NPI Reflects Summer 2023

NPI REFLECTS

Peace When There Is No Peace

By Barbara Sanders, LCSW

Utter madness

Sanctimonious and ominous

Green with greed

Malicious, malignant destruction

Those who want to rule the world

Those who cannot be halted by

Mere individuals and prayer

Continue to dig graves for

Those others who are so wiling

To believe in one way, one person

One opinion

Fake news and False prophets

Those less mad

Join hands and suffer

Feeling helpless, hopeless

Angry and sad

Unable to use our energies

Our brute strength, our votes

And our spirits to rid the world

Of this virulent cancer

Not yet

We crawl into holes in the sand

Not being able to breathe

Underneath unstable, shifting particles

Blowing over and around us

We scream, we wail

We denounce all the unfairnesses

The injustice and the terror of Living in such a world as this

Sometimes

We go about our days

No longer watching the news Too heart-wrenching

And chaotic

We work, we play, and we love Knowing that somewhere deep Within us lives a spark of possibility

Hope and Ascension

Peace when there is no peace

Now Awake

The sun is rising

See the darkness and the light Witness the truth and the fictions

Believe, believe

We are powerful, not weak

Gathering our sparks together Proclaiming We are One

Burning out this disease

Cauterizing these spectres

Who work against our human And divine values of Compassion and love

Source and Spirit

Their ashes fly up and around Lifting off from Mother Earth

Released from gravity, a spiral No magnetism no more

Spewing out of our atmosphere

Journeying beyond It

From the Chair...

As I announced in my Spring “From the Chair” column, NPI’s Fall Workshop will feature Mary Cosimano, LMSW, the Director of Guide/Facilitator Services for the Johns Hopkins psilocybin-assisted psychotherapy research program. Mary will present “The Healing Presence of the Psychedelic Therapist” on Saturday October 21. We are fortunate to have this distinguished, nationally known expert speak on such an important subject.

One of the things that impresses me about psychedelic therapy is its ability to quickly bring about authentic, healing spiritual experiences. By “spiritual experiences” I mean experiences of mystery, of the numinous, of transcendence experiences of something larger and more breathtaking than our conventional, rational minds can comprehend. These experiences are often described as ineffable; they can’t be adequately expressed in words. The experiences can take many forms, including the realization that “everything is one” or “love is all that matters.”

In the words of Alexander Beiner, these experiences can leave us with: a profound connection to a greater reality that can forever change our outlook on life…It’s how they open us up to that which really matters. They do it with love. They remind us that we are deeply held and cared for by existence. That each of us matters. That, if we can truly be here right now, we will see that the kingdom of heaven is all around us. For me, that experience is defined not just by overwhelming gratitude, but by a sense that there is a cosmic smile at the heart of things, that the world is forever an unfurling mystery.

These spiritual experiences are sorely needed in a world that feels meaningless, chaotic, and unsafe to many. Modern life has many conveniences, but its unrelenting pace and stress have taken much of the pleasure out of living and have led to an epidemic of anxiety and depression. Psychedelic psychotherapy along with mindfulness, breathwork and other transpersonal approaches to therapy can offer profound answers to these existential dilemmas of modern life.

Psychedelic psychotherapy may offer even more than a road to a more meaningful life. It may offer healing from the intolerance and hatred that seems increasingly common in the world today. I would like to share an encouraging story of just that kind of healing:

In February 2020, a young man named Brandon took part in a study at the University of Chicago on the effect of MDMA on the pleasantness of social touch in healthy volunteers. Unknown to the researchers, Brandon was a local leader of a white supremacist organization who had been outed publicly by activists at Chicago Antifascist Action; being exposed had cost him his job and many friends.

During the experiment, as the MDMA took effect, Brandon found himself doubting his choices and his usual way of thinking. Unexpectedly, he found himself thinking about connection and realizing that connections with other people were the only thing that mattered. When he was later contacted for follow-up by a research assistant, Brandon said, “Love is the most important thing. Nothing matters without love.” Brandon went on to reach out to Chicago Antifascist Action, and, with the help of the activist who exposed his identity, he examined and renounced his white supremacist beliefs!

This is a beautiful, encouraging story. I find it inspiring, but I also want to make the point that psychedelics are not a panacea. Brandon’s experience of being outed probably primed him for the transformative effects of MDMA; he already had a certain mindset going into the experiment. Nonetheless, this story adds to my optimism. If we are willing to use psychedelic therapy and similar tools with discernment, perhaps the human race can grow in wisdom and compassion. Perhaps we can learn to get along better and relate with love rather than hatred.

The NPI Fall Workshop with Mary Cosimano is on Saturday, October 21 please save the date. References

https://beiner.substack.com/p/the

https://www.bbc.com/future/article/20230614

Tom Neilso, Psy.D

The NPI Nominating Committee is currently accepting nominations for Board Membership. There are several open board positions for members who would serve in a leadership role for a three-year term beginning January 2024, as well as a one-year position for a Student Board Member.

You can apply yourself OR nominate a colleague. ALL individuals interested in serving on the board must complete an online application and profile. Nominations must be received by August 25th.

You can learn more about Board Membership or Apply at the links below:

ROLE OF THE BOARD MEMBER APPLICATION FOR BOARD MEMBERSHIP

If you would like to nominate someone else, please let them know, and forward their name to Rebecca Pearce at Rebecca@pearce.com

The NPI Social Justice Committee

NPI was founded to provide a forum for continuing education for licensed mental health clinicians and an opportunity to experience community with one another and encourage one another in all aspects relevant to our common scope of practice. The Social Justice Committee supports these goals of NPI. We do this with events we create and host, as well as by providing resources and information about events sponsored by other organizations in Middle Tennessee.

As a part of our commitment to promoting Social Justice, NPI’s Social Justice page: https://nashvillepsychotherapyinstitute.org/social-justice/ and the Diversity, Equity and Inclusion page: https://nashvillepsychotherapyinstitute.org/social-justice/ on the NPI website provide education and advocacy resources. The Social Justice page describes our mission and invites participation and suggestions by any interested NPI member. The Diversity, Equity and Inclusion page acknowledges the national moment of reckoning related to race and its intersectionality with gender, class, and other social locations and identities, and how we as therapists can be involved in this movement. It includes statements from our professional organizations, professional practice guidelines, and resources for education and action.

We are continuing to add links to assist members in tracking legislative proposals that impact our work as therapists and the people that we serve. Please let us know of any needs or suggestions that you have for the work of this Committee by contacting Linda Manning at doclgm70@gmail.com or Valerie Martin at valerie@gaiacenter.co.

The Wisdom of a Master Psychotherapist: A Review of Semrad: The Heart of a Therapist, Edited

by Susan Rako, M.D. & Harvey Mazer, M.D.

By Philip Chanin, Ed.D, ABPP, CGP Board Certified Clinical Psychologist

Assistant Clinical Professor, Department of Psychiatry at Vanderbilt University Medical Center www.drphilchanin.com ~ philchanin@gmail.com

“Experienced psychiatrists and trainees alike would look forward to the conferences (Dr. Semrad) chaired as the high point of their week. There we saw his patience, warmth, respect for others, and his deep commitment to the necessity for people to make their own decisions…

He demonstrated the importance he placed on loss and lost objects in life, and on the need to grieve these losses adequately in order to go on He had a special ability to simplify the complex, to recognize, identify and describe the feelings common to people, and to communicate this in his clinical work and teaching.” (pp. 11-12)

Elvin Semrad, M.D., (1909-1976) trained a generation of Harvard Psychiatric Residents as the Clinical Director at the Massachusetts Mental Health Center. According to the editors of this book, Doctors Susan Rako and Harvey Mazer, “On October 7, 1976, news that Dr. Elvin Semrad had suffered a sudden and fatal heart attack spread rapidly and painfully through the Boston psychiatric community. With his death at age sixty-seven, we suffered the loss of an extraordinarily gifted clinician and teacher, loved and respected by generations of colleagues and students.” (p. 11)

This volume is a collection of quotes from Dr. Semrad that the editors wrote down during their years of training with him, along with other quotes that other residents remembered. The editors write, “To some extent this project has been part of our own grieving, as we continue to mourn Dr. Semrad and to put him and his teaching into perspective in our lives.” (p. 19). The editors divided the book into sections, reflecting the topics that Dr. Semrad commented on most often.

The section on “Feeling,” includes the following quotes: “The most important part of a person’s life is his affect The one thing all people have is feelings their actions and thoughts are often means of disguising these feelings from themselves First feelings have to be acknowledged, then one has to bear them, and finally one has to decide what to do with them.” (pp. 27-30)

I have often quoted to patients Dr. Semrad’s teaching in the section entitled “Love.” “All men scheme to get their ideal woman, and all women scheme to get their ideal man. Sometimes they do it in such a subtle and sophisticated way that it’s not even conscious. They call it ‘love.’ Nobody thinks when they’re in love. If they did, the honeymoon would be over. Don’t get me wrong. I’m not against it. I got hooked myself. I don’t know who started it. I just observe it as it as it happens When people are having trouble loving currently, it’s because they have an old love that they’ve never given up One of the saddest things in life to accept is that those you love often love others more.” (pp. 33-36)

I’ve also quoted to patients from the section entitled “Men and Women.” “A girl’s a girl sometimes you make it with her and sometimes you don’t. Sometimes if you make it with her, you make a contract for a life of excitement, contentment, and difficulty…Can a woman love more than once?” (p. 40)

The book’s next section is entitled “Growing, Maturing and Sadness.” Grief and sadness were themes that Dr. Semrad returned to again and again: “The only fuel for learning is the sadness you feel from your mistakes. It’s important not to waste this fuel People grow only around sadness. It’s strange who arranged it that way, but that’s the way it seems to be It’s sad and painful not to have what you want Pretending that it can be when it can’t is how people break their hearts…You have to be able to say (feeling and bearing the pang of sadness that goes with it), ‘I want that, but it’s not for me, and I accept it.’ Renunciation is the mechanism of adaptation…Becoming one’s self is the saddest experience anyone can have. It means taking your feelings for the most important people to you, separating these feelings from them, then taking the idealized meanings of these feelings and introjecting them into one’s self.” (pp. 45-46) (Continued on page 5)

The following quotations from this same section are the ones I have most often shared with patients: “Maturity is a matter of people learning to be alone together. The more mature a relationship, the more able the two people are to give up their dependency and learn how to live alone together…Nothing is ever mutual…In everyday life each one of you, to the extent of your maturity, lives alone. You make your own decisions, which is very lonesome. You feed yourself and look after your own physiology. Then, periodically, by mutual agreement with someone in your life, you have some human contact. And the more mature you are, the less you insist that the other person change to fit your mold, albeit one does not give up that wish altogether. Nor do others give up the idea that you ought to change to fit into their mold. But it becomes a relatively minimal matter.” (pp. 47-49)

The section entitled “Marriage” includes the following: “People need to marry to have peace of mind If people chose partners by what they are rather than what they think they are, there wouldn’t be any deals. That hopefulness is what makes the deal. Getting married is a terrific loss experience. You have to take yourself out of circulation for your own peace of mind. You shut the door behind you. You open a door, too, but you don’t know what’s ahead. Getting married is a sad thing.” (pp. 59-60)

Here are some of Dr. Semrad’s words in the section “Decision Making”: “The most important task of a human being to make up his mind what’s for him and what’s not for him As soon as you make a commitment, you put yourself in line for a lot of pain. It means choosing a niche for yourself and giving up all those other possibilities.” (pp. 76-77)

The “Happiness and Normality” section includes: “A person has to face the pain in his life in order to put it in perspective. If the shit is collecting in the barn, you’ve got to shovel it out. Otherwise before you know it the barn is full and you won’t be able to manage it…What people avoid is what hurts the most…Everything is all right as long as it’s at the right time with the right people in the right place…Normality is essentially a function of where, with whom, and when.” (pp. 86-87)

Another section is entitled “On Therapy and in Therapy.” Dr. Semrad is quoted as follows:

“I don’t know many ‘ordinary people.’ I never treated anyone who didn’t need treatment

A therapist is a kind of service man. There are so many things a patient can want to use you for and if you can swallow your own ideas of how things should be, you can perform a real service As long as you take the position of talking to a person about what matters to him, then he can feel secure. Someone cares enough and is concerned enough about him to work with him and listen.” (pp. 101-102)

This same section also includes: “We must insist on talking to patients only about what they actually experience…not the stock they came from, their heredity, their genes, their biological propensities to growth. All we deal with is their reaction to their life experience; how much of it they integrated and how much of it isn’t integrated; how much they can handle and how much they can’t handle, but have to postpone or avoid or deny. And the more infantile the personality, the more they handle by avoidance We must help the patient to acknowledge, bear, and put into perspective his feelings.” (pp. 103-104)

“In response to a resident’s request for advice regarding what to say to a patient:” “We all have the same question and problem, and I follow a very simple rule: If it’s comfortable for me to say it, then it is the right thing, the right time, and the right way to say it Go after what the patients feels and cannot do himself. Help him to acknowledge what he cannot bear himself, and stay with him until he can stand it As a psychiatrist, your job is to help the patient stand his pain, and this is directly contrary to the rest of the medical profession.” (pp. 104-105)

This section continues: “No therapy is comfortable, because it involves dealing with pain. But there’s one comfortable thought: that two people sharing pain can bear it easier than one If you can’t sit with the patient until he can feel it in his own body then you’re in the wrong business Don’t get involved in judgments; concentrate on working through feelings.” (pp. 106-107)

“In answer to a resident’s question as to how long to tell a patient he will need therapy:” “As long as it takes Investigate, investigate, investigate Whenever you don’t know what to do: investigate Stay with the person’s

(Continued on page 12)

Every Blade of Grass

By Janet Heilbronn, LCSW

In this darkness

Find the courageous path

And with compassion

Go find Her

For the sake of this child frozen in time

Bring all that you’ve got and focus

Flesh her out through intent and be brave

Feel the rip

Find the trailhead and begin again

Listen to all of them who won’t let you by. Hear their stories:

The town crier

The prostitute

The murderer

The homeless one

The fear monger

The addict

The performer

The people pleaser

The dreamer

The angry one

The artist

The perfectionist

Some with torches lit

They will storm you. They WILL storm you.

Stay the course and for the sake of this child listen, and listen good

Let them all know you are coming

A merchant of Hope

The plausibility of possibility

Be with them all and feel the burn of transformation.

Visual Prompting

by Michael Murphy, L.C.S.W., C.G.P.

During a workshop at the A.G.P.A. conference this year, each of us was given this image. We were told to begin writing and would stop at 10 minutes. This is what emerged for me:

I don’t miss the ocean. It’s beautiful, but I don’t have a longing to go back, as so many people seem to have.

My mother was one of those people. She loved the ocean. We’d go to Nags Head every summer as a family. We’d drive down from Virginia, and as soon she could smell the salt air, she’d cry tears of joy. We’d tease her about that.

We’d get settled in to our cottage and then head down to the beach. We’d slather ourselves with suntan lotion in hopes of tanning – no sunscreen then. We’d body surf, walk around, sit on the gazebo ...

One day, Dad asked me to go with him to a seafood shack. He bought a half bushel of crabs. Live crabs. We went back to the cottage where he set up the big steamer. When it was ready, he poured the crabs in. One got away, and he gathered it up and put it in the steamer. There was a racket for a moment – and then silence. I was aware they had died. We all sat around the porch table and had a crab feast. They were delicious, and I felt sad.

The days wound down. We had a final swim. We packed up and drove away. Mom cried tears of sadness. We teased her about that.

Her ashes are off that shore.

Thoughts on Compassion Focused Therapy

By Khalid Stetkevych

Compassion Focused Therapy: Clinical Practice and Applications (2022).

Edited by Paul Gilbert and Gregoris Simos. Routledge

Gilbert & Simos’ (2022) edited manual on compassion focused therapy (CFT; another acronym, yay.) is a mammoth sized textbook combining the theory, techniques, and applications of CFT. While the theory section of this book is a herculean effort to integrate modern psychological sciences (such as evolutionary psychology, interpersonal neurobiology, and polyvagal theory) with a nearly comprehensive history of psychotherapy styles and techniques (such as Jungian psychoanalysis, somatics, mindfulness, functional-analysis, and good old classical conditioning), its conception was still significantly born out of cognitive therapy.

With this in mind, CFT brings about a less-often talked about layer/dimension of assessing cognition: tone. CFT argues that tone is an imperative, even if overlooked, dimension of cognition because of how it carries the emotional load of the thoughts. From a linguistic interpersonal psychology standpoint, every word is a symbol uttered by the speaker and heard by the receiver. The receiver is affected by the words in some way, shape, or form; think of general attunement, mirror neurons, what have you. Still, the words have tone; on an emotional level, how much are we the receivers influenced by tone versus influenced by the dry data of the symbols? We can play out this thought experiment with ourselves or with our clients: think of a phrase you might say with a critical tone, then try it out with contemptuous judgment and then with heartfelt compassion. There’s an obvious difference.

Let’s make this conceptually even more interesting. Imagine you have a roommate, and every morning they tell you that they hate you and you’re worthless. After a pretty short while, you’re going to start hating them back. Imagine now that this roommate is your own internal dialogue. Your internal words have a sender and a receiver, but in this case they’re both you. You keep telling yourself you hate yourself and you might just start hating yourself back (a funny way of saying there’s a self-amplifying feedback loop inherent to the action). Now, maybe you’ve had one of those funny ironic roommates who trash talks you as playful banter that could only be interpreted as love. It’s not what I was going for, but you already see one point here – the tone mattered; even the most awful words said sweetly or with unquestionable playfulness are not felt as awful. The question then becomes, how do we build a better self-talk? CFT would argue through self-compassion.

If you’re reading this, I’m honored, and this isn’t going to make you throw out the old for the new. Nor should it. Instead it contributes another layer or dimension of analysis for our thoughts:

- What is the content and structure of a thought? (Beckian)

- What is the function of a thought? (ACT)

- What is the tone of a thought? (CFT)

- What are my thought patterns and attentional biases? (metacognition)

Board Member Spotlight

Juiana Vokes, LPC-MHSP (she/her/hers)

Growing up in a small town with minimal attention to minority populations, trending topics, politics, or mental health was deeply impactful as a teenager into early adulthood. I went into my first year of school “undecided” with hopes of exploring coursework to guide me in the right direction. As it turns out, I would find my calling outside of the classroom – at a free event in the common space that I was persuaded to attend by the “free pizza” flyer posted around the campus. I didn’t bother to look at the event but quickly found myself in a room full of humans who were openly sharing mental health experiences, stories of overcoming suicide attempts, years of substance use, or escaping unhealthy relationships. At 19 years old, I had my first conversation about my own mental health after keeping my personal feelings of unworthiness deep within me. While enjoying my free slice of pizza, I emailed my academic advisor to discuss my interest in mental health.

Four years later, I graduated from Pennsylvania State University with a Bachelor’s degree in Human Development and Family Studies. I knew I wanted to continue learning about the world of mental health so I continued my education at Carlow University in Pittsburgh, PA. Within two years, I completed a dual-master’s program that allowed me to graduate with a Master of Arts in Student Affairs and a Master of Science in Professional Counseling. From there, I moved to Nashville to be with my wife. We have been married for two years and have two spunky dogs and a very social tuxedo cat.

My work in Nashville began in non-profits before COVID-19 left me unemployed. I knew immediately that networking and connecting with peers in the community would be some of the most important parts of my new career in Nashville. I was fortunate enough to connect with Patrick Nitch, who runs Mindful Nashville. I began filling my schedule immediately, and quickly fell into work that was deeply meaningful as I reflect on my own mental health journey.

My client base is primarily LGBTQIA+ folks who are experiencing anxiety or depression, gender and identity related concerns, religious deconstruction/repairs, and self-acceptance. I meet these concerns from clients with mindfulness-based interventions that allow for deep healing, creating safety in our bodies and spaces, and empowering the Self and our relationships. My work supports clients in cultivating compassion and acceptance in their past experiences and current identity to embrace a life that feels meaningful and worthy.

I joined the NPI board the first year that I knew of NPI. I jumped in eager to learn from the experienced clinicians around me who are in various chapters of life and their careers. My main intention in joining NPI as a member was to connect with other peers at luncheons and attend CE meetings to continue expanding my scope. Little did I know that COVID-19 safety was going to be a huge topic of conversation alongside communication strategies for marketing and membership, social justice discussions, and more. After meeting virtually for a large portion of my time on the board, it was a feeling of pure joy when we had our first board meeting and CE luncheon in-person. The members of NPI have shared so many similar feelings with regards to spending time together in person. While my last year as a board member is coming to an end, the laughter, storytelling, and fulfilling connections that NPI brought to my life will continue to encourage my involvement as a member within a community that welcomes all.

Juliana Vokes

(Review of Semrad, Continued from page 5) experience, and don’t get seduced by some of the fancy concepts you’ve heard about…A man’s either scared, mad, or sad. If he’s talking about anything else, he’s being superficial Anything short of the patient talking about the actual circumstances of his life is resistance, and you don’t go along with resistance The things that work are all worked out. It’s the things that don’t to which we have to address ourselves. So talking about anything short of problems is a waste of time Don’t get set on curing her, but on understanding her. If you understand, and she understands what you understand, then cure follows naturally.” (pp. 109-122)

The following section is entitled “Case Conference Comments to the Patient.” Here Dr. Semrad speaks to the patient as follows: “I don’t know how it is with you. That’s what I want to find out What’s in your life for you? You must talk only about what really matters to you You need your sleep, but you have to settle the important issues in your life to enable you to sleep.” (p. 131)

The next section is entitled “Case Conference Comments to the Therapist and Staff.” “The issue is the overwhelming pain she can’t face right now…She just doesn’t want to know what she knows, because it’s all so sad… What’s going on in his living and loving that he can’t stand to look at?...He may reject the therapist because he cannot tolerate what he begins to feel.” (p. 139)

This sections continues: “ From a letter to a private therapist who had sent a patient for consultation:” “He has little experience bearing his sadness, and is warding it off through depressive activities I asked him to tell me what he wants ‘a crutch,’ he says I told him to return to you and level with you about the life issues that matter to him most…The initiative falls on his therapist to help him acknowledge, bear, and put these issues into perspective… You must help him come to terms with his limitations and decide what he will do in his life that is consonant with his talents.” (p. 142)

This same section includes the following: “A therapist who is not oriented to going after what the patient avoids could sit with this woman for five years and get nowhere…Dying is a very serious matter, because you can do it only once. Nobody knows if an afterlife is a fact or a belief, because no one’s come back to discuss it. If she wants to believe there’s an afterlife, that’s her decision. As psychiatrists, we’re interested in making sure she knows the difference between belief and fact My favorite question is, What do you really want to do? It’s a question I’ve thought out over the years. And it’s important, because it involves how he wants to spend all the years of his life Time means nothing in this business.” (pp. 143-148)

This book ends with the following exchange: “Resident: What do you think helped build your capacity to help people bear intense feelings of loneliness and loss?” “Semrad: A life of sorrow, and the opportunity some people gave me to overcome it and deal with it.” (p. 206)

In the book’s Introduction, Dr. Mazer writes, “I learned more about being a psychotherapist from Elvin Semrad than I have learned from anyone else in my life. What he taught was not theoretical. By example, he taught respect for people and for life. He demonstrated how to sit with people and their pain to listen, to hear, and to sort out what mattered to them. He showed how to help them look at their lives in a way that would enable them to find their own solutions to their difficulties.” (pp. 14-15)

The introduction also includes Dr. Rako’s reflections on her training with Dr. Semrad. She writes, “He allowed the impression that he had been there, wherever, or that he would readily go, using the man or the woman in himself, as he would say. And there he sat, in his amplitude, very often smiling mischievously, teasingly, wisely, kindly, enigmatically, diabolically, attesting to the safety of taking life on, simply of acknowledging, bearing, and finally putting into perspective the feelings that went with the living of it. ‘We’re just big messes trying to help bigger messes, and the only reason we can do it is that we’ve been through it before and have survived.’” (p. 16)

2023 NPI BOARD OF DIRECTORS

Tom Neilson, Psy.D; Chair

Michael Murphy, LCSW; Chair-elect

Linda Manning, PhD; Past Chair/Social Justice

Krista Conrick, M.ED Candidate

Tiffany Davis, LCSW

Avi Dressler, LMFT; Finance Committee

Laura Fritsche, LPC-MHSP; Membership Chair

Rich Gorman, NCC, MA, M.Ed.

Valerie Martin, LCSW; Social Justice

Tonya Mills, LPC-MHSP/T; Treasurer

Rebecca Pearce, PsyD; Hutton Historian

Sarah Rodgers, LMFT, RDT

Khalid Stetkevych; Student Member

Doug Taylor, LPC-MHSP; Speaker Research

Juliana Vokes, MA, LPC-MHSP; Communications

Eboni Webb, PsyD, HSP

Melissa Vickroy, MS; Executive Coordinator

NEWSLETTER CREDITS

Editor: Juliana Vokes, MA, LPC-MHSP

Layout & Design: Melissa Vickroy, MS

Printing: ISSUU online publishing

**Editor’s Note: The content and opinions expressed within this newsletter do not necessarily reflect the views of nor are they endorsed by the Nashville Psychotherapy Institute, the Board of Directors of the Nashville Psychotherapy Institute, or the Editor of the newsletter.

Nashville Psychotherapy Institute

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Nashville, TN 37215

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www.NashvillePsychotherapyInstitute.org