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Amy Stambuk, LCSW

Licensed Clinical Social Worker

303-895-5116

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Amy Stambuk, LCSW     303.895.5116

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areas of treatment

The journeys of our intimate relationships, of becoming an adult, of parenthood, and of our growing-up years are so full of meaning and complexity. I like to look at problems against this backdrop. Where are you in your journey? So often people come to therapy hoping to solve a particular problem. Perhaps you want more passion with your partner, to stop yelling at your kids, or maybe you want to address depression or anxiety. In peeling back the layers of the onion, clients often stumble upon the obstacles that keep getting in their way. Resolving these core experiences often involves taking emotional risks and practicing new ways of relating to ourselves and others. It's really about ownership--not self-blame, but really getting mindful about the part we play in our life narrative. It can be a very zen-like moment to discover that we indeed hold the keys to the locked door.

I am a family therapist and draw upon on a wide variety of theories and techniques, including: Attachment, emotion-focused, Bowenian, Gottman, internal family systems, solution focused, structural and strategic family therapy theories, child-parent and dyadic developmental psychotherapies, cognitive behavioral, existential, gender informed, mindfulness and body centered practices, narrative, object relations, psychodynamic, social learning, and play therapy (including art and sandplay techniques). I also use eye movement desensitization and reprocessing (EMDR) with kids and adults to help alleviate trauma symptoms.

Click on a topic below to get a sense of my approach to a particular issue you or your family may be experiencing. I also encourage you to simply call me to discuss your concerns and explore if my approach may be the right fit for your needs.

click on a topic:

addictions
affairs & infidelity
aging & life transitions
anger
anxiety
attention, focus, & ADHD
behavior modification
boundaries
business & leadership
child therapy (play therapy)
couples therapy
depression
eating & body image
emotion regulation
existential issues
family therapy & family issues
grief & loss
identity
infertility
intimacy & relationships
mindfulness & mind-body integration
parenting
perfectionism & OCD
play therapy (child therapy)
self-discipline & procrastination
self-esteem & acceptance
sexuality
social skills & confidence
stress
therapy with teens
trauma
women's issues


addictions

The quest for perfection, for certainty, for intensity, and for what's missing in our lives gets so many of us into serious trouble. Addiction so often leaves behind a wake of broken relationships. Shame. Remorse. Denial. Perhaps too there is a deep sense of loneliness. Angst over stopping. Panic over not having. Eventually it can spiral into life threatening consequences. If you have had success in a group program, doing some intensive therapy may be a wise move. Or perhaps you may be questioning if your pattern of behavior even qualifies as an addiction. Your substance of choice may be alcohol or drugs, exercise, gambling, porn, sex, or shopping. This part is not so significant. My stance in working with people struggling with addiction issues is both compassionate and challenging. The reason for the challenge part is that I believe it's important to own the tendency to downplay. Part of the work involves looking with wide eyes at the depth of the problem. The compassion part involves a bit of deep sea diving. Addiction often surfaces from an attempt to soothe pain, to numb or to check out. In looking at your relationship patterns and key events in your life, we may get a clear sense of the burden you carry. The goal is to lighten this load and practice new strategies for managing uncomfortable feelings. We will focus on your strengths and what resources you bring to the table. We will explore the "missing pieces" in your story and wonder what writing a more meaningful next chapter might look like.

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affairs & infidelity

Whether you are married or in a committed relationship, rebuilding your relationship after an affair can be like taking a blindfolded walk in a minefield. Sometimes it's important for an individual or a couple to discern whether it's best to part ways. Counseling can help you make sense of what happened, provide emotional support, and help you cope during this difficult time. If you are the hurt party, you may feel like your world is spinning out of control and you no longer even know who you are. Working through the tumble of emotions you experience day to day and regaining a sense of self-worth will be a difficult but valuable journey. If you are the person who had the affair, you may be experiencing a mix of emotions and needing support with changes happening in your family and your world. Or perhaps as a couple you do want to take that walk in the minefield and determine if repair and reconnection is even possible. It's important for couples to understand that an affair is not simply a sexual betrayal. It's much bigger than this and involves a violation of your attachment bond, the security and love that supports and feeds your relationship. Many times an affair occurs because there is an intense hunger for connection that is not being met in the relationship. It can serve as a profound wake up call. In responding to this call, the work is really about helping you put each other first and about ensuring your relationship is grounded in a felt sense of connectedness, love and security.

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aging & life transitions

As we move towards the twilight of our lives we can either develop a deep satisfaction about how we wrote our story or experience a deep despair. Transitions such as kids leaving for college, a 50th birthday, an upcoming retirement, or the death of a friend can stir up these feelings in powerful ways. The process of aging involves letting go on so many levels. As losses accumulate, we may wonder where our place is in all of it. In reflecting back on our life, it's important to look at our coming years as a different set of chapters. Perhaps it's an opportunity to do some imagining. I love the notion that we get to be the authors of our lives, that we are the main character in our narrative. Sometimes it's the story we tell ourselves that needs to be thrown out and rewritten. Therapy can provide a platform to consider your story and where you see yourself heading. It can help you see possibilities instead of roadblocks. It can also provide a chance to take stock of your support system. Connections with friends and family and sharing interests with like-minded people are integral to sustaining our well-being. This is where creativity may come into play…adding, subtracting, shifting plot lines, introducing characters…all so you can feel life's fullness.

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anger

If you bury anger it tends to show up in your body--headaches, digestive problems, insomnia, stress. You may be passive-aggressive in how you express grievances. If you are more on the expressive side you might react with aggression and rage. The main thing to know is that anger is not a bad emotion. I think anger is about power. So often we are trying to get our power back--to protect ourselves or regain control. My approach is to validate your experience of anger so you can feel it fully. So often the move to contain anger is poorly timed. Same thing happens with expressing our anger…we rush in or wait too long. It's critical to dig deep and look at the root causes of your anger and thought patterns. In getting mindful about what's underneath your anger, you may discover that you are feeling hurt by someone, fearful about a situation or relationship, or just plain frustrated. I can teach you practical strategies for 'regulating' in the moment when you find yourself getting triggered or flooded. Or if it is beneficial to express your anger to someone we can explore effective ways to do this. Sometimes it's important to put down the sword and find a softer, more vulnerable way to share your hurts. Sometimes it's important to take the risk to speak up and make yourself heard. And then, there's that whole bit on forgiveness too.

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anxiety

When you are anxious, your thoughts are restless. Your body may feel edgy and tense. Often worries get stuck in a spin cycle and you find yourself living in the land of worst case scenario and self-doubt. Free-floating (generalized) anxiety finds all sorts of events and stresses to worry about. Or maybe your anxiety is more specific, such as getting the jitters during social or performance situations. You might be the parent of a child who constantly clings to you or refuses to talk, and you wonder if separation anxiety or selective mutism is going on. Perhaps your anxiety has developed in an even more narrow way, as a phobia. Or you may be experiencing recurrent panic attacks or obsessive compulsive thoughts and behaviors. One of the key components to treating anxiety is simply to learn how our "worry brain" works. By noticing how automatic and unreliable our "worry brain" is, we can start to regain control. The goal is to lay down a new mental/neurological path, one that activates a sense of manageable risks. Often anxiety is intergenerational, so we may take a look at how anxiety was managed in your growing-up years. Who taught you to cope with fearful and unknown situations? What messages did you learn from this coaching? How might you create a remix of the self-talk recording that plays in your head? Another powerful tool for taming anxiety involves tending to the body. We will review lifestyle practices around eating, sleeping, and exercise as well as look at negative habits that may be feeding your anxiety. Through breathing and relaxation exercises, you can learn to cue up a more relaxed physical posture. Your thoughts then are more likely to be more realistic, grounded in the present. Calm.

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attention, focus, & ADHD

You may be the parent of child or teenager who was recently diagnosed with an attention and/or hyperactivity disorder. You may be an adult who has struggled your whole life and never gotten the right kind of support. Counseling can help you get educated about this disorder-learn the ins and outs of how the ADD or ADHD brain works and its impact on behavior. Education is so empowering. If we are outfitted with the knowledge that we are dealing with a real disorder, we are more likely to come to a place of acceptance. Early in my career I spent a long time working in schools and helped identify kids with attention and hyperactivity issues. In developing strategies to help kids succeed academically and socially, I quickly realized that this is a team game. One of the ways I can support you is to provide individual counseling so your child can build on strengths and practice needed skills. Typically, a lot of cognitive problem solving is useful, as is support around making and keeping friends. Or perhaps there are also underlying issues like anxiety, depression, or more significant behavioral concerns. I also serve as a consultant or collaborator with parents, teachers and other involved professionals. Providing parents the right kind of parent education and support is crucial. I like to "walk through the day" with parents and learn what the hotspots are. We will brainstorm how to establish routines and rules that makes sense for your household. We will do a lot of talking about providing immediate and frequent feedback, how to make consequences stick and the best way to do rewards and punishment. I like to get creative with the organizational dynamic "stuff," and frequently, it's your child or teenager who may just have the best solutions. Lastly, we will talk in an ongoing way about how you can maintain the "center" in your parenting role, enjoy your child more, and take better care of yourself.

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behavior modification

Nothing is more powerful than well-timed praise, a smile, nod, wink, given at just the right moment. The kicker though is most of us are enrolled in the beat-yourself-up school of behavior modification. We are really good at noticing when things are going wrong. We are experts at negative reinforcement. We nag, pounce on mistakes, yell, wring our hands. We don't mean to…it just seems to mysteriously happen. We also tend to overanalyze behaviors and give them way more power and meaning than they actually deserve. Sometimes a behavior is simply a behavior. If you are a parent you may have found yourself making a sticker chart and then shifting to ignoring to nagging and then running to the toy store. You just want the whining to stop. I love to help parents retrain their mindset so they can make positive reinforcement work for them. I often use humor to do this, mainly because laughter is way more pleasant than whining. It's also helpful to break down the desired behavior into manageable parts. So often we miss the part where we show children what it is we are looking for, step by step. I often teach parents and kids to role-play desired behaviors during moments of calm. Practicing and rehearsing are powerful tools. You don't have to be a parent to reap the rewards of behavior mod in your life. If you have ever tried to commit to going to the gym regularly, you are more likely to go by putting on your workout clothes. Want to see more of a behavior in your life? Let's break it down, practice, and help you find ways to praise your efforts.

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boundaries

In science class, you probably learned about osmosis and how liquids pass through semipermeable membranes into solutions with more solids. Emotional boundaries are a bit like osmosis. If you have a semi-permeable boundary you are likely to be comfortable sharing who you are but keeping some stuff private. Most of us have some tuning up to do in this area and this is where counseling can provide needed insight. Being receptive to others is such a valuable interpersonal quality. Problems happen though if your interpersonal boundaries are too loose. You may over-accommodate or become too dependent on others. You may find yourself getting emotionally tangled up too quickly or feeling the need to take on others' burdens. Being able to say no and being assertive is a necessary skill. Taken to the extreme though overly rigid boundaries can result in critical attitudes and behaviors like shutting others down and detaching. You may find yourself lonely and unable to connect. Dysfunction in families follows these patterns. Enmeshed families can feel smothering and suffocating, an emotional free-for-all. Detached families often don't have enough emotional juice and information is not shared…it's an emotional desert. Individual therapy can help you become a better witness of how you relate to others, what your strengths are and where you need to grow. Family therapy can help your family rebalance power, redefine roles, rules, and rituals and find healthier ways to relate. Moving towards 'interdependency' in relationships makes them so much more enjoyable, and feels liberating. We get to be our own person and have autonomy. We get to practice relying on and giving to others and yet, we are still ultimately responsible for our own 'stuff'.

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business & leadership

So Freud was onto something when he talked about the importance of love and work (though his stance on the psychology of women was clearly problematic). Our professional lives are a huge part of who we are. Finding work that we love is key. It's also critical to find or create a working environment that supports our growth. When we experience a difficult transition or challenge at work it's often hard to know who to talk to and what to say. You may have recently experienced a lay off or are anticipating retirement. You could be wrestling with a complex ethical dilemma. Perhaps you are in the throes of a power struggle with a colleague or boss. Maybe you are the new boss and are feeling overwhelmed and insecure with how to lead your team. You may have taken a pause to raise children and have fears about re-establishing your career. Or maybe stagnation has set in and it's time to change direction. Perhaps you have known for years that you need an exit plan and are terrified with following through. Taking the time to focus in on workplace dilemmas can provide you with clarity and shine the light on potential next moves. Sometimes it's your own issues that are getting in the way and you need support in better navigating organizational dynamics. Sometimes it's the culture that's the problem and you need a nudge in making that needed change.

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child therapy (play therapy)

Play therapy is a unique treatment approach primarily used for toddler-aged children up through about 12 years of age. By allowing children to relax into a language they intimately know, they are more likely to express their feelings, identify unmet needs and reveal how they feel about themselves and their world. I use a non-directive approach and then weave in directed activities once I have a sense of the themes. For example, I often use children's literature to help your child more fully express or contain emotions. Or sometimes I use dramatic role play to develop interpersonal skills. Art and sandplay work are often part of the mix as well opportunities to manage frustration through problem solving. I often invite parents to join at the end of the session. These interweaves enhance the potential for shaping change and also allow parents to take an active role in the process. Play therapy is useful for a variety of issues that emerge during early childhood and school-aged years such as anxiety, attention issues, coping with divorce or family changes, grief and loss, self-esteem, social issues, or just to promote resiliency. For children who have experienced abuse, trauma, or attachment injuries, play therapy offers a powerful experience of healing. With these children, I work on a longer-term basis and incorporate more trauma-based techniques such as EMDR or working dyadically with the child and primary caregiver. Since we all need to play and don't get enough it, be forewarned that I also like to incorporate play with teenagers and grown-ups!

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couples therapy

There is something so mysterious and so predictable about the conflict couples find themselves in. The topic of the argument may be trivial or big-picture. Suddenly you are in a familiar groove of an all-too-familiar soundtrack, lobbing criticism back and forth or retreating in isolation. It's like being in quicksand. You are not sure how you got there and you are both desperate for an exit plan. Typically, couples struggle with what to do next. Even after making up, the tendency, as Dan Wile so aptly observes, is to "alternate between periods of indiscriminate accusation and indiscriminate politeness." Emotionally focused couples therapy is an approach that will help you move from a narrow, predictable way of interacting to one in which your relationship - fights and all - is something you can turn to for support. One of the first goals of therapy is to tap into what you are each really feeling about a situation and reclaim it. So a fiery accusation about your partner always being late needs to turn into an emotionally felt response you have which is then expressed with your partner. When you risk sharing "I feel hurt and taken for granted," your partner hears the tremble in your voice and begins to listen. Practicing new interactional dance moves is tricky business. You may feel self-conscious or vulnerable. You may be tired of making compromises. My role as a therapist is collaborative, a coach not a referee. I am curious about the moment-to-moment shifts in how you relate to one another. So often there are opportunities to repair hurts by learning new ways to share what's really on your mind and in your heart. The metaphor of music is a good one. How can I make my voice be heard and still tune into what my partner is experiencing? Not radio silence. Not blasting it. Emotional connectedness. Learning how to listen, to tune in on a deeper level may seem mysterious-but it just requires careful practice.

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depression

As a culture we are not so comfortable with sadness. Feeling depressed is another matter. James Hillman once remarked that "depression stops you cold, sets you down, makes you damn miserable." You may be experiencing shame or stigma about seeking support. I would ask you to reconsider, to see reaching out as a sign of strength, a brave step. The fact is that one out of ten adults experience depression…so, you stand on common ground. Depression is so debilitating though, and can feel like a literal death, a never-ending emptiness. And yet, depression is highly treatable. My therapy approach combines interpersonal, mindfulness and cognitive behavioral techniques. Sometimes integrating creative approaches such as sandplay and art therapy makes sense, or EMDR. At the outset, my aim is to help you successfully manage symptoms, improve your relationships and nurture social supports. Progress in these areas often yields a deeper understanding of the source of your despair. James Hillman also said that "depression opens the door to beauty of some kind." Overcoming depression is really about reclaiming--reclaiming life after a loss, a connection with self and others, a path towards a future narrative. It can be beautiful journey.

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eating & body image

Food takes us back to our roots. Our very lives depend upon the nourishment we take in. Sometimes we stray in either direction. Overindulgence. Deprivation. A roller coaster combination. All paths lead to obsession, distraction, emptiness. . . and ultimately back to hunger. Often our food issues are born around very kitchen table where we learned to eat. Or maybe it's the cultural cocktail we drink in about what our bodies are "supposed" to look like (gender issues are undoubtedly an important few layers of the onion though may impact men and women differently). Perhaps we grew up with a parent who was shaming or overly controlling. Sometimes we are just attempting to cope with an impossible situation and eating or not eating becomes a source of comfort or control. Body image issues are so complex. It's dangerous to simplify. In exploring your unique relationship with eating and body image, it is my aim to take take you back to your roots. How is this relationship nourishing you? How is it doing harm? What is it you are really hungry for? This is a spiritual question but it's also a pragmatic one. In a compassionate way, we will review your practices related to nutrition and exercise. We will examine the mind-body connection and how negative thoughts get wired into habits. Through mindfulness exercises you can learn to calm overwhelming feelings, to notice patterns and make changes in your day-to-day life.

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emotion regulation

One way of developing emotional intelligence is to tune in to a deeper, wider range of feelings. It helps to take a curious posture towards your emotional life--to take notice of what is coming up for you. So often we limit the 'channels' of feeling we allow ourselves to feel because we are taught that certain emotions like anger or jealousy are negative. Or perhaps we learned to not show weakness or fear. The opposite end of tamping everything down is being too reactive. If we over-express how we feel, we fail to look at situations from different angles. We often miss the layers. Understanding that your partner's anger is masking their feelings of vulnerability and fear may help you restrain your urge to lash back. It's important to do a self-inventory of how you regulate: Are you more likely to (a) refuse to have a difficult conversation, (b) leave, or (c) change the subject? Or are you more likely to overreact? If you are willing to practice new skills, you might break new ground in how you resolve conflicts. Developing tolerance for your own feelings, and communicating them clearly are great skills to learn and practice. Lastly, it's important to know how to take care of yourself and other people during times of distress. Breathing. The power of touch. Calming activities. Tuning in to our basic needs for security and comfort. These are all essential skills that help us effectively regulate our emotions.

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existential issues

Our difficulties in life can leave us feeling unsettled and unsure. Learning to trust the world, and defining our place with family, peers, and ourselves is supposed to happen during our early years. As we grow a more solid sense of who we are, we look for love and connection to balance the sobering reality that we are essentially alone. If you often feel alone and disconnected from others, therapy can help you find ways to seek out nurturing relationships and build community in your day-to-day life. Another existential question that often surfaces in therapy is, "Does my life have any meaning?" Many of us have the trappings of a profession and and possessions but we quietly struggle with a sense of life being purposeless. Creating a meaning-filled life demands that we do some weeding out of what is no longer working, some retooling. Or perhaps the road not taken in your earlier years is truly the path you are most passionate about. Therapy can help you step back and get mindful about the bigger picture. The simple answer to these big questions often circles back to how we face our innermost fears. I also think it relates to our sense of power, creativity, and playfulness. I am reminded of Woody Allen's quip when he says "I took a test in Existentialism. I left all the answers blank and got 100." Taking the risk to unravel the answers is a big step, and you may discover some surprises along the way.

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family therapy & family issues

I offer family therapy as a primary way of working as well as a way to complement individual therapy. In fact, family therapy can take place with just an individual. The focus here is on understanding and changing relationships to family members, typically your family-of-origin. Your goal may be to survive the holidays, to get out of the middle of conflicts between your parent and your sibling, or to make sense of what it meant to grow up with parents who divorced or had addiction issues. Looking at your "part" in relation to the whole will expand your awareness. You will get more flexible in how you react and respond to family dynamics. You will be more likely to balance staying connected with being your own person. You will start to notice ripple effects in your present day relationships or in your workplace. Family therapy is also structured with more people in the room: as a group, between parent and child, between siblings or between parent and adult child. It is so common for stressful events or life transitions to cause tension or turbulence in family relationships. Dealing with divorce, remarriage and co-parenting is a big one. Financial hardship. Moving. A marriage or birth of a child. Old family conflicts that were never resolved. Perhaps there is a member of your family struggling with mental illness or addiction. These are all common entry points. Ultimately my role is to help you relax enough to have the conversation that needs to be had. It's a radical shift from "fixing the problem" to looking at relationships in a more comprehensive way.

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grief & loss

The heartache of grief comes knocking on our door throughout our lives. Parting with the innocence of childhood. Saying goodbye to a cherished pet. The loss of a first love. Facing a miscarriage or infertility. Moving. The loss of freedom that comes with parenting and then, the empty nest. The loss of health or beauty that comes with aging. Receiving a life-changing medical diagnosis. Loss of reputation. Retiring. The sudden or anticipated death of a loved one. . . Loss also includes yearning for what never was or what may not ever be. The support of friends, a spiritual practice, or simply the passage of time often carries us through this sadness. Sometimes though, grief is so overwhelming that we lose our bearings. C.S. Lewis describes grief as fear, an amputation, a numbing. . . "a sort of invisible blanket" between you and the world. If you are struggling with a more complicated grief, your emotions may be unpredictable. You may have difficulty stepping back into basic routines, work or social gatherings. You may be experiencing prolonged feelings of depression, guilt or anger. You may question if you are grieving in the right way. Counseling can offer comfort during this uncharted territory, allowing you the space to grieve in your own way. Finding creative ways to honor your loss through art, ritual or reflection can be very healing. Family therapy sessions may also offer an opportunity to witness your loss together, to adjust, to commemorate.

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identity

In the crime world, identity theft is when one person pretends to be someone else so they can get away with something. But on a more subtle level, a variety of people take on a false identity--they present a side of themselves to the world that is not authentic and not connected to what is really going on inside. At the extreme end with narcissism, the self that is constructed is smoke and mirrors, an attempt to have more power in one's life. Struggles with identity are not simply about self-absorption…it's more about a self that is not able to take flight. So often it ripples back to earlier experiences. Our sense of self is shaped by our relationships with early attachment figures and the stories that were reflected back to us--how much we learned to trust or mistrust others and ourselves. As adults we throw our own pebbles into the pond. If you are not feeling secure with who you are, this dramatically shapes the relationships you seek out. In reviewing your family and relationship history, the point is not to get mired in the past, but rather to figure out where you got off track. Finding a sense of true self is really about coming home. It's about feeling comfortable in your own skin and being receptive and flexible in many different contexts. Identity is also about culture. This is such a big ocean and includes important things like gender, ethnicity, race, religion, spirituality, class and so much more. What groups and environments do you find yourself swimming in? Where do you feel disconnected and dislocated and where do you feel truly at home?

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infertility

Even though so many people experience infertility, it's a very bizarre and isolating journey to move through. Receiving the news that you can't conceive naturally and will have to undergo a maze of treatments can be so devastating. It's also difficult for couples to come together on which types of procedures you are willing to try and which ones you may not be comfortable with. Can you even afford it? Is adoption an option for your family? Or are you considering forgoing children and dedicating yourselves to your relationship and other interests? The costs are not simply monetary. Moving through infertility consumes you. Riding the waves of hopefulness and dealing with losses or miscarriages takes an emotional toll on your relationship. You may have different expectations and very different ways of dealing with this struggle. Your ability to sustain intimacy and have a satisfying sex life may also be impacted. You may experience intense feelings of anger and jealousy. The grief can be overwhelming. Counseling can affirm your experience and help you weather the stress together. It can provide a forum to voice opinions and express feelings is a safe, supportive place. You may also prefer to come in individually and this too is always an option.

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intimacy & relationships

Our need for connection--to be seen, heard, and understood--is truly a life force, a lodestone we seek throughout our lives. So often what we didn't get in earlier years is what we continue to seek out. The trick is learning to stop going back to the well if it is not life-giving. True intimacy with a partner or in our friendships really demands that we are comfortable with being separate and being together. Overly clingy relationships often don't allow for claiming a separate sense of self…you get swallowed up. True intimacy means you get to breathe. Or sometimes we find ourselves in one-down relationships in which we hold all the control or we allow ourselves to be dominated. A relationship based in mutuality and trust allows for power and decision-making to be shared. I love the way Virginia Satir puts it when she says, "I want to love you without clutching, appreciate you without judging, join you without invading, invite you without demanding, leave you without guilt, criticize you without blaming, and help you without insulting. If I can have the same from you, then we can truly meet and enrich each other."

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mindfulness & mind-body integration

I think the most exciting intersection in the field of psychology today is where mindfulness meets attachment. In neuroscience, this brain-heart connection is called the "smart vagal system" and regulates things like heart rate, breathing, emotional expression and human speech. We live in a hectic world. The pace of our lives and schedules is not likely to slow down. Practicing mindfulness allows us to wake up, to shift out of automatic pilot and really take notice of what is happening around us and reflect on how we are doing. Turning off those thoughts that seem to spin endlessly around our heads often involves taking notice of our bodies and incorporating practices like breathing, exercise, relaxation, and meditation. But mindfulness is not some esoteric, solitary practice. It's meant to be shared. Attachment theory involves the lasting emotional bond that develops between parent and child and in our intimate relationships. We need nurturing and loving relationships to grow. When we are feeling relaxed and grounded in the here-and-now, we are more likely to communicate in ways that promote safety and emotional connection. We are more playful. We are able to share our inner experiences and feelings without getting defensive. We are more open and receptive to ourselves and others and we can tolerate stress along the way. It's a really good place to be.

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parenting

If we are honest, many of us have had grocery store moments with our children when we behaved badly. Maybe we too transformed into a sulky teenager or a toddler having a fit. One of the joys of raising kids is that we get to ride with them on their developmental journey, though all too often this tugs on our unfinished business or we are just plain stressed out. I love working with parents on retooling parenting philosophies and ensuring your children's developmental needs are truly being met. I often frame problems as dilemmas. It takes the heat off a bit. There are many right ways to parent. It's also fun to talk about those elusive concepts like grit and self-reliance and how you might nurture these together as a family. Whether you are a couple bickering about the "right" way to discipline, in the midst of a chaotic divorce, a single parent needing support or raising an adopted child, there is a way for you nurture connection and shape behavior in a more positive direction. In fact, it's critical for your children to know that you experience them as delightful. Perhaps the ultimate goal may be for you to take delight in your role as parent. In All Joy and No Fun: The Paradox of Modern Parenthood Jennifer Senior writes openly about the sacrifice parents make on a daily basis. That's the trick, balancing your individual needs alongside the ongoing giving of self within a fairly driven cultural playground.

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perfectionism & OCD

The quest for perfection is often simply about the need to gain approval and to feel needed and valued. In over-focusing on externals like our looks, our bodies, and our performance, we often pull off the pretense of success. And yet sadly, enough is usually never enough. We set a new bar, a new goal on which to make our happiness and self-worth contingent, and we never quite cross that finish line. Sometimes in childhood, roles get reversed and instead of experiencing a parent that mirrors and tunes into us we wind up serving a parent's narcissistic needs. As adults, our need to stand out or be special to others is really an expression of this earlier hunger--our deep longing for attention. Another form of perfectionism is all about maintaining control or certainty. Clinging to rigid belief systems is an expression of perfectionism that disallows others to hold beliefs different from us. We develop judgmental and critical attitudes. Or, in its severe form, as with Obsessive Compulsive Disorder, we become driven by obsessive thoughts or develop compulsions as means of warding off anxiety. The irony of perfectionism is that we often create beautiful vessels that never get filled. We find ourselves unable or unwilling to be in communion with others. Learning to accept our humanness is the way out. It is our weaknesses and vulnerabilities that bind us together. Making this shift involves head work (changing your mindset) and heart work (learning to love yourself as you are).

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self-discipline & procrastination

Many procrastinators are perfectionists and creative types. Therapy can help you become the kind of project manager you want to work for. You will feel more accomplished and have more fun along the way. If you find you are constantly spinning plates at home and in your work life, it's time to find a better rhythm. Procrastinators always have good intentions; it's their timing that's off. One version is to avoid taking action because you find certain tasks too humdrum. Or perhaps you need help on the organizational front, whether it's your physical space or how you break down a project into manageable parts. Or you may be missing the forest for the trees because you get overwhelmed. When we are overwhelmed, we get paralyzed or stuck on the hamster wheel. We lose focus. Sometimes we fear failure and success. Getting clear about your expectations is key. What do you want to accomplish? Who is the work for? What does it mean if you succeed? What will it mean if you make mistakes along the way? It's important to keep in mind that some of the most powerful learning happens when we make mistakes. When we can shift from responding to external performance measures like "working to get an A" to a more internally driven set of motivations, we can really take flight. This is the fun part. Creativity demands structure and messiness. Learning to delay gratification and work hard also means you get to celebrate.

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self-esteem & acceptance

Learning to value and truly feel good about yourself is a life-long adventure. If your sense of self is built on shaky ground or is poorly differentiated you may seek constant approval from others and be a chameleon in your interactions. Richard Schwartz writes about the importance of developing a self that is "competent, secure, self-assured, relaxed, and able to listen and respond to feedback." People sometimes begin therapy to work on a particular issue and soon discover the 'project' they are signing on for is much more ambitious. We all have parts of ourselves we are proud of and that allow us to shine. Often these are the parts of ourselves we show the world--the parts that are in control, that perform and achieve. We also have parts of ourselves that have been wounded and hurt. We tend to push these parts away, and painful and shameful emotions reside here. Other parts of ourselves kick into high gear when we get stressed or emotionally activated and we respond by numbing the pain. Therapy can offer a non-judging atmosphere to support you in witnessing the parts of yourself you may have difficulty accepting. Taking an adventure means you are open to discovery. You notice patterns in your relationships and in how you face challenges. As your acceptance grows, your internal experiences feel more congruent with what is going in in your life. Ultimately the reward for embarking on this trek is such a big prize. You get to feel more authentically you.

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sexuality

In thinking about sexuality it's interesting to think about how as babies we experience touch, how we learn to receive and reach out for touch, how we experience the world around us in a highly sensual way. As young kids, we may learn about sex on the playground, from the television, an older sibling. We start to understand its power and mystery. In our adolescent years, hormones kick in and we get a bit more curious (or a lot) and then, in adult years, experiencing the more erotic side of our sexuality becomes more central. Frequently, problems can emerge if we are not comfortable with sexual activity or our sexual desires. We may have internalized negative feelings from family messages, religious experiences, the media. Or perhaps we may have experienced trauma due to a rape or repeated sexual abuse. Having a safe place to explore these concerns can help develop more healthy intimacy in relationships-to be more able to receive and reach out in a way that feels comfortable. Other sexuality issues include our sexual orientation. Do we identify as straight, gay, lesbian, bisexual or transgendered? Though we live in a more open society, it can often be confusing and challenging to come to a place of true self-acceptance. Sometimes as parents, we may experience anxiety or a strong reaction about having a son or daughter who is GLBTQ. Or maybe we are flustered about how to talk about puberty and sexuality with our emerging adolescent. Counseling in an individual or family therapy format can provide a neutral, nonjudgemental place to openly discuss concerns. Sometimes too it's helpful simply to schedule a consultation meeting.

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social skills & confidence

Acceptance. Affinity. Attachment. Inclusion. Kinship. Loyalty. Rapport. Relationship. These are all synonyms for that universal need we all have to belong. We all deserve a place at the table. Yet sometimes, due to shyness or lack of confidence, you may feel bewildered with how to take a seat. Or perhaps you keep getting the subtle or not-so-subtle message that others find your communication style overbearing or quirky and you feel shut out. In growing your confidence we will start with your need to belong. We will explore times you have experienced belongingness and exclusion in your growing up years, social circles and professional life. Next we will do some dreaming about how you would like to rewrite your story. Then we will troubleshoot where you experience anxiety in social situations. Lastly, we will get practical and do some skill building. Our body postures and facial expressions speak volumes about who we are. What is your nonverbal communication saying to others? If you are getting stuck with conversational skills we may run through how to start, sustain and close conversations. Or we may work on drawing others out so there is more ebb and flow to your social interactions. You may also want help on communicating your needs in an assertive yet respectful way…so, not a doormat and not a bulldozer. In taking your place at the table, it will also be important to listen for the negative cognitive tape that runs in your head. Why not create one that supports your need to belong?

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stress

In The Upside of Stress, Kelly McGonigal asks us to re-think our stress mindset and see the silver lining that stress contributes to our lives. How often have you heard or said the words, "I am so stressed out!"? If flight-or-flight takes over, we either shift into overdrive and take on more responsibilities or we respond by numbing or tuning out. Extended screen time. Alcohol. Food. You name it. How do you do stress? Shifting from a negative stress mindset means moving from feeling overwhelmed and powerless to feeling hopeful and ready to take on challenges. McGonigal also highlights that we can move from stress to a challenge response in which we feel "focused and not fearful." So, if you shift your mindset, stress can help you increase your focus and channel your creativity. In looking at how you do stress, we will examine the moments you find yourself completely absorbed in what you are doing. What are your peak moments? Putting flow back into your everyday life is not an easy process given the pace of our modern world. In addition to talking about practical things like lifestyle choices around sleep, eating, and exercise, we may also crack open Pandora's box and look at big-picture questions: What gives your life meaning and purpose? Do you have a support system to turn to when you feel stress coming on? It turns out that regulating stress is all about neurotransmitters-the kind we get from doing things we love, from feeling loved, and from putting our minds and our bodies into this present moment.

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therapy with teens

If we shuffle back through the decades we could probably unearth several truckloads of commentary on the state of "teenagers today." The truth is teenagers are traversing a vast canyon land. Signposts for the trip ahead include Puberty, Peers, Gender Role Expectations, Brain Development, Sexuality, Autonomy, Accountability, Moral Decisions, Identity, and Intimacy. Deep in the canyon there is a life-giving stream, an emerging adult self that will either successfully or unsuccessfully leave home. It's a huge journey. It's an important journey. In my work with teens, I honor the enormity of the trek by being real. I risk sharing my opinion. I find a way to connect. I call them on their "stuff." In calling it like I see it, I don't let parents off the hook either. Parents often underreact or overreact to problems that surface during adolescence. We might back off too quickly, thereby depriving teens of the support they continue to need. On the other hand, we might hold on too tightly and fail to give teens enough room to make mistakes or "try on" being their own person. My approach to working with teens is dynamic. Though I offer individual therapy, I frequently work from a model that combines family therapy with targeted individual work. I sometimes involve "second family" by including friends or other surrogate supports. I like to mix it up and shift from a talking format to one that includes art or sandplay work or perhaps learning about how our brains shape our emotions and behaviors. If your teenager is uncertain or resistant about coming in, this is okay. I typically tell teens to try out a few meetings and see if it's a fit. Or, I start with parents and communicate that they are welcome to join the conversation at any time.

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trauma

Experiencing a trauma is like being caught in a painful riddle. . . even in moments of slight relief its presence keeps resurfacing. Within seconds your heart starts to beat and suddenly you are reliving a moment. . . the car crash, a sexual violation, being hit by your partner, childhood abuse. . . the list goes on. Typically, people think of trauma as horrific, unspeakable. It is. This type of trauma is often called "Big T" trauma and can occur once or many times over. So many of us also experience "Little t" traumas like an excruciating break up, an overly critical or absent parent, addiction, adoption, bullying. . . this list, too, goes on. All kinds of trauma damage our sense of self. We may have trouble sustaining meaningful relationships. We become disconnected. Frozen. Perhaps we escape and avoid. Or maybe we adopt a fighting stance. These are all normal responses to trauma. Successful treatment calls for a deliberate approach. Pacing matters. Starting with the body strengthens your ability to stay calm and engaged-- to breathe. Tapping into your inner resources and finding ways to relax is also critical. Eventually the goal is to return, to move through the painful experience so you can take it in, though in a different way. A well-researched technique called EMDR may be useful to incorporate (for more information about this way of working please see emdria.org). Ultimately the goal is to restore your sense of harmony and well-being, and yes, to discover some solutions along the way.

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women's issues

So many of us women are doing a tightrope act on a daily basis, balancing multiple roles and endless tasks. We have PhDs in caretaking and yet we routinely neglect to care for ourselves. One of the issues I am passionate about is helping women step back and look at the load they are carrying at home, in the workplace, and in their personal lives. We feel pressured to be all things for all people, to keep it together, and to look really good while doing it all! In a 2012 TED talk, Brené Brown shares research on the shame women experience for not being able to be perfect (you can find the link on my resource page). Shame for not being perfect? Sounds crazy, but the truth is that so many women experience shame in our everyday lives. Sometimes this experience of shame is so profound that we become emotionally paralyzed. Bringing more balance into our lives is not a quick fix; it requires discernment and the courage to make difficult decisions. Usually, something has to give. Women's lives are not linear. So often the decision to have children (or not have children) shapes our relationships, our careers and our capacities to pursue passions. While I don't think we can completely give up the juggling act, it's essential to find your 'center' and to be intentional about your choices. Finding time for yourself and your interests is fundamental, so this means truly carving out a 'room of one's own'. This is such a worthy conversation to have no matter what stage of life you happen to be in. I would be delighted to join you in this important work.

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The Colorado Center
for Clinical Excellence