Please note: Nancy will be presenting on this topic at our May luncheon. Registration will open on this site during the first week on May.

As we explored the hurt, anger and shame she felt in relation to Meg, and recognized
the antecedents in her family history of a neglectful Mom, she realized this was an old
familiar pattern that has held her hostage her entire life. She allows her tears to stream
down her face and feels how painful it is to not feel wanted and not made time for. Lori
seldom initiates relationships in an attempt to protect herself from a reminiscent, familial
hurt.

I had been having a hard time scheduling Lori after my 5 days away and unfortunately
we had to wait two weeks for our next appointment. It occurred to me that she might
have felt neglected and not valued by me as well. Lo and behold, lurking under the radar
of our own knowing, when asked about this in the context of this new friendship, Lori
did admit to feeling disregarded and excluded by me. She thought I couldn’t appreciate
how bad it felt that I wasn’t able to “make time” for her. While the adult part of her
knew the vacation interrupted our usual time together, the younger part of her felt shame,
dismissed and unattended to.

Lori and I had tried to schedule her sooner but were unable to find a mutual time.
What she didn’t know was how disappointed I was that we had to miss our session.
We had been making steady progress, and I felt bad that we had to interrupt our work
together and would need to wait two weeks until we could meet again. Diana Fosha (The
Transforming Power of Affect: A model of Accelerated Change. New York:Basic Books.
2000.) says, if patients are going to feel safe enough to experience vulnerable or long
held emotions, the therapist needs to be brave, genuine and emotionally engaged. In this
case, therapist self-disclosure may be a reasonable intervention, perhaps conflicting with
of a more traditional training that urges us to remain neutral and hidden. I consider this
possibility as we enter our next session and wonder what the “best” thing to do is. I am
thankful for Winnicott who reminds us, we only have to be “good enough.”

Nancy Gunzberg is a licensed clinical social worker currently practicing psychodynamic psychotherapy in private practice in Santa Barbara, California. She has worked as a therapist in medical settings at Cottage Hospital, The Cancer Center of Santa Barbara, Sansum Psychiatric Department, and Hospice of Santa Barbara. Areas of specialty include trauma, depression and anxiety, grief and loss, attachments, eating disorders, identity, aging, illness, and end of life issues. Recently Nancy has been involved with Diana Fosha’s Immersion Trainings and currently is involved with a 10 month Training in Dynamic Emotion–Focused Therapy (DEFT) devoted to deepening and integrating affect.

1991— BA Psychology, Antioch University, Santa Barbara, California
1996—MSW Master of Social Work, Smith College, Northampton, Massachusetts
2000—LCSW Licensed Clinical Social Worker, LCS 19951

ngwile@verizon.net

I remember an instance in my twenties, when my profession was as an actress. I went to an audition for a summer theatre company located in a southeastern state. At the audition, was a young black woman, a dancer, who had just auditioned for the same company. Those auditioning her praised her ability, and told her that she is a beautiful dancer. But… the producer told her that, unfortunately, he could not hire her because he did not believe that his audiences would accept her because of her color. I remember her anguish. I remember how pained I felt hearing that.   Life is not always fair, is it?
Fortunately, times have changed, and I truly believe that that woman today, would not be faced with the same response if she auditioned today. And that gives hope, that things do change.  

In seeking acceptance and equal rights for employment as Medicare Providers, we ask ourselves, “What will it take to evoke that change?”  It’s been ten years now, that CAMFT is plugging away on our behalf, so that our members are included as Medicare Providers. “What will create a shift in the Legislator’s perceptions, so legislation is finally passed?”
In her interview with Lady Gaga recently, Oprah said to Lady Gaga, “That is how shift happens. People like you, having the guts to use your voice for something bigger than yourself. That’s how shift happens.      

Article: “Oprah Winfrey sees Lady Gaga carrying her baton” by Lori Melton, Flint TV Examiner

Oprah’s statement causes us to search inside of ourselves, and ask ourselves, “What am I doing to contribute to the betterment of my profession, and to life on this planet?” “Am I stepping up to the plate and doing my part?” “Do I have the guts to step forward and use my voice for something bigger than myself?”

Right now, our plight, and also our mission, is to move past the boulders and barriers blocking our fair inclusion as Medicare Providers.   It is a worthy struggle. It will open the doors for MFT’s now and those to come, that we receive equal opportunity for employment as Medicare Providers, and legitimate recognition as core mental health providers.
We need to express our voices, member by member, each of us contributing to the whole, if, indeed, the forthcoming legislation bill on Medicare is to be passed. Your voice matters a lot.

In the near future, CAMFT will have a link to express your voice in regards to the upcoming Medicare Legislation.   In the meantime, please send an email or make a call to one of our legislators asking them to vote “yes,” in the legislation bill: “Seniors Mental Health Access Improvement Act of 2011. (S.604)

Below are the legislators to contact in regards to passing the legislation for MFTs to be included as Medicare Providers.

Senator Dianne Feinstein: Phone: (202)224-3841
Email Web Form: https://www.feinstein.senate.gov/public/index.cfm/e-mail-me
On the email page, Click the box “Medicare”

Senator Barbara Boxer: Phone: (202)224-3553
Email webform: http://www.boxer.senate.gov/en/contact/policycomments.cfm
Click on E-mail the Senator under: Legislation and Policy

President Obama: Phone line: (202)456-1111 Email Web Form: http://www.whitehouse.gov/contact/submit-questions-and-comments/old2
click on: Contact the Whitehouse; then check the box: “I have a policy comment”, then click either Healthcare or Seniors

House Minority Leader Nancy Pelosi Phone: (202)225-4965
Email Web Form: http://www.democraticleader.gov/contact

Congresswoman Lois Capps Phone: (805)730-1710
Santa Barbara District Office: 1216 State Street Suite 403 Santa Barbara, CA 93101
Website: http://capps.house.gov
Then click “Contact Me” and that will pull up the box beneath “email me”, then enter your zip code on the next page. That will enable you to go to the next page to enter your email address address. When you have finished writing your message, click “I would like to hear back from Congresswoman Capps in a formal written reply.”

Senate Committee on Finance Chaired by Max Baucus of Montana Phone: (202)224-2651
Email Web Form: http://www.baucus.senate.gov/?p=contact

Orrin G. Hatch, Utah, Ranking Minority Member Phone: (202) 224-5251
Email Web Form: www.hatch.senate.gov/public/index.cfm/contact?p=Email-Orrin

Ron Wyden, Oregon – introduced the the “Seniors Mental Health Access Improvement Act of 2011.(S.604) Phone:(202)224-5244
Web Form: www.wyden.senate.gov/contact/

The findings of this study were drawn from four years of data from 2001–2004 of Cigna health care insurer, which has over 9 million subscribers.  The study is comprised of more than 5 million psychotherapy medical claims.     
 
The results of the findings go on to say that: “The recidivism rates for MFTs were the lowest, while all other professional groups had significantly higher rates.”

This is an eye-opening study.  It provides compelling evidence of the significant worth and value of MFTs to the Federal Government. It demonstrates, that in the big picture, our profession is providing therapy that is holding up best over time in comparison to the other mental health professions.

Since budgets and money continue to be such a big factor in the decisions that legislators make, it would behoove legislators to sit up and pay attention to these findings. By decreasing the recidivism rate, it saves the Federal Government money, because not as many clients are needing to return for more therapy for the same issues. And larger than that, with higher success rates, we are building a healthier and better functioning society. That reaps great rewards on so many different levels in the long run.

Other statistics of the study substantiate the importance of MFTs as mental health providers. “Results demonstrate that overall, using family therapy exclusively was the most cost-effective form of psychotherapy.” Family Therapy is part and parcel of what we, as MFTs, are trained to do. It is our specialty.

These results offer solid grounds for voting “yes” to the upcoming legislation bill: “Seniors Mental Health Access Improvement Act of 2011. (S.604).   

Legislators need to be informed of these facts and statistics, so that they will know that by voting affirmatively for this bill,  it will be benefiting both the Federal Government by reducing the costs to Medicare,   and on a greater scale, that  therapy provided by MFTs  is working for the greater good of society at large. 
Coming up, in the near future, CAMFT members will be able go directly to the link on CAMFT website to add your voice, and to participate and take action on Medicare and other advocacy issues. This will create an even greater sense of unity and strength amongst our members from all the different California CAMFT chapters. And it will demonstrate to legislators the cohesion, and involvement of our members.

As soon as the link is provided to us, we will put it up on the Etree. In the meantime, please continue to email and/or call our legislators.   It will take just a couples of minutes of your time, and it will help in making the impact needed.  In order to get legislation passed,  legislators need to be reminded consistently and repeatedly of the bill at hand.    The more emails and calls they get, the better.   Numbers matter.
 
In your emails to the legislators, it will add important fuel to include the statistics of the study. It may be just the thing needed to give our legislators the confidence to vote “yes,” in the legislation bill: “Seniors Mental Health Access Improvement Act of 2011. (S.604), so that, at long last, MFTs are included as Medicare Providers.

Below are the legislators to contact in regards to passing the legislation for MFTs to be included as Medicare Providers.

Senator Dianne Feinstein: Phone: (202)224-3841
Email Web Form: https://www.feinstein.senate.gov/public/index.cfm/e-mail-me
On the email page, Click the box “Medicare”

Senator Barbara Boxer: Phone: (202)224-3553
Email webform: http://www.boxer.senate.gov/en/contact/policycomments.cfm
Click on E-mail the Senator under: Legislation and Policy

President Obama: Phone line: (202)456-1111 Email Web Form: http://www.whitehouse.gov/contact/submit-questions-and-comments/old2
click on: Contact the Whitehouse; then check the box: “I have a policy comment”, then click either Healthcare or Seniors

House Minority Leader Nancy Pelosi Phone: (202)225-4965
Email Web Form: http://www.democraticleader.gov/contact

Congresswoman Lois Capps Phone: (805)730-1710
Santa Barbara District Office: 1216 State Street Suite 403 Santa Barbara, CA 93101
Website: http://capps.house.gov
Then click “Contact Me” and that will pull up the box beneath “email me”, then enter your zip code on the next page. That will enable you to go to the next page to enter your email address address. When you have finished writing your message, click “I would like to hear back from Congresswoman Capps in a formal written reply.”

Senate Committee on Finance Chaired by Max Baucus of Montana Phone: (202)224-2651
Email Web Form: http://www.baucus.senate.gov/?p=contact

Orrin G. Hatch, Utah, Ranking Minority Member Phone: (202) 224-5251
Email Web Form: www.hatch.senate.gov/public/index.cfm/contact?p=Email-Orrin

Ron Wyden, Oregon – introduced the the “Seniors Mental Health Access Improvement Act of 2011.(S.604) Phone:(202)224-5244
Web Form: www.wyden.senate.gov/contact/

The number of  LCSWs and   PhDs,  who are willing to see Medicare patients, is rapidly declining.     It is the same with doctors.   The truth is that the playing field is lessening dramatically in regards to Medicare clients and patients finding help,  finding a doctor,  finding a mental health professional.   And at the same time, the reality is that the aging population continues to increase in numbers.    

This gives major grounds for the argument that MFTs should and need to be included as Medicare Insurance Providers.   The paucity of professionals willing to see Medicare clients is creating a vacuum which needs to be filled in the immediate future.    

What this does is to create a sense of urgency of why Legislation needs to be passed now.
Even amongst MFTs,  there are those who do not wish to see Medicare clients,   whether it is because of the  pay structure or having to deal with Medicare.  And that is certainly within each MFT’s right to choose how each of us wishes to be compensated for the work we do.

And so, the question is,  if you are one of those MFTs who feel that way,  why bother to support Medicare coverage for MFTs?  

The answer is:   This issue is bigger than anyone of us individually.  What you are supporting is the dignity and recognition of our profession.  You are speaking up for the fairness of equal opportunity for employment,  for the deserved acceptance of Marriage and Family Therapists as qualified mental health professionals.  The excellence of our training  makes us very valuable and important for addressing the issues of Medicare clients. 

If MFTs are not allowed to see Medicare clients,  then it would be understandable  that those entering graduate school would pick a profession in which they have the maximum opportunity to gain clients.  People seeking employment go with there is work to be had.  The ability to see Medicare clients enters into the equation  in deciding which mental health profession to choose.  We want to see the continuation of our profession.       It is important that there is not a dwindling down and diminishing in the number of new people choosing to become Marriage and Family Therapists.   We want to see our profession thrive.

Please take a moment and support CAMFT’s efforts to get legislation passed.     Just 5 minutes of your time, once or twice a week will make a big difference.  Your calls and emails will all add to the pot,  and will demonstrate, that as a profession,  we, MFTs,  are standing together for the greater cause.  By standing up and speaking out you are saying that “MFTs matter.”  Your emails, your phone calls to our legislators, will make an important impact and contribute to the hard efforts by CAMFT on our behalf to gain approval for MFTs to be included as Medicare Providers.
You may prefer to write your own email to the legislators listed below,  or, to use either of the two sample emails,  or even parts of them.   Thank you for adding your voice.

Sample #1
Dear…..
As a Marriage and Family Therapist,   I urge you to support upcoming legislation granting approval for MFTs as Medicare Insurance Providers.
The state of the mental health of the aging population and their families affects all of society.  Please support and sign the legislation bill  the “Seniors Mental Health Access Improvement Act of 2011. (S.604). S. 604 which would provide Medicare Part B coverage for marriage and family therapists, and mental health counselors with the goal of increasing access and availability of mental health care for Medicare beneficiaries.
The emphasis of  training and the schooling, that Licensed Marriage and Family Therapists have received, makes MFTs  extremely valuable and qualified to meet the mental health needs of  the ever-rising numbers of the aging population and their families seeking help.  
                                                              Yours truly,
Sample #2
Dear……..
As a Marriage and Family Therapist,   I urge you to support upcoming legislation granting approval for MFTs as Medicare Insurance Providers.  With the rise in numbers of the aging population,  the need for well-trained mental health professional to meet the issues at hand,  continues to increase.
The need for help,  for support,  for coping skills is greater than ever.   The affect illness,  pain, loss,  change in residence,  affects not only the elderly population,   but the families coping with the situation as well.   Anxiety,  depression,  stress,  grief,  takes its toll upon all.  
Please support and sign the legislation bill  the “Seniors Mental Health Access Improvement Act of 2011. (S.604). S. 604 which would provide Medicare Part B coverage for marriage and family therapists, and mental health counselors with the goal of increasing access and availability of mental health care for Medicare beneficiaries.
                                                                  Yours truly,

Legislators to Contact　

Senator Dianne Feinstein: Phone: (202)224-3841
Email Web Form: https://www.feinstein.senate.gov/public/index.cfm/e-mail-me
On the email page, Click the box “Medicare”

Senator Barbara Boxer: Phone: (202)224-3553
Email webform: http://www.boxer.senate.gov/en/contact/policycomments.cfm
Click on E-mail the Senator under: Legislation and Policy

President Obama: Phone line: (202)456-1111 Email Web Form: http://www.whitehouse.gov/contact/submit-questions-and-comments/old2
click on: Contact the Whitehouse; then check the box: “I have a policy comment”, then click either Healthcare or Seniors

House Minority Leader Nancy Pelosi Phone: (202)225-4965
Email Web Form: http://www.democraticleader.gov/contact

Congresswoman Lois Capps Phone: (805)730-1710
Santa Barbara District Office: 1216 State Street Suite 403 Santa Barbara, CA 93101
Website: http://capps.house.gov
Then click “Contact Me” and that will pull up the box beneath “email me”, then enter your zip code on the next page. That will enable you to go to the next page to enter your email address address. When you have finished writing your message, click “I would like to hear back from Congresswoman Capps in a formal written reply.”

Senate Committee on Finance Chaired by Max Baucus of Montana Phone: (202)224-2651
Email Web Form: http://www.baucus.senate.gov/?p=contact

Orrin G. Hatch, Utah, Ranking Minority Member Phone: (202) 224-5251
Email Web Form: www.hatch.senate.gov/public/index.cfm/contact?p=Email-Orrin

Ron Wyden, Oregon – introduced the the “Seniors Mental Health Access Improvement Act of 2011.(S.604) Phone:(202)224-5244
Web Form: www.wyden.senate.gov/contact/

“He not busy being born is busy dying.” -Bob Dylan

Given these unappealing depictions, is it any wonder so many find the very topic of aging ‘uninteresting?’ If this thought has crossed your mind, perhaps you may recognize some of your own resistance, avoidance and/or denial in the mix. Directing attention towards aging is a hard sell, though facing aging is as simple and terrifying as looking in the mirror. And holding a mirror to our client’s lives precisely what we do as we help them negotiate life’s challenges, invite them to explore their hopes and dreams and engage in meaningful relationship with the self.

While this exploration requires courage and motivation, we and our clients know that the alternative (of not looking) is worse; why else would we be here? We also know that if we ourselves cannot look in the mirror, we cannot ask others to do the same. To engage in any discussion on what ‘healthy’ aging looks like, we must first be willing to look; to face the mirror and come to terms with our own aging and what that means to us. This proposition may seem simplistic and obvious, but facing our own aging goes against the very grain of our youth oriented culture and consequently, our own inclinations. Looking at and embracing aging is the last taboo, requiring nothing short of an attitudinal transformation.

Given that we know for certain we are all headed in that direction, we may as well look at what is already happening (aging) and what will certainly happen (death). From this important beginning, we can move meet the challenges of our own vulnerabilities and resistances with eyes wide open, empowering ourselves to discover the secrets of our own ‘healthy aging.’

Surprisingly, it is the acceptance of death that most inspires a willingness to look at our own aging process. When we head down a path, we generally know our final destination; we know where the walk will end. The path of life has only one possible ending, as the comedian George Carlin quipped: “Life is a near death experience.” Paradoxically, we live our lives ignoring this certainty, behaving as if death were some unthinkable entity outside the realm of consideration.

We are willing to ponder so many unknowns; the existence of God, the meaning of mythology, the possibility of mystical experience, and the irrationality of love. We are less likely to give attention to the fact of our pending death, relegating it to the realm of things we cannot understand or discuss. While death is certainly a mystery, living a life where we cannot consider our own certain death is a missed opportunity to explore the very thing that helps make meaning of life. Moreover, as the aging process nears us to that final destination, we only become more acutely sensitized to the preciousness of life. In this respect, the first secret of ‘healthy aging,’ (and of healthy living) is the willingness to embrace our destination before we arrive.

If our relationship to death can be more naturally incorporated into our life experience as the organic conclusion to the gestalt of living and aging, the journey itself and the diminishing time ahead takes on new meaning. We may become exquisitely sensitized to the preciousness of time; more alert to and cognizant of our surroundings.

The experienced hiker knows that awareness, alertness and preparedness helps in the negotiation of twists, turns, bumps, and whatever happens along the way. The alert hiker is less likely to stumble or fall and adjusts his/her step to the ever shifting path. These adjustments; the interface of the path and our ability to negotiate the path with our equipment- mind, body, spirit as they are- determines the nature of the journey and comprises the essential challenge of living. The heart of a discussion on ‘healthy aging’ explores the interface of the reality of the body in its downward descent as it dovetails with a potentially enriched psychological awareness and appreciation of life.

An holistic approach which integrates mind, body and spirit, from a preventative, wellness perspective that supports social, emotional, psychological and spiritual well being is suggested as we embark upon this path for ourselves and, with clients. These considerations must include an attitudinal stance which embraces change and is open to the new realities of later life including; the decline of the body, increased losses, dying and death.

Erik Erikson famously described the basic crisis of the last stages of life as ego integrity vs. despair . Mary Catherine Bateson offers a nuanced interpretation to the meaning of this phase as; a time when we trust our own integrity in a way which enables us to ‘let go’. This notion of ‘letting go’ is a powerful guide for living and clinical practice, dovetailing with the existential questions that precipitate personal evolution in aging such as; How will psychological and spiritual awareness serve us? How will our ‘self-worth’ be measured as work, relationships, and our physical and cognitive capacities shift? Can we be enriched and find inspiration from the process of aging itself?

In striving for ‘healthy aging’ we explore not only how to manage the challenges of aging, but how we can enrich and be enriched by the experience. Our individual and personal explorations are intrinsically embedded in a larger context of cultural, geographic, demographic, socio-economic and other issues which must be considered and understood. For example: What does it mean that an entire population of baby boomers are disproportionally swelling the numbers of aged populations? Will this group approach aging in a significantly different manner than did previous generations, given the paradigm cultural shift engendered by their participation in the revolutions of the 60s and 70s? What is the impact of the reality that we are all living healthier and longer? What are the unique challenges for the different genders, given our different aging processes and the fact that women statistically outlive men? What does retirement mean in an economy that has propelled older adults into extended or second careers and younger adults back into dependency on parental support?

We can never know what lies ahead however, it is critical to consider these questions if we hope to be equipped before we are well down the path. It is also life affirming. The willingness to begin the discussion may be the catalyst for each one of us to enter into a lively engagement and vibrant appreciation of all that may be encountered in ‘healthy aging’ for ourselves, for our clients, and for our culture as a whole.

REFERENCES
Erik Erikson, (1963) Childhood and Society. New York: WW. Norton

Mary Catherine Bateson, (2010). Composing a Further Life: The Age of Active Wisdom. New York: Vintage Books

Elizabeth Wolfson, Ph.D., LCSW is Chair of the Master’s in Clinical Psychology program at Antioch University and in private practice in Santa Barbara, California. Dr. Wolfson has been a licensed practicing psychotherapist for over twenty six years in addition to working in agency settings and teaching and advising graduate students in Psychology and Social Work at Columbia University (New York) and Antioch University (Santa Barbara, California). She serves on the Board of the National Association of Social Workers, Santa Barbara Chapter as Vice President of Professional Development, is the author of several published articles, and is an editor of the Psychotherapy section of allthingshealing.com. Dr. Wolfson is a founder of the recently launched Santa Barbara Village (a community membership organization supporting elders in their homes). Most recently, Dr. Wolfson developed the new Concentration in Healthy Aging within the MACP program at Antioch University, Santa Barbara.

Past Presidents:

Kathleen A. Barry, M.A., Ph.D., MFT

Areas of professional interest include Adult Children of Alcoholics, Bereavement/Grief, Couples Work, Depression, Depth Psychology.

Jacqueline Kurta, M.A., MFT

Areas of professional interest include Adolescents/Teens, Adult Children of Alcoholics, Anger Management, Co-dependency, Crisis Intervention.

Russell Collins, PsyD., M.A., MFT

Areas of professional interest include Couples, Couples Work, Divorce/Mediation, Marital Therapy.

We are now at the 10 year mark in our efforts to be included, which is a typical timeframe to get legislation passed.

This is a moment in time in which your support is more vital than ever.

Senator Dianne Feinstein responded directly to this issue in a letter to me dated Nov. 22. 2011, she wrote:

“Thank you for contacting me to express your support for Medicare coverage of Marriage and Family Therapists (MFTs)…… Like you, I believe that people suffering from mental illness should have equal access to mental health benefits through their private and public health insurance plans.……”

“On March 17th, 2011, Senator Ron Wyden (D-OR) introduced the “Seniors Mental Health Access Improvement Act of 2011. (S.604). S. 604 would provide Medicare Part B coverage for marriage and family therapists, and mental health counselors with the goal of increasing access and availability of mental health care for Medicare beneficiaries.

Currently, S.604 is pending in the Senate Committee on Finance. While I am not a member of that Committee, please know that I will keep your support in mind should this should this legislation come before the full Senate for consideration……. Please feel free to contact my Washington, D.C. office at (202)224-3841.”

Now, more than ever, it is so urgent that we, as MFTs, stand up and be counted. We need to make our voices heard, to give strength and ignite the necessary “move to action.”

We are so close. We don’t want to let this to slide away. We need to create enough stir so that legislation will indeed come before the full Senate for consideration, and yes, get passed.

Your emails, your phone calls to our legislators below, will make an important impact and contribute to the hard efforts by CAMFT on our behalf to gain approval for MFTs to be included as Medicare Providers.

Senator Dianne Feinstein:
Phone: (202)224-3841
Email Web Form: https://www.feinstein.senate.gov/public/index.cfm/e-mail-me
On the email page, Click the box “Medicare”

Senator Barbara Boxer:
Phone: (202)224-3553
Email webform: http://www.boxer.senate.gov/en/contact/policycomments.cfm
Click on E-mail the Senator under: Legislation and Policy

President Obama:
Phone line: (202)456-1111
Email Web Form: http://www.whitehouse.gov/contact/submit-questions-and-comments/old2 click on: Contact the Whitehouse; then check the box: “I have a policy comment”
then click either Healthcare or Seniors

House Minority Leader Nancy Pelosi
Phone: (202)225-4965
Email Web Form: http://www.democraticleader.gov/contact

Congresswoman Lois Capps
Phone: (805)730-1710
Santa Barbara District Office: 1216 State Street
Suite 403 Santa Barbara, CA 93101
Website: http://capps.house.gov Then click “Contact Me” and that will pull up the box beneath “email me”
Enter your zip code on the next page.
That will enable you to go to the next page to enter your email address When you have finished writing your message, click “I would like to hear back from Congresswoman Capps in a formal written reply.”

Senate Committee on Finance
Chaired by Max Baucus of Montana
Phone: (202)224-2651
Email Web Form: www.baucus.senate.gov/contact/emailForm.cfm?subj=issue

Orrin G. Hatch, Utah, Ranking Minority Member
Phone: (202) 224-5251
Email Web Form: www.hatch.senate.gov/public/index.cfm/contact?p=Email-Orrin

Ron Wyden, Oregon
introduced the the “Seniors Mental Health Access Improvement Act of 2011.(S.604)
Phone:(202)224-5244
Web Form: www.wyden.senate.gov/contact/

Note: Marjorie will be speaking on this topic on February 15th. Registration will open on this site during the first week of February.

Mindfulness was part of the Buddha’s basic prescription for the cure of human suffering. This seemingly psychotherapeutic goal perhaps sheds light on why increasing numbers of mental health professionals (as well as lay people) are attracted to Buddhist practices, psychology, and philosophy.

What is mindfulness, and what are its psychological benefits?
How does it differ from other forms of introspective awareness?
Is mindfulness meditation essentially a form of psychotherapy?
Does all psychotherapy implicitly involve mindful awareness?

The orientation provided will focus on mindfulness as part of the process of psychological discovery in psychodynamic psychotherapy. In contrast to treatment strategies which employ mindfulness as a cognitive behavioral intervention, emphasis will be on mindful awareness as a reflective stance in psychodynamic psychotherapy. My experience has been that creative application of mindfulness within the context of the treatment relationship can help facilitate insight into self and other.

My clinical approach, which my colleagues and I call “contemplative relational psychotherapy”, integrates meditative inquiry into a psychoanalytic framework. Within a traditional psychodynamic focus on issues of attachment, separation, and loss, this approach weaves mindfulness practice and the principles of Buddhist psychology into the therapeutic narrative. Where appropriate, I invite clients to use mindful awareness as a way of engaging specific aspects of psychological experience.

In this presentation, I will convey the essence of the contemplative relational approach in two different ways. First, I will give case examples in which mindfulness is implicitly or explicitly included the treatment. These vignettes show how I frame my clinical work and illustrate the Buddhist elements in my therapeutic stance. Second, I will lead a set of brief experiential exercises to help convey the ‘feel’ of mindfulness and “contemplative space” in the clinical encounter.

The cornerstone of a psychoanalytic approach is in-depth inquiry into each person’s unique life experience and suffering, explored in the here and now of the therapeutic relationship. We seek to understand how the developmental events of early life influence problems in the present.

This relational approach is based on the fact that subjective experiences are organized in response to our relationships with others; relationship is embedded in the very structure of our minds and brains. I believe that this explains why psychodynamic therapy is such a powerful agent in bringing about psychological change. The therapeutic relationship provides an opportunity for clients to see themselves more fully in the mirror of another while the therapist helps to illuminate the relational dimension of emotional upsets and reactions.

In contrast, in Buddhist psychology the foundational premise is that the basic nature of mind is to seek its own unifying wisdom and compassion. Mindfulness meditation is a practice designed to access a dimension of consciousness in which it is possible to see clearly how the mind functions. Clarity of observation supports the capacity to let go of what is dysfunctional. Contemplative relational psychotherapy combines these two approaches by inviting meditative inquiry into psychological patterns and reactions in the context of a relationship that effectively supports change. The responsive empathy of the therapist helps the client metabolize experience in a new way, and helps clients to acknowledge and accept what may otherwise have been disowned.

Mindfulness enriches psychotherapy for both therapist and client. For the therapist, mindfulness engages the capacity to be present and facilitates the free-flow of clinical creativity. It fosters the capacity to listen with “beginner’s mind” and allows the clinician to transcend fixed clinical models. For the client, mindfulness practice contributes to the ability to discern subtleties and nuances of psychological responses that arise from moment to moment.

In sum, the dimension of mindfulness in the psychotherapeutic encounter helps to highlight where someone is having difficulty, enhances clarity about where there is opportunity for change, and opens up the possibility of moving beyond unconscious stereotypes of self and other.
Contemplative relational psychotherapy weaves together the relational theories of contemporary psychoanalysis with the insights available in Buddhist mindfulness meditation. Together, these perspectives cultivate greater awareness of the dynamic unfolding drama of life and allow the potential meanings which are implicit in suffering to unfold in the therapeutic process.

Marjorie Schuman, Ph.D. is a clinical psychologist who teaches and practices psychodynamic therapy both in Santa Barbara and West Los Angeles. After earning her Ph.D. at the University of Michigan, Dr. Schuman came to Los Angeles where she did postdoctoral training in the Department of Psychiatry at UCLA and later earned her certification in psychoanalysis. Currently she is a member of the faculty at the Los Angeles Institute and Society for Psychoanalytic Studies.

I have been teaching and practicing psychotherapy and psychoanalysis throughout my career.”