Professional Counseling Services

(541) 788-1415 terrelkatie@gmail.com

2020-11-11T10:42:00.000-08:00

Articles to see below are:

Couples Therapy
Therapy Can Help With...
Anxiety and Getting More Out of Your Life
Non-Twelve Step Addiction Recovery
"Mindfulness" and How To Practice it in Your Daily Life: Eastern Philosophy Origins
Loss of a Pet: Dealing with the Pain and Grief
Managed Care vs Paying Cash Upfront

Couples Therapy / Marriage Counseling

2019-08-30T08:48:00.000-07:00

Couples experiencing conflict, or those wanting to take their marriage or committed relationship to a deeper level, will learn how to talk and listen to each other so that each gains a real, intimate understanding of the other.

You'll be able to move from that gut-level, reactionary mode of communicating to an intentional, conscious, non-defensive way of interacting. You'll make sense to each other. You'll both learn about where those deep feelings and frustrations come from in your past and theirs, what your unmet needs are and what it is you want and need from your partner. We'll create a safe environment to explore each person's thoughts and feelings. Your marriage can become a secure place to allow intimacy--"into-me-see."

While you may even feel now that you made a mistake in choosing this partner, it is highly likely that they are after all the perfect person to meet your needs (and you theirs). It is possible to regain the joy and contentment that we usually experience in the beginning of a romantic relationship. It's normal for the hormones and excitement of new love to wear off. If you can work through the disappointments and power struggles that inevitably follow, the love you create can be even more satisfying as you get to know your partner for who they are.

This therapeutic process isn't a lecture; my goal is that you'll be able to experience the possibility of taking your relationship to a new, healing, comforting and exciting place from the first session. If you can commit to looking inside yourself, doing the "inner work," you've taken the first step. Diversity is always welcomed.

Therapy Can Help With:

2019-08-29T08:03:00.000-07:00

Depression

Feelings of sadness, lack of energy, negative thoughts, low self-worth, lack of pleasure, lack of motivation; expecting the worst and not really caring any more.

Depression can occur after a specific sad or traumatic event, or may occur for no reason the client can easily identify. Messages you got in childhood can deeply affect your core beliefs about yourself, and we can look at those and see if they're true or if they need updating. Role playing with me can help you get in touch with some beliefs you live with that you might not be aware of. We explore thoughts, feelings and behaviors so you can identify where you'd like change and steps you can take.

Anxiety

May be acute feelings that something bad is going to happen, with heart racing and other somatic manifestations; or chronic negative thoughts, lack of confidence, constant worry, having the same thoughts over and over, intrusive thoughts; avoiding certain situations; a chronic unsettled feeling; feeling "not present."

Anxiety may lead to tension-reduction behaviors that are compulsive: Eating disorders, sex addiction behaviors, other addictions and unwanted behaviors
When you avoid what you fear, you reinforce that behavior by avoiding the anxious feeling--so you continue the behavior until the avoidance itself becomes a problem...There is a better way.

Smoking Cessation

Hypnosis is an effective tool to use to help support your desire to stop smoking.

Your subconscious has made an association: Stress relief/cigarette. You can change that automatic behavior, gain conscious control over it.

Weight Loss

Again, hypnosis is effective to help the "automatic overeating."

Phobias

Fear and anxiety about specific objects or situations

And they get worse as you avoid the situation or object and so reinforce your idea that it is good to avoid it. Pain and suffering are not the same: Getting bitten by a dog is pain--fearing all dogs afterwards is suffering

Relationships

Living with a partner triggers old defenses you learned in your family of origin. After the first year or so, you may be questioning who that person you were so attracted to has turned into. The honeymoon stage ends, and real growth towards true love can begin. You can learn to really view the other person as--well, another person. They're not you. You may learn that the two of you are, however, ideally suited to meet the needs and longings you've both always had. Learn a way to communicate that is conscious, intentional, and leads to mutual understanding and compassion. You may also need to learn how to be assertive and effective in communicating your needs and wants to employers, employees, or friends.

Isolation

Changes such as a move, job change, divorce/break up, can leave a person without the support systems they counted on and you may feel at a loss until you can create new ones

Trauma

Car accidents, rape, medical procedures, violence, natural disaster can cause trauma responses which if not processed early and well can lead to PTSD long term symptoms of anxiety, intrusive thoughts, flashbacks, avoidance of situations reminding the person of the original experience, nightmares, a feeling of depersonalization, nightmares. Counseling is a safe place to deal with those feelings and replace them with stronger, more adaptable and flexible feelings and more rational in-the-moment thoughts.

"Complex trauma" responses can arise from poor early attachment and childhood environment: Daily criticism, name-calling, ignoring, subtle or obvious neglect, intrusiveness, physical or emotional or sexual abuse, cold emotional atmosphere, or simply not being able to meet the child's emotional needs--these can also lead to depression, feelings of shame, anxiety, and other PTSD-like symptoms, including a feeling of deep emptiness, isolation, and unhappiness. These can also be treated.

Grief and Loss

Losing a spouse or partner, a good friend, or a child can be an almost unbearable pain
Loss of a pet, if that pet meant a lot to you, can also be very traumatic

Anxiety and Getting More Out of Your Life

2019-08-28T09:46:00.000-07:00

If you're considering counseling, you're probably feeling that you need a change in some area of your life. Many people come to counseling to learn how to be less chronically anxious, less self-conscious, less at the mercy of noisy and disturbing thoughts and feelings that keep them from being at peace.

Chronic feelings of anxiety, besides being uncomfortable, tend to limit our apparent choices. If you really value deep friendships and close relationships, yet you get so anxious at the idea of going out and meeting people that you avoid it, you might not get what you most want in life but may find yourself living in a smaller, more confined way. And so the problem becomes not just the anxious feelings, but what you do to protect yourself from them.

Some pain is unavoidable in this life, but being animals with vivid imaginations, we tend to suffer to a greater degree than necessary. You can get stuck in thoughts about who you think you are, why people are treating you the way they are, why you always act a certain way... and find yourself living with a mind that feels like a hamster on a wheel.

There are many therapeutic techniques for managing feelings of anxiety depending on the type of anxiety you're experiencing. Panic attacks are somatic experiences involving racing or pounding heart, shakiness, feelings of disconnect, and dread. You should know that as unpleasant as these feelings are, they're not "damaging" and they will pass. Chronic anxiety-- feeling unsettled, mind racing or compulsive thoughts, empty feeling, uneasy, fearful, constant worry-- however this manifests for you, makes life difficult. Sometimes a recent event, an interaction with someone or a loss, can trigger a reaction that has to do with how you experienced your early childhood environment. Criticism from a boss? Does that bring to life all the difficult feelings you had growing up, feeling you were never quite good enough? Getting healing for the past, whether it's your childhood past or recent events, can open you to a whole new world in the present and replace anxiety with confidence and calm.

We all want a life that is purposeful, meaningful, and we want to be active participants in it. We all want to have inner peace, close connection to others, and to know that we are competent, and belong. Counseling can help with emotional suffering, and you can gain a clearer picture of what you as an individual value most in life, and how to get there. If you've got that clear vision, you'll be able to willingly accept the moment as it is, and confidently continue towards what's meaningful to you. Therapy can help you do this in however many small steps you require and at your own pace.

Non-Twelve-Step Addiction Recovery

2017-08-23T10:56:00.000-07:00

Many people are helped by AA/NA, and many others do not care for the Twelve-Step program for a variety of reasons. Whether you attend meetings or not, there are alternative treatment methods. (In fact, Twelve-Step programs are not actually "treatment", but they are intended to be self-help support groups and protocol for people in treatment or following treatment.) In counseling we address several areas of your life important to recovery. In the area of drug/alcohol use, you may be powerless. In other areas of life you probably function very well. We'll identify your resources and use your strengths to deal with the issues and challenges of addiction.We'll identify the barriers to your recovery, too--you're probably all too well aware of those.

Motivational Enhancement Therapy focuses on the reasons you want to change your addictive habits. You may have mixed feelings about giving up alcohol or other drugs even though you know you need to--that's to be expected. We'll focus on how to deal with cravings, and how to create a plan (short term and long term) for your life without alcohol or other drugs. There must be something in your life that you value more than your drug of choice, or you wouldn't be wanting to quit. We will focus on that healthy part of you that wants and needs something more, while finding ways to block the triggers. You'll need to change your lifestyle and perhaps some of the company you keep. You'll identify your true friends--they'll support you in your goals.

Besides identifying and blocking triggers to abuse you'll be practicing skills you need to be a sociable person without the alcohol/drug social lubricant, and gaining some insight as to why using/drinking have been able to acquire so much power in your life. That might mean looking at your past history: Family dynamics, traumas, losses, and emotional pain? Or perhaps you just fell into drinking too much and now it's out of control.

Your situation is unique and your relationship to your drug of choice is unique as well. Using Cognitive Behavioral Therapy methods you'll learn to be aware of and challenge the thoughts that get you into trouble. Sometimes they're so subtle you think you just act without thinking...but you can tune into those underlying thoughts and feelings in time to catch yourself. You can pay attention to and increase the self-talk that leads to achieving the goals that you want for yourself. By being more aware of your thoughts and feelings at any given moment you are in a better position to deal with them in healthier ways. Sometimes our minds tend to turn into an internal battlefield, trying to solve problems of anxiety or other negative feelings and thoughts. Learning to accept those feelings as just one of the things your mind does to you is one way out of that inner mess.

Behavioral Therapy has been around for a long time and is also very effective. We'll look at what precedes your self-destructive behavior, and what reinforces it. You'll need to identify and change some of the behaviors that are part of your addiction cycle. That's good news, because you'll find that your pain and need is lessened as you make changes.

I also tend to use methods drawn from Gestalt therapy and inner parts work--you're not all "Addict;" there are other sides of you including a healthy part, that need to be identified, addressed and encouraged. (If you've been to rehab recently you are probably quite familiar with these theories and we will use what is helpful to you to support your progress.)

Having someone you can be completely honest with is an important part of therapy. People with addictions tend to have a secret life--giving up the secrets is basic to creating the new life you want. Counseling is confidential, by law and ethics, and provides a secure place to be open about your problems. If you're in a romantic relationship, secrets are keeping you from intimacy. Counseling can be a good place to decide when and how to tell a loved one what your situation really is, and begin to build trust again. Part of AA/NA that I think is helpful is the "sponsor" role; it's good to have someone nonjudgmental on your side when you need support.

(541) 788-1415 Call or email for info, with questions, or to set up an appointment.

"Mindfulness" and How to Practice it in Your Daily Life: Eastern Philosophy Origins

2017-08-22T10:11:00.000-07:00

There has been a lot of talk lately about "mindfulness." There's nothing new about mindfulness; ancient Vedic texts described it centuries ago. What does it have to do with you? Mindfulness is awareness of your "true Self," your physical sensations, your environment, your state of mind and your emotions. It is a sense of grounding, centeredness and mind/body connection; it is being in-the-zone and present for the moment and situation you're in. Below is a discussion of meditation, Self, False self (ego), and connecting with the spiritual and each other.

Meditating Hindu sages found "atman," the Brahman, the Life Force, the Eternal Soul, to be the same life force within every human. We tend to look for god "out there" but they said, "No, what you're looking for out there--That thou art"--Atman is within you.

Buddha later introduced the notion of "anatman" "no atman"--he said look for your Self and what do you find? Nothing. Emptiness. Anything that seems to have substance is dependent on something else--all is transitory including your feeling of having a self.

We do have a "Buddha nature" we were born with, which is the connection to the universal source of life, and is intrinsically compassionate and loving. Buddhists teach that we have an ego we experience as a "self" but in reality this too is just an illusion and as transitory as our body, and will end. We spend a lot of time protecting that "self," but if you will sit and meditate and do a search for it, you won't be able to locate it. This can be disconcerting at first, but is actually quite a relief to realize that most of our thoughts, feelings and behaviors are directed towards protecting this self-created identity or ego, and once we are mindful of those efforts, we can stop being so attached to them.

This attachment to the ego is what Ego psychology calls the "False Self." The True Self? Adyashanti describes humans as simply Consciousness--awareness itself. Aware of our sensory input, our environment, and our own awareness. We're aware of being aware.... (See a video clip of Adya's teachings by following the link to his site on this page.) Phenomenologically this is a "place inside" us that doesn't change over time and is not negatively influenced by external events. It's not the ego--it is unconcerned, and is aware of the ego. It's a sense of continuity of experience.

The word "Buddha" means "The Awakened One" and refers to his state of mind: He was conscious of the present moment and the true state of affairs of his own mind and Self in the world. He was enlightened to the fact that suffering is caused by craving--attachment to the notion that we can hold on to pleasant sensations forever, and that pain can be avoided.

The truth is, all things are transient: thoughts, material items, feelings, and our own egos. What "woke him up" was the realization that we are in a world where old age, disease, and death await everyone, and he wanted to know how to escape that fate. Being a good Ksatriya (warrior caste member) he believed that we're in a cycle of birth, aging, death and rebirth--a cycle of suffering.

What he discovered was that to end that karmic cycle, we have to realize that "emptiness" (the inherent insubstantial-ness and temporary condition of all things) underlies our existence, and live accordingly. He didn't mean that nothing matters--far from it. We must live with right speech, right thoughts, right work, right intentions, right mindfulness, right actions. And what do we do about the suffering we see around us? We meet it with compassion.

"Emptiness and compassion" are the two mainstays of early Buddhism. Why compassion? The truth is we are intimately connected to every other living being on earth, so why would we not care about their happiness as much as our own? We are all manifestations of Consciousness. Meditating on emptiness and on compassion are common Buddhist practices.

Modern therapists usually also advise a type of meditation that brings our awareness to the here and now:

Practicing Meditation and mindfulness can help you relieve anxiety and create a balanced and centered state of mind--equanimity-- that can be carried with you throughout your day and your life. To practice mindfulness meditation just find a comfortable spot and sit. Sitting cross-legged is the old Zen way and seems to connect mind with body and left and right sides of the body. You can hold your hands resting on your thighs or knees with thumb and middle finger touching, or resting just below your navel, right hand on top of left, palms up. I learned (from a Tibetan lama) to let my eyes rest on a spot on the floor in front of you. Or you can close them.

Focus on your breathing. Your breath and heart beat are about all you're guaranteed in this life--when they're gone, so are you. So focus on the instant when your breath is completely out, exhaled to its farthest point. This brings you to right "now," and again, the only moment you have is the one right now. As you focus on your breath, thoughts will come into your mind. "I could do this better if I got up and ate first." "I could concentrate better if I vacuumed first." "Why did he say that to me yesterday...." "Where will I go tomorrow..."

As these thoughts arise, just note them for what they are, don't try to stop them. Thoughts consist of--what? They're not solid objects. You can't find one to examine its properties. They are like mist or clouds or smoke--just let them pass through your mind like birds flying in one attic window and out the other. Be aware of them but don't catch them and get involved with them, let them go and re-focus on your breath. It may not feel comfortable at first to rest from anxieties--as though we "should" be anxious! As Adya puts it, if our minds can't find someone nearby to have conflict with, it will start in on itself.

You can begin to label the thoughts that arise. Thinking about what to have for dinner? Notice that, and label that thought "planning" and let it go, by re-focusing on your breath. A thought about a conversation you had yesterday could be labeled "memory." If there's a feeling associated with a thought, label it whatever comes to mind: anxiety, fear, happy, worry, discouragement....and continue to focus on breath. Acknowledging a feeling is a step towards acceptance of it. Trying to control feelings leads to struggle--just acknowledge, accept, and let it be.

The benefits of mindfulness and meditation are many. You learn at a deep level that thoughts are really empty. They come and go, arise and pass. They only mean what you decide they mean. Fear is based on thoughts of the future--your attention to your breath is right now. Shame and regret are based on past memories--breath is right now. A fast efficient way to turn your attention to the present moment is to focus on your breathing, wherever you are and whatever you're doing . After a little practice with the sitting method, you can easily do meditation in the car, walking, at meetings.... You might want to keep your eyes open--but just focus on your breath. Take frequent "check ins:" How do your hands feel on the steering wheel? What sounds do you hear? What is your anxiety level, on a 1-10 scale?

Another therapeutic technique to add to meditation is to name any feeling that seems to be possessing you at the moment (worry, depression, anger, etc.) and sit and invite it to reveal more of itself to you. Be curious about it. Meditate on it by naming it, inviting it, and then noticing where in your body you feel it. Don't try to change it--just experience it. You may then try to discover it's origin in your past history. Did you feel like this often as a small child? Is it a very familiar feeling? Where did it come from? If you find yourself feeling overwhelmed by the memories and self-exploration, redirect your attention to your present breathing.Whatever your past history, you're an adult now and not helpless.

Eckhart Tolle wasn't the first to talk about the power of now although he does it in a very articulate way. The Upanishads and texts more ancient than those tell us that although we look for god or whatever guides the universe "out there," it is to be found "in here." How do we connect with "it," experience it? We don't need to get ready, or change, or search for the eternal, beyond learning to accept the present moment for what it is. Looking within, accepting your life and self as it is with all the pain that's bound to be there at times (and the joy, too), not in five minutes from now but right now, is the way to connect with the spiritual.

However stressed or worried or anxious or depressed you might be, sitting in meditation and consciously saying, "I accept this moment just the way it is--this is my life in this universe right now" can really open doors to peace and contentment. Our minds tell us, "When I get over this anxiety I'll start to live. When I get over this sad feeling, I'll get what I need." We don't have to become a certain kind of person to gain access to the spiritual, we don't have to be in any particular mental state or moral condition. We do have to look for god in the here and now of this moment, realizing that this moment is all we have. The Zen Buddhist tea ceremony is an attempt to slow down an ordinary act of everyday life, by drinking and noticing the tea as though it were the first and only taste of it you will ever have. Any moment of time has something to offer us if we will stop and pay attention to what we are and what we're doing.

Loss of a Pet: Dealing with the Pain & Grief

2016-09-14T10:50:00.000-07:00

For those of us who consider our pets a member of our family, when they die it can be a devastating experience. The importance of our pets to us can run on a continuum from, "He's an ok dog," to "he's my best friend." If our lives are wrapped up in their care and companionship, we have to deal with true grief and pain in order to get on with our lives when we lose a pet.

Whether we expect our animal friend's death or it is sudden, there is often a feeling of shock and disbelief. The entire world can look and feel like a different place. We may wonder how other people around us continue on with their daily activities after such a tragedy. It may be hard to find people who are supportive enough for the feelings you have. We get sympathy for losing a human family member--sometimes not so much for a pet, yet the grief can be as deep.

It's important to know at that time that there are other people somewhere in your town going through exactly the same loss, the same kind of pain. If you have a friend you can share your true feelings with, that friend is golden. If you don't know anyone who can understand your suffering, there are pet loss groups that can be very supportive. (Contact information below.) There are websites to find by googling "pet loss." It can help to know that your feelings are healthy and normal. It's a sign you know how to love deeply.

It's important to be able to talk about your pet, with a friend, relative, or support group. You might feel like talking about what he/she was like, what you loved about them, what they did to bug you, what little habits they had, and what a great friend they were. You may feel like the world doesn't appreciate what an incredible little spirit your pet was! That can be a lonely feeling, so again, support groups are invaluable. And, whoever/whatever gives animals life in the first, that universal power, probably does know just how unique and special they are.

Creating a ceremony of some type can also be useful to memorialize your pet. When my horse died I took some of her mane to her favorite spot (a tree on a river trail she used to insist on standing and napping under) and buried some of it there. I burned some, and tossed some into the river. And kept some. On the anniversary of her death I go there and sit under the tree and remember some of the good times we had, and imagine her being free now to go wherever she likes. She never did like to be told what to do.

Some people can't talk about their pet without crying, even years after the death. If you still get teary-eyed and it's been a year, or two years, or three, don't worry--it can often take up to five years until the good memories replace the tearful ones and you can talk about him/her without crying. The tone of your emotions will gradually change, and the memories will not always cause such sadness. Research has shown that people who invite memories of their time with the pet, feel sadness more often. (That just makes sense.) People who refuse to think about the time they spent with their friend get over it faster--but they lose the positive memories as well as the pain. It's kind of a choice.

A word of advice: Let yourself feel. It may seem as though if you let yourself feel the total sadness of your loss, it will kill you. It won't, and in fact acknowledging your pain to yourself and even welcoming it and letting yourself cry for as long as you need to is in the long run more healing than trying to push the feelings away. There may be times (in the grocery store, at work...) when you need to tell yourself not to think about them now. But mentally set aside a time specifically to allow any feelings that want to come, and nurture yourself by giving permission to feel what you feel. A willing acceptance of your present state of mind is always a wise choice.

Do you have a spiritual faith or belief? Now is the time to draw on that. Other people may tell you their ideas on what happens after death. Let them. You know best what you believe. However, at this time it's ok to bend your beliefs a bit if necessary. If you've always believed that death is the end, but you'd like to think your friend is in a happy place--believe it. And you may well be right.

"Be kind to yourself" should be your motto for as long as you need it to be. If other people don't recognize that you need special treatment and consideration these days, you might remind them. Be as honest as possible about how you feel with as many people as possible. If you can tell a co-worker that you're not up to par because you just lost a pet, you may find that they've experienced a similar loss and DO understand.

If all of the above is not helping enough, you might consider going to a counselor. We can be supportive, caring, and empathetic! Loss can also bring up issues about other grief in life you've experienced. Overwhelming sadness may be completely about your animal friend, or it may have something to do with the death of a parent or other person as well. You will know that best. If it would help to talk to a counselor, go--we want to help.

Peace be with you, and remember that you did the best you could for your pet; ask yourself if their life was better for having known you. You will come out the other side of this.

Contact numbers for Central Oregon:

Partners in Care (formerly HospiceCenter of Bend-LaPine) has a support group for pet loss: call them at 541) 382-5882 and ask for Sharen Meyers who facilitates the group. I work with individuals who've lost a pet, and you may want to attend the group and also do individual counseling.

Katie Terrel, MS, NCC
541.788.1415
terrelkatie@gmail.com

Managed Care v. Paying Cash Upfront

2016-08-15T08:43:00.000-07:00

Having medical insurance that will pay for mental health care is a great blessing, but it does come at a cost not everyone is willing to pay. Your therapist will send your personal and private information to unknown persons in a big corporation, including your mental disorder diagnosis (required), and often, your past history of treatment, current treatment plan, intervention techniques, and prognosis. This is more or less detailed depending on the company, but do be aware that there is some loss of privacy.

Years ago I worked as a medical transcriptionist in a doctors' office. I was appalled at how every clerk in the office had access to files. We all helped with patient files, updating them and putting new information into them, and looking through them to find information some doctor wanted. File clerks included teenagers coming from temp agencies, often only hired for a couple weeks. HIPAA requirements were met, and yet certainly did not provide full privacy.

If you have insurance and want reimbursement for counseling provided by me, I can give you a form to submit to them, and will review it with you first so you can see what information is going out. Sometimes the company will then have me fill out their own form online instead, but the information given will be the same (or I will notify you and ask for your permission.) Usually you will get reimbursed at least some portion of the fee you paid. Call and ask your health insurance company what their policy is for out-of-network mental health or behavioral health providers.

If you're a private person and don't like the idea of sending out confidential information about your most personal life, cash/check payment solves that problem by keeping your hard copy records in a locked file, with access by no one except your counselor.