Date: Sunday September 17th 2:00-3:30pm
OUT MetroWest is an incredibly important organization in the greater Boston area that serves LGBTQ+ youth. I’m on the host committee for their annual gala event; it takes place Saturday, September 23 and I would love to see you there!
The fourth annual Come Out & Celebrate gala will honor Dr. Asa Sevelius, principal of the Heath School in Brookline, MA. Dr. Sevelius is the first out transgender principal in Massachusetts and amongst the very few out trans school leaders nationwide.
Tickets to the event are available here:
As part of the Department of Pediatrics at Boston Medical Center, CATCH provides support and care to children, adolescents, and young adults who identify as transgender, gender non-conforming, or are gender exploring and looking for additional support. First time patients can expect their initial visit to last between 60-90 minutes. During this visit, medical history, gender history, and patient and family goals will be reviewed, followed by a discussion around gender affirming care options offered at the clinic. Individual treatment plans are created based on individual patient and family goals. Additionally, all first time patients will undergo a complete psychological assessment.
CATCH aims to see new patients within 4-6 weeks. To schedule an appointment, please call 617.414.4841.
Offered services include:
When clients come into my office for psychotherapy, they are usually focused inward, potentially seeking a diagnosis, and often asking “what’s wrong with me?” Yes, the majority of my clients are working through gender dysphoria or pursuing recovery from an eating disorder, and while these are indeed conditions I can diagnose, much of the work I do with folks is about exploring the ways in which structural oppression related to their sexual orientation, gender expression or race is causing distress, both directly and in its internalized forms. In other words, we shift from asking “what’s wrong with me?” to “why do I think something’s wrong with me?”
From a social justice perspective, one of the most insidious ways oppression in the form of patriarchy, misogyny, class bias and racism (among others) does its work is through internalization. When people internalize these structures of power and disempowerment, the self hatred and self doubt that ensue wreak all kinds of havoc in terms of beliefs that impact behavior and emotional experience, which then often leads to the development of some form of psychopathology. I vividly recall a professor at the Smith College School for Social Work stating: “The greater the oppression, the greater the depression” and I have seen this to be true over and over again in the lives of the people who walk through my office doors.
There was a time (and in some cases, that time is now) when people in my chosen profession, social work, were largely tools of oppressive structures. In the words of Michel Foucault: “The judges of normality are present everywhere. We are in the society of the teacher-judge, the doctor-judge, the educator-judge, the social worker-judge.” For example, as the majority of my clients are transgender or gender non-conforming people, many require authorization from me for their insurance companies that they are “trans enough” to receive gender affirming hormone therapies or surgeries. Many of these folks also experience profound depression and/or anxiety: how would you feel if your fate, your ability to live a life as yourself, was in the hands of an ostensible expert, deemed more expert than you about your own self-hood by virtue of their social position and capital?
My work, as a social justice oriented feminist relational psychotherapist, is kaleidoscopic. I work to support my clients in identifying the ways in which they’ve internalized oppressive structures. We work together to identify the ways they’re policing themselves and warping their sense of self through these lenses, and then we work to dismantle the problematic internalized beliefs that are setting them up for emotional distress and behavioral dysregulation. In other words, I sincerely look forward to a day when I become obsolete.
I am a serious fan of perspectives. I had a high school history teacher who was fond of saying that “truth is increasing complexity”, and in both my personal and professional lives, I have found this to be, well, true.
When a client presents me with a truth, about themselves, about an experience, we work to increase complexity. Are you sure that’s true? Has it always been true? What else might be true? What do others in your life believe to be true? Often, in this way, we are able to triangulate, and to move in the direction of deeper knowing, of more true, but also to open space for subjectivity, and breathe some light or humor or next questions into that space.
It is in the spirit of that kind of inquiry that I offer the following blog post by Holly Glenn Whitaker: http://www.hipsobriety.com/home/2015/2/18/why-aa-didnt-work-for-me-my-story-part-1
This is not a prescription. This is not an indictment of AA. It is also not an endorsement of Holly’s sobriety coaching program. It is, however, a perspective. There’s this Buddhist expression, “If you meet the Buddha on the road, kill him!” It speaks to the dangers of making something or someone your god, which is easy to do when you feel as though you have been saved, but the reification of any one concept or any one guru or organization can be fraught with peril.
I work with a lot of clients who struggle with substance abuse because when the world offers you its misogyny, its transphobia, its racisim and its fat phobia (amongst others) to internalize, numbness and escape often sound like the loveliest of sirens. I have folks who come to my office who have found a sober life working an AA program, and it’s glorious. I also work with clients who have found that the language of powerlessness and surrender was inaccessible to them in the context of a history of sexual trauma or internalized hatred and disempowerment, and who echo Holly’s statement that in fact, making the choice to let go of alcohol because you can’t use it and be well is profoundly powerful, and profoundly empowering.
You can’t get sober by yourself, but you’re also the only one who can get you sober. The rooms of AA are one available community within which to do that work, but they are not the only one: could this be a truth?
“Informed consent is a medical provider laying out your risks and benefits, and the most current information they have about those risks and benefits, and giving you the choice about what to do with your own body. For me this is a basic human right, a matter of bodily autonomy,” Abernathey said.
While I subscribe, personally, to the informed consent model of managing hormone therapy (HRT), I am available in instances when a provider requires a therapeutic “gatekeeper” to work with a client before providing HRT, as well as being available to work with folks on the feelings of alienation, depression and/or anxiety that can often emerge when gender dysphoria is present.
So, I highly recommend you go read this http://www.danikabrysha.com/blog/dear-danika-food-addiction-stress-management-and-how-im-finally-finding-peace-and-freedom, knowing that the author is someone I choose to follow on social media and in her blog even though I have specifically chosen not to follow the path she has used to address her eating disorder, and our very definitions of eating disorder and recovery diverge. Here’s why:
1. What if her path is right for you or one of my clients? I have found that I don’t stay on the healthy side of the blurry line between OA and restriction very long, and so it’s not my scene, but recovery is individual.
2. If it’s not your scene either, can you engage with her words as an act of empathic connection with someone whose struggles you share? We’re so quick to judge, and it keeps us separate in our own food and body prisons, rather than forging the community and connections we need to feel seen, heard and not totally nuts.
3. It’s worth it purely for her insight into the absolute brain drain (and effort of futility) that is dieting.
4. Because I’m choosing to put my energy into pumping breast milk these days, rather than blogging much, but I still want you to have good things to read.
“What’s in a Number? Hint: Nothing! BMI and/or the number on your scale mean nothing about your health! How can it? Health is so much more than just your height and weight. We are just too complex for such simplicity! Do your body and mind a favor and stop weighing yourself (or letting others weigh you). That scale number is only a measure of your self-worth. Please stop checking your self-worth on the bathroom scale! A better measure would be to ask a good friend why they value you. That is way more meaningful than any information a scale will tell you!”
The above is a link to the Health at Every Size website, and details the principles of that movement. It’s important to me professionally to ensure that folks know that I’m not in the business of telling people to lose weight, although I sometimes reference weight management or body composition changes because those are things I support clients with when it’s medically or personally warranted. For example, if my client loves to kayak, and her body size is interfering with her ability to participate in that activity, and she wants to take a look at food choices, sleep, exercise and stress management (all of which impact body size), we’re going to do that. Another example would be if my client has a lifestyle related disease such as diabetes or chronic joint problems. If, however, she’s eating well, sleeping well, managing stress well and functioning well in her professional and personal life, but just doesn’t like the the way she looks, we’re going to have a very different conversation and a very different set of goals related to acceptance and body image.
If you’re living in a body that’s larger than some theoretical image of how you think you “should” look, ask yourself:
Is my body healthy, in terms of how systems function, my energy levels etc? Is my mind healthy? Do the thoughts I think support my well being and ability to move through the world with ease?
Because health truly is possible at every size, and to be frank, it’s far more common for me to encounter folks who are unhealthy and unhappy because they are trying to force their bodies to remain (even slightly) underweight by making impoverished nutritional choices and overexercising.
On a related note, try this. If you’re hungry, go eat something. You’ll feel better. If you’re sad, food’s not really a related phenomenon (unless you’re actually sad because you’re not eating enough dietary fat which does a number on the brain and tends to give rise to feelings of depression and anxiety) and a snack probably isn’t what you need. Just saying.
Somewhere along the line, I read an article that suggested I compare my stated priorities with the list of activities most engaged in. For example, I wouldn’t call checking Facebook a priority, and I frequently express frustration that I haven’t been able to consistently find time to do strength training now that I have two kids. However, I definitely spend 20 minutes per day on Facebook… And guess how long my strength training routine is?
I have since made righting those kind of inconsistencies a priority, which is part of how this blog began to develop a fine layer of dust over it: I love to read, and I decided that when I have a block of time where I can’t be active because my daughter has fallen asleep on my lap and I’m not moving until she wakes up, I wanted to read rather than spend time on a screen doing social media or blogging. I have been increasingly excited about using essential oils to enhance my own wellness and manage my mood (as well as for cleaning, and making food taste awesome), so I’ve been using my “found” formerly wasted on social media time to read and learn as much as I can about the topic (feel free to contact me if you’d like to learn more yourself!).
What I have discovered is that social media is definitely a lower priority than my actions were making it, even though I could have told you that I already believed it was not a priority. However, I did really miss expressing my thoughts and ideas and connecting with folks here on my blog, so I’ve recommitted to posting a bit more frequently than every 48 days.
So, do yourself a favor… Make a list of what you believe your priorities are, and note where you would like to be spending more time e.g. if nourishing yourself well is a priority, and you’re frustrated that you don’t seem to have enough time to do prep tasks like hard-boiling a week’s worth of eggs or getting a week’s worth of snack veggies into Tupperware, that line on your list gets highlighted. Next, for 1-3 days, jot down or note in your phone what you have been doing each hour. Comparing these two lists is a great way to find time you’re wasting on low priority activities without realizing it.
We all get the same 24 hours: how do you want to be spending yours?