Is Teletherapy Working?

Although the COVID-19 pandemic has brought ongoing traumatic stress for most if not all of us, it is arguably not without its silver linings.

For instance, many people have found great benefit afforded by things like: the increased availability of work-from-home jobs, the normalization of home-schooling and/or the opportunity (albeit forced) to reset priorities, reevaluate life-goals and redefine the meaning of success.

Another silver lining from the pandemic has been increased accessibility to therapy via telehealth. We no longer need to spend as much time and energy on things like driving to appointments, finding parking, waiting rooms, etc.

Our choice of therapist is also no longer as dictated by physical proximity as it once was (except that state licensure laws and level of care must be considered).

But many of us have been wondering how well it works when compared to in-person. This article from the American Psychological Association (APA) website (dated 7/1/2020, 10-min read) offers some interesting answers.

What we’ve seen is that telehealth is essentially just as effective as face-to-face psychotherapy — and retention rates are higher.

David Mohr, PhD

What do you think? Will you read the article? What has your experience been with therapy via telehealth? In your view, what are its pros and cons? Do you have a preference? I’d love to know your thoughts!

Please feel free to comment below, and don’t hesitate to send me a note to start a conversation.

What is Neurodiversity?

Neurodiversity is a concept that has gained popularity in recent years, so much so that lately it seems like a popular buzzword, especially on social media, especially among folks who have either been diagnosed with (or recognize within themselves) characteristics common to the sensory and/or neurodevelopmental challenges associated with ADHD, autism or (something not thought possible before) a combination of the two.

But what does neurodiversity mean? According to a 2021 article on Harvard Medical School’s blog (Harvard Health – here) “neurodiversity describes the idea that people experience and interact with the world around them in many different ways; there is no one ‘right’ way of thinking, learning, and behaving, and differences are not viewed as deficits.”

Historically autism has been so heavily stigmatized (read: severely stereotyped and profoundly misunderstood) that many individuals with autistic traits have felt that the only way to deal with them was to deny, minimize, downplay, or hide them — even from themselves.

But lately, as our collective understanding of autism grows richer, more individuals, especially those who identify with autistic traits associated with its “high-masking,” and/or “feminine” presentations are now wondering if they have in fact been “actually autistic” all along.

The word neurodiversity refers to the diversity of all people, but it is often used in the context of autism spectrum disorder (ASD), as well as other neurological or developmental conditions such as ADHD or learning disabilities. The neurodiversity movement emerged during the 1990s, aiming to increase acceptance and inclusion of all people while embracing neurological differences. Through online platforms, more and more autistic people were able to connect and form a self-advocacy movement. At the same time, Judy Singer, an Australian sociologist, coined the term neurodiversity to promote equality and inclusion of “neurological minorities.” While it is primarily a social justice movement, neurodiversity research and education is increasingly important in how clinicians view and address certain disabilities and neurological conditions.

 Nicole Baumer, MD, MEd and Julia Frueh, MD

This more nuanced understanding of autism has also led to an emerging realization that ADHD and autism are not mutually exclusive (as was previously thought). In the past, mental health practitioners were expected to diagnose only one or the other, not both. Factor in the fear and stigma surrounding autism and it makes sense that as children many of us were assigned the label ADHD or simply labeled “sensitive” and/or “eccentric” without looking any further. Many of us felt alien or too odd for this world and preferred to remain hidden or unseen rather that risk being rejected and/or misunderstood.

As a result, many adults who grew up with these labels and some who did not — due in large part to masking (remaining unnoticed to avoid social pitfalls) now wonder if they are actually autistic instead, or if their experience might best be described by the combination of these two neurodivergent (ND) presentations, now lovingly labeled AuDHD (in the vernacular — this is not a clinical term — yet).

Books like Unmasking Autism by Dr. Devon Price have heralded a sea change around the topic of neurodivergence and neurodiversity, even to the point of suggesting that self-diagnosis is valid (or should be), particularly when self-understanding is the goal.

If you are curious about this topic and wonder, like so many now do, whether your way of being in the world might actually intersect with autism, especially if you have a highly sensitive temperament and/or grew up feeling invalidated and/or like you do not fit in to “neurotypical” (NT) society, maybe you should try searching hashtags like #actuallyautistic #neurodivergent #nd #audhd #youmightbeautistic on social media (i.e., TikTok, Instagram, Twitter, Reddit) to see what people are saying about this topic and find out whether and how this conversation resonates with you.

Connecting the Brain to the Rest of the Body

A recent article published by the Harvard Center on the Developing Child states:

A child who is living in an environment with supportive relationships and consistent routines is more likely to develop well-functioning biological systems, including brain circuits, that promote positive development and lifelong health. Children who feel threatened or unsafe may develop physiological responses and coping behaviors that are attuned to the harsh conditions they are experiencing at the time, at the long-term expense of physical and mental well-being, self-regulation, and effective learning. Policymakers, leaders of human services systems, intervention developers, and practitioners can all use this knowledge to create innovative solutions to reduce preventable diseases and premature deaths and lower the high costs of health care for chronic illnesses.

InBrief – developingchild.harvard.edu

Now, you may be thinking “Dr. Smith?! I am not a child. Heck, I don’t even have kids! What does this have to do with me?”

Well, guess what? If we were not raised in an optimal environment, and if whatever strategies our body and mind adopted to survive the environmental failures we experienced have not been updated and re-wired to support our present day Self, this not only perpetuates a self-defeating mindset (our thoughts), many times it is also affecting both our emotional wellbeing (our feelings) and our physical health (our entire body & all its systems, connected by the central nervous system).

This is why therapy is such a good investment. Whatever you want to call it: “reparenting,” “parts work,” “inner child work,” “shadow work,” “insight work,” or “accessing wise mind,”– learning to connect to, tolerate, and experience all those terrifying feelings we cut-off from in order to survive our less-than-optimal childhood (and which now unconsciously highjack our nervous system in an effort to be processed) — this is how we begin to heal.

The right therapist can really help. If this article resonates for you and you’re seeking support on your healing path, look for someone who does trauma-informed work that is informed by their own lived experience of overcoming their own childhood adversity (i.e., find someone who has been to therapy, is ideally still in therapy and who reflects a palpable level of healing within their own life).

Here is a link to the article, and it is attached below in image form. If it resonates for you please comment, like, share, and don’t hesitate to reach out to let me know your thoughts! For more posts like this, I’m on social media as @catherinelistens (mainly IG and FB). Hope to see you there!

Warmly, Catherine

What is CEN?

What is Childhood Emotional Neglect (CEN)? How does it happen and what are its lasting effects?

Many people think that since their parents were very good people, they could not have experienced CEN. However, it pays to look deeper, especially if you are someone who tends to feel empty and/or disconnected inside.

one of the most surprising things about childhood emotional neglect is that the parents are often good and loving people. Many are trying their very best to raise their children well. But they cannot give their children what they never received themselves: emotional awareness, emotional education,
and emotional validation.

– Dr. Jonice Webb

This brief article (link below) by Dr. Jonice Webb includes an excerpt from her book, Running On Empty No More: Transform Your Relationships, which explains a bit more about CEN and offers some guidance for people who think they might have experienced it.

Follow the link below to discover whether CEN sounds like something that might have impacted your life.

If it resonates for you, feel free to comment your thoughts below, and please don’t hesitate to reach out if you are interested in therapy to help you process your experiences and re-connect to your truest self.


Do Emotions Affect Your Physical Health?

When you shut down emotion, you’re also affecting your immune system, your nervous system. So the repression of emotion, which is a survival strategy, then becomes a source of physiological illness later on.

Gabor Maté, MD

Did you know psychotherapy can have positive effects on your physical health? At first I didn’t believe it either, but I’ve experienced it personally (in my own therapy) & seen several clients make this connection as well — as our emotional health resolves, so can our physical problems.

Check out this interview with Dr. Gabor Mate, on the important link between trauma, emotions & chronic illness.


What do you think about this? Comment below if this resonates for you.