All Posts by Cisais

Chill & Create: Winter Art Therapy for Tweens

By Cisais | Anxiety and Trauma

Rediscover Healing Connection: Embrace In-Person Psychotherapy Sessions

By Cisais | Anxiety and Trauma

Legal Update: No Surprise Act

By Cisais | Anxiety and Trauma

What is Teletherapy?

By Cisais | Anxiety and Trauma

What is Play Therapy?

By Cisais | Anxiety and Trauma

As psychotherapists, our focus is in child development and play therapy. We use a playful and individualized approach to empower children to cooperate, self-regulate and effectively communicate their needs.

Play therapy is most often used with children ages 3-12 and usually occurs in weekly sessions.  Some children’s behaviors may improve very quickly with play therapy (averaging 15-20 sessions), while others may have more serious or ongoing problems that may take longer to resolve. Play therapy works best when a parent, family member, or caretaker is supportive and actively involved in the treatment process.

Why Play Therapy?

Developmentally, even the brightest children have not developed the capacity to use the insight-based verbal reasoning– which is needed to be successful in one-on-one talk therapy. What works in the world of play therapy is that it play can be used as a language by the child,  overcoming the challenge of more traditional language-based communication while still allowing the therapist to assess and respond to the underlying needs of the child-client. Also, because therapy sessions are child-centered, there is less resistance and often more rapid change than with talk therapy.

Play therapy is different from regular “playdates” because in these specialized sessions, therapeutic space is created to allow the child-client to express, address, and resolve the challenges they have faced. Play provides a psychological distancing from a child’s issues and allows expression of thoughts and feelings– which is the process work of therapy. Through play, therapists can help children learn more adaptive behaviors when there are emotional or social skills deficits. Children learn to communicate with others, express feelings, modify behavior, develop problem-solving skills, and learn a variety of ways of relating to others. Even the most troubling problems can be confronted in play therapy and lasting resilience can be discovered, rehearsed, mastered, and adapted into lifelong strategies.

Play therapy is effective with children experiencing life stressors, such as relocation, hospitalization, chronic illness, abuse, domestic violence, and natural disasters. Therapeutic play and can be used with children dealing with:

• anger management
• grief and loss
• divorce, family dissolution, and abandonment
• crises and trauma
• anxiety
• depression
• ADHD
• Autism or pervasive developmental disorder
• academic and social problems
• learning disabilities
• conduct disorders

Are We a Right Fit?

By Cisais | Motivation and Choice , Musings

One-on-One Coaching

My clients change.  This is something I say often.  And it is true.

The vast majority of my clients achieve success for themselves. This is because I only work with clients who I believe will succeed.

If I sense up-front that someone isn’t right for my approach, I’d rather not take take their time or money.  Read below to find out if you and I were meant to be…

My clients –

• Are looking for a short-term boost rather than a long-term solution.
• Want to passively have someone “fix them”.
• Are serious about getting their problem solved.
• Are ready to take responsibility for their lives and relationships.

I look forward to working with you if –

• You are ready to do the work it takes to get your goal accomplished.
• You are ready to learn and change to achieve your outcome.
• You take responsibility for your decisions and actions.
• You want a natural, drug-free solution to your issue.

A few other things you should know about me –

• Pricing:  The services I offer enable clients to make profound changes in their lives, usually very quickly.  I charge accordingly.
• Approach: All work is done with a tailored, one-on-one approach working with me directly.  There are no use of scripts, light/sound goggles or CDs.  In addition to weekly goal oriented solutions, working with me often involves coaching and tasks done outside of the office. Yes, I give “homework”. 
• Medication:  I cannot prescribe, nor am I a proponent of psychotropic drugs. That being said, I understand that they can be a short term buffer between “no longer” and “not yet”.  For most, there are great alternatives to anti-anxiety and antidepressant medications. and I have great referral sources to local medical doctors who can support that. Let’s talk.

If you have read this far, thank you. If you have questions and would like to reach me, please do not hesitate in contacting me via email or by phone at (530) 601-1003 .

Thinking As a Way of Being

By Cisais | Health , Motivation and Choice

Those of us on the path of personal and spiritual growth have a tendency to analyze our unhappiness in order to find the causes and make improvements. But it is just as important, if not more so, to analyze our happiness. Since we have the ability to rise above and observe our emotions, we can recognize when we are feeling joyful and content. Then we can harness the power of the moment by savoring our feelings and taking time to be grateful for them.

Recognition is the first step in creating change, therefore recognizing what it feels like to be happy is the first step toward sustaining happiness in our lives. We can examine how joy feels in our bodies and what thoughts run through our minds in times of bliss. Without diminishing its power, we can retrace our steps to discover what may have put us in this frame of mind, and then we can take note of the choices we’ve made while there. We might realize that we are generally more giving and forgiving when there’s a smile on our face, or that we are more likely to laugh off small annoyances and the actions of others when they don’t resonate with our light mood.

Once we know what it feels like and can identify some of the triggers and are aware of our actions, we can recreate that happiness when we are feeling low. Knowing that like attracts like, we can pull ourselves out of a blue mood by focusing on joy. We might find that forcing ourselves to be giving and forgiving, even when it doesn’t seem to come naturally, helps us to reconnect with the joy that usually precedes it. If we can identify a song, a picture, or a pet as a happiness trigger, we can use them as tools to recapture joy if we are having trouble finding it. By focusing our energy on analyzing happiness and all that it encompasses, we feed, nurture, and attract more of it into our lives, eventually making a habit of happiness.

What is PTSD?

By Cisais | Anxiety and Trauma

PTSD is the acronym for Post Traumatic Stress Disorder and refers to a cluster of symptoms that result from a past trauma. But what’s a trauma?. Trauma refers to a psychological or emotional imprint that occurs when an event or series events threatens our sense of safety or well-being to the extent that our minds react to protect us from any further exposure.

In order to protect ourselves until we are either healthy enough or supported well enough to address issues from the past, sometimes, our experience or memory of a traumatizing event can be compartmentalized or stored away. PTSD can be diagnosed as soon as 30 days after an event or as long as 30 years or more after an event. The good news is that the healing process can begin at any time.

Couples Therapy

By Cisais | Couples and Relationships

First, it is important to realize that couples therapy, marriage counseling, and marital therapy are all the same. These different names have been used to describe the same process, with the difference often based on which psychotherapy theory is favored by the psychologist using the term, or whether an insurance company requires a specific name for reimbursement.

Couples therapy is often seen as different from psychotherapy because a relationship is the focus of attention, instead of one individual diagnosed with a specific psychological problem. This difference only arises if you consider psychological problems to be similar to medical illnesses, and therefore confined to a “sick” individual who needs treatment. That medical model of psychological diagnosis and treatment is common, but is really inadequate to describe and resolve psychological problems. All psychological problems, and all psychological changes involve both individual symptoms (behavior, emotions, conflicts, thought processes) and changes in interpersonal relationships.

Couples therapy focuses on the problems existing in the relationship between two people. But, these relationship problems always involve individual symptoms and problems, as well as the relationship conflicts. For example, if you are constantly arguing with your spouse, you will probably also be chronically anxious, angry or depressed (or all three). Or, if you have difficulty controlling your temper, you will have more arguments with your partner.

In couples therapy, the therapist will help you and your partner identify the conflict issues within your relationship, and will help you decide what changes are needed, in the relationship and in the behavior of each partner, for both of you to feel satisfied with the relationship.

These changes may be different ways of interacting within the relationship, or they may be individual changes related to personal psychological problems. Couples therapy involves learning how to communicate more effectively, and how to listen more closely. Couples must learn how to avoid competing with each other and need to identify common life goals and how to share responsibilities within their relationship. Sometimes the process is very similar to individual psychotherapy, sometimes it is more like mediation, and sometimes it is educational. The combination of these three components is what makes it effective.

Conversations with Couples

By Cisais | Couples and Relationships

It is very common for couples to contact me and, in our first conversation prior to an appointment, ask for help in these areas:

• Infidelity/Trust Issues
• Communication ‘Tools’ or ‘Skills’
• Parenting Issues
• Anger Issues
• Intimacy Issuesand…last but not least….
• ”I’m pretty sure my husband is a Narcissist”

One might think that all of these issues are varied and drastically different from one another.  What might ‘anger’ issues have to do with ‘infidelity’”? What does ‘communication’ have to do with ‘parenting’ or ‘intimacy’ issues?  Actually, this is where therapy becomes therapy vs. communication coaching or teaching.

Follow me here……I can teach you communication skills, I can provide you models for effective parenting, I can provide you with self soothing/de-escalation skills to interrupt patterns of impulse and anger, we can even identify blocks to vulnerability or access to one’s own emotional responses, and, there is tremendous  initial value and insight by acquiring these skill sets….this is important stuff for sure.

However, these are what I deem to be behavioral changes vs authentic changes.  Have you ever heard of, or known a ‘dry drunk’ (excuse my slang)?  This is person who has changed their maladaptive behavior (alcohol = bad idea) for a less damaging behavior (sober = better idea)…but what about the reason the person drank, or had the affair or was a rigid parent or was prone to rage in the first place?  Changing behavior may not change the underlying dynamic…at all.  Dry drunks are difficult by nature, a person who has had an affair and stops is no less prone to a relapse than a person refraining from alcohol…..unless underlying issues are addressed.

Behavioral changes are only part of the process.  They are put in place to prevent more damage from occurring to the relationship, and, ‘they’ are in no way the fruition of a couple’s journey towards true partnering for life.

What all of these issues in fact have in common is, how we are attached or bonded, to others and ourselves.  At the core of us all we have experienced some loss or disconnect in our primary attachments very early in life.  Having had firm attachments to a healthy primary care giver, we are able to develop a strong sense of self and maintain that self even in the deepest of relationships.  When we have experienced poor attachment or bonding, or, when we have had a strong bond to a primary caregiver with a strong deficits, we develop our own deficits in our ability to access our self.  It is from these broken attachments (which literally we all have to some extent) we can cause problems in our relationships.  In Susan Johnson’s book, Hold Me Tight, she describes healing these attachments to one’s partner and within one’s self as the basis of the most effective approach to couples counseling to date.

As a couples therapist for over 16 years, this model has been extremely complementary to the work I do with couples.  This level of work with couples is profound.  Each partner is able to see how their own woundedness is working them from the inside-out, affecting perception of their partner, keeping them stuck in a cycle but not understanding exactly what the cycle is, how it starts or how to interrupt it.

As a couples therapist, I will often meet with partners individually, early on, to get a separate assessment of their current perception(s), a sense of their strengths in problem solving and communication, where blind spots might be and, family/relationship history.  This more progressive/aggressive approach to treatment is a departure from traditional couples counseling.  However, I have yet to work with a couple who has not appreciated this part of the process, and, benefited from it.

The direct benefit to the client is really being heard, without judgement, knee jerk reactions, making a big plan right away or, taking either side.  How it makes the process more efficient is by providing me clearer insight into isolating who is contributing what to the overall dynamic.  And when I say ‘efficient’ I mean it saves everyone time, money and allows us to get traction in doing the individual work necessary in closing the distance between partners.