteem crumble, like a house collapsing from within. No matter how much you learn, how many people you meet, no matter things you do that once gave you enjoyment, all of a sudden you cannot tackle even the simplest of tasks, and for many, this can reveal itself as a blank mind.
 
In my work as a psychotherapist, I use Polyvagal Theory to help people understand what our body and mind might be doing when it is stressed. In terms of Polyvagal Theory, a blank mind might be explained as our nervous system in the dorsal vagal state. This is the most unevolved state, when we do not feel safe, and our body and mind shuts down. Think of the prey that has been stalked by a saber tooth tiger, and it cannot escape; it needs to shut down so it does not feel the pain of the tiger’s jaws.
 
In our work, I might help you to identify when you notice that you are in the dorsal vagal state, and you can learn how to try and flex out of it using breathing exercises or grounding exercises (for example, using your senses to identify sights and sounds, even smells, in the room).
 
Further up the nervous system is the slightly more evolved sympathetic nervous system, otherwise knowsn as fight-or-flight. Think of the prey having a chance of escape from the saber tooth tiger, when its heartrate increases so it can try and fight off, or flee, the saber tooth tiger. When we experience anxiety, this is often because we are stuck in the sympathetic state. We sense danger and so our heart beats too much, we sweat, and we are nervous about the slightest thing. This is the nervous system, so we might not even be immediately aware of anything that should make our heart beat so fast.
 
No matter the cause, we need to learn how to calm things down a little. The sympathetic state, and the dorsal vagal state, are both needed when we sense that we are not safe, so if we are safe, we need to help calm things down so we can use the most evolved part of the nervous system, the ventral vagal state. This is when we can connect with ourselves and others, when we can play and create and enjoy intimacy.
 
What we need to get into this state, and stay in it, will differ for each person. For some, we might need to heal from trauma, for others, we might need to learn about the assumptions we are making, or the patterns of our behavior that are making things worse.
 
But the first step is to understand our nervous system, what it is doing, and why it is doing it. The stunned silence of a blank mind, or the sweatiness of a racing heart is simply our nervous system doing what it is supposed to do; to protect us when it senses danger. With the right help, we can learn to respond to these biological tendencies in a calm and compassionate way, so we are best placed to go about our lives. After all, we cannot live, work, or love fully if too much of our time is spent blank-minded or sweatily heart-racy!
 
I hope this makes sense. If it raises things you would like to explore, do get in contact.
 
Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917
​
#Anxiety, #Stress, #Panic, #Trauma, #Trauma, #FindATherapist, #ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #Counseling, #Psychotherapy, #psychology, #MentalHealth, 

Take care when you trust

4/10/2023

 
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It is hard to open up to someone and admit that you are struggling.  So imagine what it is like when you do finally reach out, and you feel vulnerable, and you are met with more judgment, gaslighting, bullying and shaming.  And imagine if all of this is thrown at you by your own therapist, doctor, pastor, or teacher.

This happens on a daily basis.  I have met countless professionals who work with the LGBTQIA+ community when they should not.  They should be marked with a red line around them and a warning sign that they are toxic and likely to further traumatize you.  They smile and nod, claiming that they never turn away ‘such clients’, and then they let slip that their religious views do not allow them to recognize gender diversity, and they view marriage and adoption as available only for a man and woman, and their personal views do not allow for LGBTQIA+ education in their schools or churches.  And so it goes on (the potential for discrimination is endless).

As a community, we need to make sure that we are only seeking help from professionals who are affirming.  It is not enough that they accept us, or turn a blind eye, or overlook certain aspects.  Dr Jamie Marich recently wrote an open letter about this important distinction, and it is an essential read.   Dr Marich explains that some of these professionals are working with members of the LGBTQ+ community when the professionals still hold onto harmful beliefs such as 'hate the sin, love the sinner', or using terminology such as ''choice', 'preference', 'lifestyle' and 'sin'.

If you encounter a professional who falls short of affirming you then ask them for a referral to someone who can.  A non-affirming professional does not have the expertise to understand the cumulative impact of microaggressions, and no matter how hard they claim that they are 'putting aside their personal beliefs', these will leak out and the relationship will fail.  Due to the power imbalance, it is likely that the professional will leave you with the feeling that you are to blame for this failure.  If you are already feeling vulnerable and in need of help, this could be catastrophic.  As Dr Marich points out, non-affirming professionals who insist on working with us are 'literally killing members of the LGBTQ+ community’. 

Take care when you trust a professional.  If they are not willing or able to affirm you, they are not in a position to truly help you.    

If you would like to explore any of this with me, please get in contact.

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917
​
#QueerTherapist, #AffirmingTherapy, #LGBTQIA, #FindATherapist, #ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #Counseling, #Psychotherapy, #psychology, #MentalHealth, #Depression, #Anxiety, #Trauma, #Stress

Trauma and addiction

4/10/2023

 
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Trauma forms the meat and bones of much of my work at Explore Transform LLC, and so, if we view addiction as an attempt to escape suffering, addiction is bound to show itself in my work as a psychotherapist in New Jersey. And who can forget that drug overdoses kill 81.000 Americans each year.

Gabor Maté explains that “so much of what we call abnormality in this culture is actually normal responses to an abnormal culture. The abnormality does not reside in the pathology of individuals, but in the very culture that drives people into suffering and dysfunction.” To address addiction, we need to address the suffering that is being endured. That includes helping someone heal from trauma, helping them learn more helpful ways to regulate their emotions.

As a psychotherapist who uses Polyvagal Theory, this includes learning to notice and name different states (whether that is the shut-down of the dorsal vagal state, the fight-or-flight of the sympathetic nervous system, or the safe, calm and connected state of the ventral vagal state).

I am based in New Jersey, so I mainly see clients here, but since the pandemic, I have also been helping clients who are based in my home country of the United Kingdom (London, in particular). When I lived there, I loved working alongside Jamie Willis, who is an experienced counselor in London. Jamie does some great work with people who are struggling with addiciton.

In this short video, we discuss our work, and he reminded me of Rumi's words of wisdom: "There is a voice that does not use words'" but instead it manifests. One of the ways it manifests is in addiction. To address addiction, to address any sort of unhelpful behavior or emotions, we need to tackle the source of distress. In the case of my work, we need to work on the trauma, and in the words of Rumi, "the wound is the place where the light enters you."

If you would like to explore this further, get in touch.

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917
​
#EMDR, #FindanEMDRtherapist, #EMDRTherapy, #EMDRTherapist, #TraumaTherapy, #FindATraumaTherapist, #HealingFromTrauma, #FindATherapist, #ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #Counseling, #Psychotherapy, #psychology, #MentalHealth, #Depression, #Anxiety, #Trauma, #Stress

When it feels safe to move on

3/31/2023

 
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As a psychotherapist who regularly uses Eye Movement Desensitization and Reprocessing therapy (EMDR) to help people with anxiety, depression, relationship conflict, and trauma, people often ask me why EMDR works.

Here is a fascinating video from Stanford Neuroscientist Dr Andrew Huberman where he explains the interplay between EMDR and your brain -
When you attend an EMDR therapy session, eventually (after preliminary work) we will identify target memories that relate to your current difficulties. For example, from a young age you might have formed the belief that you are ‘unsafe’ or ‘unlovable’, or you might carry around an overwhelming sense of shame or abandonment.

Focusing on a target memory, we will guide your eyes laterally (left and right, rather than vertically, up and down). This process helps to quieten your amygdala (your brain’s alarm system) in relation to that target memory, and the triggering belief or emotion. 

Why do we know this works? Because research shows that when we walk or otherwise move forward, and things move past us, this causes our eyes to move laterally, and thus quietens our amygdala. So the lateral eye movements in EMDR replicates the brain’s natural ability to quieten the amygdala.

But that is not all…

When you are triggered, or experience a threat (whether that is in the present, or a distressing memory of a past event), you might fight, flee, or freeze. In 2018 Dr Andrew Huberman carried out research into the part of the brain that is responsible for the fight response, or “forward confrontation”, and Dr Huberman explains that this part of the brain is linked to the dopamine reward pathway (and this plays a big part in us experiencing pleasure).

Faced with a threat, when we move forward in a safe way, we suppress the amygdala, and we send signals to the dopamine reward centers of our brain “to reward us for forward effort” (Dr Huberman).

So in the face of a threat, a sense of forward action will help, and that can be replicated through the use of the lateral eye movements in EMDR - the brain thinks you are moving forward, and this suppresses the fear/alarm system of the amygdala, and it also rewards you through the production of dopamine.
 
EMDR delivered to the comfort of your home
 
When the pandemic hit, we were all required to use an online format to deliver EMDR therapy.  I use a HIPAA compliant portal to meet you online; we still get to face each other, and use the EMDR protocol effectively, and the only difference is that we face each other on a video screen, rather than sit with each other in an office. 

The benefit is that you can benefit from therapy in the comfort of your home, and you can schedule your sessions with more ease (cutting out any travel time).  This has worked extremely well with my clients, and therapists have been using this format long before the pandemic. 

Here is some research to support the use of EMDR in a virtual setting - 
  • Brown, G. O. S. (2021). Reflections on Providing Virtual Eye Movement Desensitization and Reprocessing Therapy in the Wake of COVID-19: Survival Through Adaptation. In Shared Trauma, Shared Resilience During a Pandemic (pp. 235-248). Springer, Cham
  • Jones, C., Miguel-Cruz, A., Smith-MacDonald, L., Cruikshank, E., Baghoori, D., Chohan, A. K., ... & Brémault-Phillips, S. (2020). Virtual Trauma-Focused Therapy for Military Members, Veterans, and Public Safety Personnel With Posttraumatic Stress Injury: Systematic Scoping Review. JMIR mHealth and uHealth, 8(9), e22079
  • Tarquinio, C., Brennstuhl, M. J., Rydberg, J. A., Bassan, F., Peter, L., Tarquinio, C. L., ... & Tarquinio, P. (2020). EMDR in telemental health counseling for healthcare workers caring for COVID-19 patients: a pilot study. Issues in Mental Health Nursing, 1-12.
  • Bongaerts, et al. (2021). Safety and effectiveness of intensive treatment for complex PTSD delivered via home-based telehealth

I hope you found this as interesting as I did! If you have any questions, get in touch. 

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917

#EMDR, #FindanEMDRtherapist, #EMDRTherapy, #EMDRTherapist, #TraumaTherapy, #FindATraumaTherapist, #HealingFromTrauma, #FindATherapist, #ridgewood, #BergenCounty, #NewJersey, #teletherapy, #FindACounselor, #Counseling, #Psychotherapy, #psychology, #MentalHealth, #Depression, #Anxiety, #Trauma, #Stress
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Due to the COVID-19 health crisis, we are only offering sessions online. ​
Our address is 143 E Ridgewood Ave, #1484, Ridgewood, NJ 07450

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​EXPLORE TRANSFORM LLC

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