Welcome To This Blog!
My doctoral training in psychology is complemented by a background in dance/movement and different types of bodywork. This mixture of experiences leads to particular interests and strengths in mind-body approaches to mental, physical, and spiritual health.
Prior to embarking on development of a private practice, I trained and worked within the VA system for about seven years. I have felt honored to be admitted into the experiences and inner worlds of many veterans (from WW II through OIF/OEF) struggling so valiantly to make sense of wartime experiences as well as their return to a home and a life that is no longer the same because they themselves have irrevocably changed.
I've also trained and worked in several university and community hospitals, where I gained valued experience in accompanying people on their journeys to reconcile their "old" and "new" selves after experiencing serious accidents, illnesses, and other "bolts from the blue."
Finally, I've experienced my own challenges and risks in life that have shaped and taught me. The learning process is never-ending. What I offer to you is the perspective of a trained therapist as well as an imperfect human being who is herself taking risks towards achieving greater balance in life, and who is -- like all of us -- a work in progress.
If you read on and think you might be interested in working together, I'd be happy to start with a phone conversation or a couple of back-and-forths via e-mail to learn more about what you are looking for related to your life and psychotherapy, and whether my work may be a good fit.
Ruth Q. Leibowitz, Ph.D.
My Work in a Nutshell
I work collaboratively with you to promote deeper connections between the mind and body, to affirm a life that is worth living no matter what losses you have experienced. I especially enjoy working with people who find themselves ready to experience more joy and connection in life, yet want some assistance in figuring out how to move in that direction.
I combine several approaches to match clients' needs and interests: Cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), Somatic Experiencing (SE; a mind-body approach to trauma), and "parts" or shadow work. Most recently, I have added self-compassion to the "brew." Information on these is described below, and also on the following websites:
For ACT: https://www.contextualpsychology.org/
For SE: http://www.traumahealing.com/
For CBT: http://www.aabt.org/
www.self-compassion.org and www.mindfulselfcompassion.org
Sessions are typically 45-50 minutes in length at a cost of $135. This differs with insurance -- if I am on a particular company's panel your responsibility is only the copayment or deductible if you have one). The initial interview and evaluation is from 50 to 60 minutes in length and is $210. I am open to doing a one-time low-fee consultation for clients who would like to meet once without any evaluation or therapy to simply get a sense of whether what I offer might be a good fit for you. A free telephone consultation of up to 15 minutes is also possible if you'd like to ask me any questions and/or tell me a bit about what you are looking for in a therapy experience. I am on the insurance panels of Aetna, Blue Cross-Blue Shield (Regence), Cigna, First Choice (which includes Oregon's Health Co-op, Broad Plan only), Moda, Pacific Source, Providence, and United. I also accept Medicare Part B. For other types of insurance, I can see you as an out-of-network provider and give you monthly receipts for submission to your health insurance company.
Cognitive-Behavioral Therapy (CBT) - In CBT, the key components we focus on are thoughts (cognitions), behaviors, emotions, and aspects of biology. These four domains of human experience interact with one another continually, so that a positive change in any one domain affects all the others, and can lead to a positive change in the experience of being human. For instance, learning to become less physiologically reactive (a physical/biological change) can lead to more frequent pleasurable moods and decreased anxiety (emotional changes), and a decreased likelihood of interpreting other people's behaviors as hurtful (changes in beliefs, cognitions). In turn, these changes may lead to more enjoyable activities experienced with friends or loved ones (a behavioral, social change). Each person is a complex system with patterns of beliefs, behaviors, feelings, and biology that are unique. Everyone has room to become more aware of how these "ingredients" interact together within them and with aspects of their social and physical environments. Everyone has the capacity to shape and interact with these ingredients in ways that promote a more meaningful, harmonious life. In the next blog update, I will add a list of several good books (including client-friendly workbooks) on CBT.
Acceptance and Commitment Therapy (ACT) - Although ACT and CBT have related historical roots in behaviorism, they also differ in important ways. The most important difference in my mind is that ACT focuses on moving towards valued directions and goals in life, without necessarily getting involved in thoughts, beliefs or one's "personal story" at all. For example, in a CBT session I might help you examine your thoughts with the goal of reframing dysfunctional beliefs into those that cause less pain and lead to more enjoyment of life. In an ACT session, we would focus more on your most important values and how you might take risks and act in the world in order to live the life you want to live. We wouldn't bother very much about examining the content of your thoughts, which in ACT is seen as less important than their function. For example, in CBT a painful belief like "I am a failure who can never succeed at anything" might be discussed and challenged to help you realize that in all likelihood it is not true. In ACT, we might instead notice that this belief appears to be holding you back from the potential pain of taking risks that could lead to success in areas of life that are meaningful for you. We might bypass exploration of the belief in favor of helping you to take the risks necessary to live a life that honors your most important values. ACT was largely developed by Dr. Steven Hayes and a good internet resource to learn more about ACT and related areas of knowledge is https://www.contextualpsychology.org/. A few books from an ACT perspective are listed in "Recommended Books" to the right, and when I next update this blog, I'll add more.
Somatic Experiencing (SE) - Somatic experiencing, developed by Dr. Peter Levine, is based on what is known about human beings at our deepest levels as organisms. The focus of SE is on noticing and developing fluency in describing bodily sensations that are associated with survival, attachment, and aliveness. We also notice impulses in the body that can help us complete actions that were not able to be completed in the past. For example, imagine a person recovering from a motor vehicle accident who, during the event, did not have time to orient to the oncoming car prior to being hit and losing consciousness. In an SE session this individual might find his or her head beginning to slowly turn in the direction of the oncoming vehicle, in order to complete in the present the act of orienting that remained incomplete in the past. Rather than working from the "top down" (cerebral cortex to brain stem) we work from the "bottom up" (brain stem up to cerebral cortex). We listen to the wisdom of the body. This is helpful, because the lower parts of the brain are not as affected by culture, "shoulds," and social "over-rides" as is the intellect. For this reason, listening to the language of your body will often help you get to a deeper truth about yourself and your experience than can words alone.Words are important in SE, because we use words to describe the language of the body and explore the meaning of what the body speaks. However, in SE sensations themselves are honored as separate and important sources of wisdom that have helped us to survive and need to be heard and nurtured. SE is difficult to describe in words, because its main focus is essentially not verbal! Two good web-based sources of information on SE are http://www.traumahealing.com and wwwtraumaresourceinstitute.com. Some excellent books to read on SE and related body-mind approaches can be found among the trauma books listed on the right, and I'll add more resources over time.
Self Compassion. Often when we attempt to contact our authentic selves and cultivate the kind of life we would truly like to live, major obstacles barring the way include negative self-criticism and beliefs that perhaps we don't deserve happiness, well-being, or forgiveness. We were all born with the propensity to give and receive love, though often life experiences lead us to close our hearts -- including towards ourselves. Self-compassion is not a mysterious state that only a minority of lucky individuals can access, but rather an intention we can all cultivate through formal and informal practices. Both personal experience and research indicate that self-compassion can be learned and practiced, and is associated with increased well-being and positive health behaviors. I have been trained as a teacher of Mindful Self Compassion (MSC), have facilitated two self-compassion classes this past year (2015) and will be teaching the full 8-week Mindful Self Compassion (MSC) program in 2016. Additionally, I weave aspects of both MSC and Compassion Focused Therapy into one-on-one psychotherapy sessions. For more information on MSC, developed by Drs. Drs. Kristen Neff and Christopher Germer, please see the following websites: www.mindfulselfcompassion.org, and www.centerformsc.org. For information on self-compassion more generally please see: http://self-compassion.org/.
Shadow Work/"Parts" Work -Each of us has many different "parts" inside. In the process of making a life choice, one "part" might have a particular preference while another "part" wants something different. This can be expressed in ambivalence or procrastination. For example, a person who wants to marry and raise a family might at the same time desire a life of adventure with no commitments to anyone else. Sometimes we consciously believe one thing, yet find ourselves impulsively doing something that is completely against that belief. For example, I might highly value friendship and compassion, yet lose my temper with a friend in a way that deeply hurts that person and threatens the integrity of the friendship. Often the "parts" of us that get us in trouble originally came into being because at some point in life we truly needed them in order to feel safe, or loved, or valued. Sometimes we "disown" parts of ourselves, believing we cannot be OK if these energies remain with us. For example, someone who has played the role of the "good child" in their family may disown those aspects of the self seen as angry or rebellious. Yet, these devalued parts in only slightly different forms can be tremendous allies -- if only they can be understood and integrated in a new way. For example, anger or rebelliousness may offer gifts of assertiveness, creativity, and independence without taking away a person's basic goodness. "Parts" work allows you to begin to learn about the different aspects of who you are with curiosity, and to see that they do not have to be fixed in time or space, but can change within you to create a fuller, deeper overall experience of life.
Self-compassion is something we often lack in the modern, western world, where individuality and achievement are considered so important. Many of us grow up, and grow older, with the deeply held belief that in order to be loveable, valuable, and worthwhile as human beings we must be better than average (in at least a few areas, and sometimes in all!). This places us in an impossible situation, since by definition of the word "average," it is not possible for most people to be better than average! We have a choice then about which internal voices to cultivate most strongly-- the voices that tell us we're no good because we imperfect, ordinary, or even less than average in some ways -- or the voices that offer comfort, friendliness, and acceptance even with our imperfections.
I think of the affection I feel for my cat Bromley, who I adopted from the Oregon Humane Society about three weeks ago. He has experienced worse luck than average, having been "dumped" at the Humane Society with no note to let anyone know about why he was deserted by his previous human companion(s). At the shelter he was so traumatized that he would not eat anything and needed to be force fed. He likely survived only because a kind "foster mom" took him into her home, providing a quiet and safe space -- and there he stayed, slowly emerging from his frozen, traumatized state, until I met him there. At our first meeting he hid inside a cat bed and would not look at me, so I had only the word of the foster mom that he had any ability to connect at all.
Bromley is thought to be between 10 and 11 years of age, so he is older than average and is more likely to have (expensive) health problems and not grace my life for as long as a younger cat would. He is shyer than average, so it is taking him a long time to make his way out of the closet I set up for him with a comfortable blanket and cat bed. He is average in his appearance -- a typical looking orange tabby. I could have adopted a cat who was younger, could relate to me more quickly, and was more physically beautiful and decorative. Yet... here is Bromley, who is worthy of a forever home not because he is above average, but because he is a sentient, living being who has been abandoned and is deserving of kindness.
If I were to try to cajole or force Bromley out of the closet, that would only activate his fight-flight system and he would stay inside longer, or even come to fear me. So what I do is speak to him calmly, invite him with my tone of voice and my energy to expand his world. I provide him with fresh water, nourishment, a large box of kitty litter, places to climb and a window to look out of. I incline towards him with caring, gentleness, and friendly intentions.
This is how it is to begin to practice self-compassion. We can consider the possibility that we are worthy of love, care, and safety regardless of our worldly achievements, regardless of whether we are above or below average in a given trait, and regardless of what difficult things we have heard about ourselves or experienced when growing up. We can incline towards ourselves with caring, gentleness, and friendly intentions. We can invite a sense of safety and connection. We cannot force the feeling of safety and well-being, however we can invite it with practices such as comforting self-touch, gentle words towards ourselves, lovingkindness meditation focused on the self.
Intention is a large part of an expanded sense of safety and loving, yet more than intention is needed. For Bromley. my providing him with practical things -- like soft blankets in the closet and the offerings of fresh food and water - are three-dimensional acts of care that set the basic conditions for comfort and safety and back up my intentions with actions. So it is with nurturing ourselves. In addition to inclining towards ourselves with good will, we can also set some real world conditions of self-care. This real-world component will look different for each of us. For example, for one person it might look like adding a new activity to the schedule that is pleasurable or interesting, while for another it might mean setting aside an activity or two in favor of more rest and unstructured time.
Bromley is responding to both the kind intentions and the real-world actions by spending a little more time out of the closet every day in my presence. In the last couple of days he has even sat next to me, touched noses, and allowed me to stroke his belly. His inherent playfulness is beginning to show itself. Our journey of positive connection is underway.
The bigger challenge for me is this: To what degree can I treat myself with the same patience, and kind regard that I naturally feel for my new feline friend? This is much more difficult! Like Bromley, I am not young, and I am somewhat shy -- I don't "shine" socially. I am not above-average in appearance and possibly not in any other attribute that is highly valued by my culture. Might I still have the ability to love myself, to sit with myself in friendliness, acceptance, and kind regard? Sometimes I think it would be more possible to sprout wings and fly. And yet... as I cultivate skills for self-compassion. I sit with myself sometimes. I speak to myself kindly, and let myself know that I am here even in moments of difficulty. I let myself know that I am not the only one in the world who suffers inside, who is imperfect, experiences difficulty, doesn't have all the correct answers. And like my dear cat Bromley, I begin to experience more safety and spaciousness in my life. Slowly, slowly.
I have been particularly inspired by the work of Kristin Neff and Christopher Germer, and took an intensive self-compassion course with them in November of 2013. If you think you might like to learn how to be more compassionate towards yourself, please see their website for Mindful Self Compassion at: http://www.centerformsc.org/. They and the teachers they train do both weekly and intensive self-compassion trainings in different parts of the U.S. and the world.
As I experience the clear benefits of self-compassion practice in my own life, I have become inspired to share the practices learned from Germer and Neff (as well as others) with people in my local community. In that spirit I've begun developing and teaching self-compassion skills in the Portland area. If you are interested in the upcoming series of self-compassion classes or would like for me to contact you about future classes, please let me know via e-mail at Dr.Leibq@hotmail.com.
May you be happy, healthy, and accompany yourself with kindness.
P.S. Close to a year has passed since I wrote the original post on Bromley. He long ago emerged from the closet, retreating back to it only when a complete stranger visits. He curls up by my side every night and is a master producer and bestower of purrs. He touches noses. He bats at the cat dancer from beneath the dining room chairs, and tears through my home, stopping to give me that "look" that invites me to chase him. He has such an excellent appetite it is hard to believe there was ever a time when he refused food. Bromley does not have the natural confidence of a theoretical cat who was blessed with a secure, forever home throughout life -- he will probably always be somewhat bashful and wary of strangers. These qualities are part of who he is -- part of his charm, uniqueness and loveliness. When he feels safe, which is almost all the time these days, his kindness and ability to connect shine forth from his beautiful feline eyes. May he continue to be safe from inner and outer harm, healthy and strong, and filled with lovingkindness.
Many readers will know the myth involving the earth goddess Demeter and her daughter Persephone. In this ancient story, young Persephone is "kidnapped" by Hades, the king of the underworld. Demeter is mad with grief over the loss of her beloved daughter. With Persephone trapped in the underworld, spring cannot occur and the earth becomes barren. A "deal" is finally made between the Demeter and Hades by which Persephone lives in the underworld part of the year, and comes back above for the other part -- thus allowing for the seasons of death and regeneration.
Many years ago I took a mask workshop in which each participant was asked to "take on" the role of one of the characters of this myth. In particular, we were instructed to choose a character with whom we found it difficult to identify. I was young then, and it was easiest for me to identify with the daughter Persephone. The mother Demeter was less similar, yet like me she was a woman who was very much attached to living things. That left Hades, the king of the underworld. I chose to be him for a while. I put on a mask that reminded me of darkness and death, went out onto the mask maker's property, and began to learn about myself. As I did this work, the importance of the underworld became more and more evident. After all, there could be no true appreciation of the bounties of spring and summer were it not for the decline of autumn into winter. The underworld was where shadows dwelled -- shadows that lived inside people, even if they didn't want to own them. Again, there was no real light without the possibility also of darkness. Finally, I thought, Persephone had started out as a "nice" girl, but one who was somewhat dorky and naive before she met me. After spending time in the underworld, she became a much more complex human being -- capable of living in darkness as well as light, appreciative of the many facets of reality. In fact, she came to have an appreciation of the underworld, and felt some sadness at leaving my domain each year.
Back in the role of an ordinary human being and many years later, I do appreciate the beautiful flowers in their full glory visible all over my neighborhood, vibrant greens of every type of leaf, fiddleheads unfurling into great ferns. I walk forward into spring and summer with gladness for the longer hours of sunlight, and wamer air against my skin. Yet, like Persephone, I have experienced a darker time and place that had its value, too. I note in myself a sense of bittersweetness for the lost winter even while welcoming the warm light.
Poetry of the Soul
I first found this beautiful poem by Naomi Shihab Nye in a book on kindness by Sharon Salzberg. I was in the bookstore at a retreat center at the time, and the book seemed to call to me to take it off the shelf. I opened up and here was this poem -- I stood weeping in the aisle of the store, feeling as if these words had welcomed me home...
Before you know what kindness really is
you must lose things,
feel the future dissolve in a moment
like salt in a weakened broth.
What you hold in your hand,
what you counted and carefully saved,
all this must go so you know how desolate the landscape can be between the regions of kindness.
How you ride and ride
thinking the bus will never stop,
the passengers eating maize and chicken
will stare out of the window forever.
Before you learn the tender gravity of kindness,
you must travel where the Indian in a white poncho
has died by the side of the road.
You must see how this could be you,
how he too was someone
who journeyed through the night with plans
and the simple breath that kept him alive.
Before you know kindness as the deepest thing inside,
you must know sorrow as the other deepest thing.
You must wake up with sorrow.
You must speak to it till your voice
Catches the thread of all sorrows
And you see the size of the cloth.
Then it is only kindness that makes sense anymore,
only kindness that ties your shoes
and sends you into the day to mail letters and purchase bread,
only kindness that raises its head from the crowd of the world to say
It is I you have been looking for,
and then goes with you everywhere
like a shadow or a friend.
Naomi Shihab Nye
Previous featured poetry
Talking to Grief
Ah, grief, I should not treat you
like a homeless dog
who comes to the back door
for a crust, for a meatless bone.
I should trust you.
I should coax you
into the house and give you
your own corner,
a worn mat to lie on,
your own water dish.
You think I don’t know you’ve been living
under my porch.
You long for your real place to be readied
before winter comes. You need
your collar and tag. You need
the right to warn off intruders,
my house your own
and me your person
my own dog.
-- Denise Levertov
Poem #2. This poem by the Sufi poet Rumi is the second to appear in the space of this blog. It touches me in the honoring of the light that is shed by darkness. Often we learn that the "dark" aspects of life are to be rejected and pushed away. Yet, whether we wish them to be part of us or not -- there they are. Given that we can't ever completely extinguish them, perhaps there are ways to hold and live with them honestly and gracefully, while at the same time honoring our deepest values. "No matter how fast you run, your shadow keeps up." "What hurts you blesses you." These are lines that invite contemplation. What are ways in which your darkest, most difficult experiences, have shed light upon you as a person, or on the nature of being a human being in a complex world? In what ways might the shadow that keeps up with you also remind you about what is most important in your life?
Shadow and Light Source Both
How does a part of the world leave the world?
How does wetness leave water?
Don't try to put out fire by throwing on more fire! Don't
wash a wound with blood. No matter how fast
you run, your shadow keeps up. Sometimes it's
in front! Only full overhead sun diminishes
your shadow. But that shadow has been serving
you. What hurts you, blesses you. Darkness is
your candle. Your boundaries are your quest.
I could explain this, but it will break the
glass cover on your heart, and there's no
fixing that. You must have shadow and light
source both. Listen, and lay your head under
the tree of awe. When from that tree feathers
and wings sprout on you, be quieter than
a dove. Don't even open your moth for even a coo.