Category Archives: therapy

Understanding When a Partner Withdraws Through Therapy

The five most common reasons why a partner withdraws.

Telehealth therapy understanding why a partner withdraws

Intimate partners create internal maps of how their partners think and feel about themselves and the relationship. They can pretty accurately predict what thoughts and behaviors they can expect in most situations from that knowledge and understanding.

But sometimes, those comfortable and secure expectations slowly or suddenly go awry. A partner’s predictive behavioral patterns shift without warning or explanation, leaving the other partner confused and unsettled. A withdrawing partner often becomes even more inaccessible when pressed for reasons or attempts to understand.

Rarely have I been called by those partners. It is much more likely that the newly-exiled partners are worried that something is wrong and need help to understand and what they can do.

Continue reading at Psychology Today.

Report: Women May Get More Depressed as Romantic Relationships Progress

Women’s self-esteem suffers more than men’s as romantic relationships progress

study finds women more depressed as relationship progresses

For people in romantic relationships, how do their feelings about themselves and their lives change over time? If their romantic relationship is a marriage, do they really live happily ever after? What if they are just dating or cohabiting? Suppose the partnership is a new one, formed after a previous one ended—do coupled people do better at relationships over time, after they’ve had some previous romantic relationship experience? Women are supposed to be the romantic relationship specialists, according to our stereotypes. Compared to men, they supposedly feel more and more satisfied with their lives as their relationships progress, and they supposedly enjoy greater boosts to their self-esteem, too. But do they really?

All of those questions and more were addressed in “Subjective well-being across partnerships,” a report published in the June 2021 issue of the Journal of Family Psychology. Matthew D. Johnson of the University of Alberta and two colleagues from Germany, Franz J. Neyer and Christine Finn, analyzed data from a longitudinal study of a nationally representative sample of Germans. For this investigation, the social scientists focused on 554 people who were in two romantic partnerships over the course of the study.

Continue reading at Psychology Today.

Make a telehealth appointment if you live in Washington and are looking for therapy help.

Telehealth Therapy for Understanding the Fantasy to Get Your Relationship Back on Track

Understand the Effect of Fear on Your Relationship With Telehealth Therapy

How telehealth therapy can help with fear in your relationship

Many of us are in the process of recovering from the last year of living under the threat of Covid-19; we are vaccinated, pulling off our masks, and moving in to hug the people we have missed. We are venturing out into the world, whether that means visiting friends’ homes, dining in restaurants, or shopping in stores. Now that some of our fear is lifting and our focus is not solely on our survival and the safety of others, we are going about getting our lives back into balance.

This means looking at the ways that our relationship might have been knocked off-kilter during the pandemic and getting it on track again. It is an unfortunate reality that when we are operating in survival mode, we stop paying attention to other aspects of our life. Chief among these is our personal relationships. It is very likely that, with our hardly noticing it, the undercurrent of tension/alarm during the pandemic has had an impact on the way we relate to our partner. Prolonged stress has that kind of effect.

Fear has been a dominant emotion for all of us over the past year. It has affected every one of us, regardless of whether you are unaware, partially aware, or fully aware of having felt it. Fear is an appropriate reaction to danger. We need to feel it; it keeps us safe. But it can also make us self-protective and distrustful. Then we shut down emotionally, which causes us to stop being vulnerable and available to others, especially our partner. Fear can also leave us feeling overwhelmed and powerless. This may make us desperate to be helped or saved by someone else, and during the pandemic, often the only person to turn to for this would have been — you guessed it — our partner. So, we have conflicting reactions: We want to push away our partner, while at the same time, we feel an intense need for them. We often resolve this dilemma by forming a fantasy bond in our relationship. This is a largely unconscious, defensive strategy that we originally developed in early childhood to deal with pain and frustration.

The fantasy bond offers an illusion of being merged with and connected to another person. When we become fearful and self-protective, we withdraw from the emotional give-and-take of interpersonal exchanges to a fantasy of love. When we become anxious and alarmed, we forfeit our independence to maintain this imagination of being one with our partner. However, the fantasy bond eventually takes a toll as it replaces the actual love and intimacy between two people.

Continue reading at Psychology Today.

Make an online telehealth appointment for residents of Washington, Oregon and Florida.

Telehealth Therapy Tips: Listing to Your Future Self

Oregon Runner Considers Therapy of Listening to Self

Oregon Runner Contemplates Therapy of Listening to Self

I went running today. I would not consider myself a runner yet I do run. I picked it up after adopting my son and I stopped going to the gym. I needed the exercise for my general well being and I feel better when I get my heart rate up. I stopped after a knee injury and then picked it up again once in the pandemic. So this go around I have been running for almost a year, so really I think I can call myself a runner.

How do we characterize ourselves? What labels do we own or push away. What do others put on us that we accept or reject. Sometimes these labels can be helpful and sometimes limiting.

I would not say I like running. Often times I choose to push myself to go because I really don’t want to. Pick the excuse: it is hard, it is rainy and cold, it is not a good time, maybe the rain will stop, I can do it later. And I learned years ago after going to gym classes regularly that I always felt better after. I used to have a chat with my future self when I didn’t want to go. And she always said, “You will feel better. Go. Talk to me after. Move it. Just go.” She gave me a gentle shove out. And I have learned to listen to her. And to be honest, I did sometimes have this conversation out loud. Now I just experience a deep down knowing to go now; if I wait too long  the inaction will become the decision of not going because there isn’t enough time.

Can we all check in with our future selves and see what may be something that would be beneficial in the future that we may not see or know now? How often do we listen to this? How often do we choose the easy instead of the hard, and choose not to push ourselves?

I do not run for speed. Or for distance. I do not compete yet. I do compete against myself. I push myself to go a little harder in the big picture. And I also listen to my body when it says it needs something easier. Better, faster, harder is not always better. I have good days and bad days; days when I need some slow gentle run and days when I need to push hard.

Can we give ourselves compassion and listen to what we need? And to be okay with what we need changing?

Just a few thoughts running through my head (no pun intended, yet a good one).

Take care, Caroline
If you or someone you know is interested in Oregon telehealth therapy, contact me to make an appointment.

Is Your Telehealth Therapist Licensed for Your State?

Therapy Licensing for Oregon, Washington & Florida

telehealth therapy licensing explainedYou may think that telehealth allows you to see any clinician anywhere. This makes logical sense. You are on video. Your therapist is on video. Why would it matter where you are located?

It does matter where you are located. Legally you need to be in the state where the therapist is licensed.

When I had an office where people came to see me in person, we were all located in the same place. It was never an issue. Easy peasy, it was not an issue. People came in or cancelled.  We didn’t typically just switch venues to video or phone because of a cancellation.

Telehealth changes everything because you and the therapist can be located anywhere. Yet legally, your therapist needs to be licensed in the state where you are in when you are having the session. I will state psychologists may be able to cross state lines. Other types of mental health practitioners are trying to gain access to be able to cross state lines with the change to video sessions. That is not yet the case.

As an LCSW, I am licensed in Oregon and Washington State. I am also able to practice in Florida. Some states have an easier system to be able to get a temporary license or to get permission to provide therapy to people in their state. Other states require you to go through more paperwork as if you were getting licensed.

This is something to consider when thinking about seeing a clinician.

Take care, Caroline

If you have more questions about Oregon, Washington or Florida state therapy licensing, contact me or make an appointment.

Seasonal Winter Mood Therapy

The Neuroscience of Springtime Bliss & Wintertime Doldrums

Seasonal rhythms may affect our mood via mu-opioid receptor (MOR) availability.

“We were shining our light into the days of blooming wonder. On and on and on, we kept singing our song. It’s easy to describe leaves in the autumn. And it’s oh so easy in the spring. But down through January and February, it’s a very different thing. On and on and on, through the winter of our discontent. When the wind blows up your collar and the ears are frostbitten, too.”
—from “A Sense of Wonder” by Van Morrison

Seasonal Affective Disorder’s acronym, SAD, sums up how many of us in the Northern Hemisphere feel during this time of year—when the days tend to be shorter and colder. February is one of Americans’ least favorite months, Gallup Polls have found.

Long before SAD was included in the DSM-IV in 1994, William Shakespeare summed up the seasonal pattern of recurrent depressive symptoms that usually begin in late autumn and continue through early spring in the opening line of William III: “Now is the winter of our discontent.”

In 1985, this age-old phrase was repurposed by Van Morrison in “Sense of Wonder” to juxtapose how the song’s protagonist feels in January and February compared to the spring and summer months. The Winter of Our Discontent is also the title of John Steinbeck’s final novel, which has been described as a “tale of spiritual crisis.”

When it comes to seasonal variations of mood, humans since de temps immémorial seem to grow increasingly happy and contented as the days get warmer and longer, which happens in opposite months for those living in Northern vs. Southern Hemispheres. (December to February is summer in Australia, for example.) Literally and figuratively, the transition from spring to summer is generally considered a hopeful and regenerative time of growth or rebirth.

Continue reading at Psychology Today.

If you or someone you know needs help, contact me about telehealth Therapy in Oregon.

Grief Counseling Advice During Pandemic

Counseling Reflection on Grief & Loss During the Pandemic

We are now close to a year into this pandemic and life has been trying on many levels. People who used to have access to ways to care for themselves don’t have the same access as before. Self care is challenging to say the least and I know people have different levels of comfort with risk.

One thing I talk to my clients, as well as my family, about is that there is a lot of loss. And the loss keeps coming. Winter holidays have come and gone, and for a lot of people holidays were extremely different then years past. Life is different. Most people have had birthdays already. And yet we are still in it.

Please don’t compare your pain. On a Brenee Brown pod cast with David Kessler, who is an expert in grief, he shared that the worst grief is the one you are going through. Don’t compare, you can almost always find people in worse situations or better positions. Comparison keeps you from feeling what is really going on. You grief is your grief. Feel it.

If you need help in this trying time, contact me for ways I can help.

I wanted to share this video, It does have curse word in it, just FYI.

Benefits & Obstacles of Telehealth Therapy

Review of Telehealth Therapy Sessions

It has been an interesting time. Back in March I thought 2 weeks for telehealth, then it extended again and again. Here are some things that I have found to be helpful for my clients, as well as the downfalls.Telehealth therapy review from Oregon Therapist

Telehealth Benefits

1) It is easy. People love being able to just sign in. They can just have woken up. Be running late. And then sign on. When in person, I would text and they would scramble, unless they lived in the neighborhood, they couldn’t make it in time, so it was a missed session. So in addition to ease no late cancellation fee.

2) No need for babysitters and no commute. I am able to see people all over Oregon. Hopefully in Washington and California soon with getting licensed. It opens up possibilities for people to be able to see who they want and not be confined to geography and commute and schedules.

3) it can be much easier to schedule because there isn’t a commute or geography to deal with. People can use their lunch break or leave work and talk in their car.

4) We can talk and not wear masks. Masks cover much of the face which is a big part of therapy, me being able to see you as well as you seeing my reaction.

Obstacles for Telehealth Therapy

1) no babysitters, so depending on the age of the kids, they can come in and interrupt the session as they also need attention.

2) The physical location. Not having a space to go to, that is safe, and confidential. Sometimes it can be very challenging for people to be able to find a quiet, confidential space to talk.  Some people have mentioned they miss coming in to a different space than their home or car.

3) Being in person. And there isn’t the same three dimensional aspect of seeing someone in person.

Contact me for more information on Oregon telehealth therapy.

Gender Diversity Health Model

Gender and Sex are Complex

Gender and sexy health therapy.Gender is not as simple as putting people into neat boxes of “male” or “female.” A useful way to understand gender diversity is the gender health model, which encourages people to fully explore all parts of their gender identity and gender expression. Gender identity is one’s internal sense of self as male, female, both, neither, or something else. Neurologically and philosophically, gender identity is anchored in the brain or mind. But what about sex?

Continue reading on

Gender and sex are complex.

How I work with people: part 4

Things to Love About Coaching Homework

Another word on homework. I often have people come in having not done their homework. It is not my job to shame you, I find that people do that enough without adding any more. We can explore what occurred that you didn’t do it. Although, I often find that a couple of things can happen when people haven’t “done” their homework:

  1. they did and just didn’t realize it
  2. they explored something else that had meaning to them
  3. what was homework, didn’t show up for them so they didn’t have the opportunity to explore it
  4. there was hesitation to facing into the homework and then the work is to explore that.

LGTBQ-friendly coaching homework Portland.The thing I love about homework is that the therapy or coaching session is not just this isolated event, a bubble of time for you to focus on you. Granted it is time for you, sometimes the only place people have to be listened to, connect with another and heard fully. Homework is a thread that connects the sessions together. It is a time for you to continue your intention to work on your goals outside of the walls of my Portland office. It is practice in “real time” in your “real life.”

To get started with your homework contact me to start your Portland coaching sessions with an LGTBQ-friendly therapist.

Photo compliments of Mister GC at