Board Member Spotlight

Juliana 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.

(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)