Mindfulness Based Stress Reduction Group

Drew Prochniak, one of my staff, is going to offer a mindfulness-based stress reduction group beginning in mid-January.  View our website to email him for more information.  www.traumacenternw.com.

Craving the Mundane

Anytime something that shakes us up happens, we crave the return to the mundane.  It is so comforting to engage with what we don't think about, perhaps because trauma can consume what feels like every inch of our cognitive and emotional capacity.  The smells associated with simplicity can bring feelings of warmth and comfort; coffee in the morning, our bed linens, the smell of our children (okay these are the things that comfort me).  All things home and familiar are what we want most when confronted with disaster.  Perhaps this is part of the draw of isolation for survivors; avoiding the outside world keeps us connected to comfort.  Predictability is a form of fortune telling; if I know what happens in the next few hours or days, things will be fine.  At least it feels that way.

The mundane, the boring, the thoughtless and otherwise seemingly empty parts of our lives are actually so profound.  This is what we are drawn to in response to the unbearable.  I find myself thinking of this anytime my mind wanders to Newtown.  Newtown followed a violent public shooting here in Oregon, thus the locals here were managing two atrocities in two days.  As I go to each event in my mind, particularly to the children, almost immediately I want the comfort of my routine, of what and who is familiar.  This is a major source of regulation of emotion.  Recent events are highlighting the significance of what we rely on for comfort.

Many of the advice givers (myself included) advise re-engaging with routine following tragedy, although there isn't much examination or discussion as to why.  Perhaps examination is unnecessary because our pursuit of the familiar is so intuitive; we needn't be told to do that because it's what we want to do.

Thus, the predictable return to the strengths and resilience of people and trauma survivors... Survivors know what to do to feel better much of the time, and if it isn't clear what to do, there is often a persistence of  trying to figure it out.  Sometimes the answer to this particular question (what to do to feel better) leads to addiction, to avoidance, or other forms of escape.  Sometimes, if we stick with our pursuit of the mundane, we are lead back to it through a meandering, undefined path that demands our trust in our own capacity.

Link to Oregonian article ITTC is mentioned in

http://blog.oregonlive.com/themombeat/2012/12/clackamas_town_center_shooting_1.html

Connecticut, Grief, and Hope, & What My Clients Have Taught Me

I have a six, almost seven year-old boy.  His eyes are big and brown; his lashes long and luxurious.  He  calls me "mama" in his sweet voice, and each time I hear him say it I feel warmth in my heart.  I look at him now and wonder so many things that I am certain everyone is wondering too; how does one disturb that kind of innocence, ignore it, destroy it?  And the pain the parents in CT are left with seems unbearable.  I have to grieve with them and for them and recognize what kind of risk one takes in loving someone in that way (a risk well worth it).  So, like many others, I find myself searching for something~information, understanding, insight, and most certainly I would like some hope for those in the midst of such unbearable grief and horror.

I hear a lot of stories in the work that I do.  So many things that seem insurmountable, and yet, day after day I see my clients and listen to them tell me their stories.   It's a thing I have said before~that trauma survivors are heroes.   That doesn't mean there is no suffering or grief, that recovery is easy, and I wouldn't be so naive as to say that time heals all wounds.  However, what I continue to learn from them  is that each person, within the context of their own experience, is in those moments of horror, coping with it in some way.  The coping isn't visible-we learn of it later when words can be paired up with events.  Part of the truth I hear from survivors, over and over, is how they survived...what they did on the inside to manage what was happening on the outside.  My little tidbit of hope is that for each and every victim and survivor of a victim there is and was coping.  There is family, there is community, there is an entire nation grieving with them, and there is no doubt of the gravity of their pain.

Essentially, what I hope to remind myself of is that thing I have learned in the work I do; that we do have a capacity to care for ourselves in nuanced ways.  It's difficult to talk about hope without sounding  as though I don't understand or that I am naive.  Perhaps this is my own coping~I can't be certain.  I can, however speak to what I have seen and be thankful to those who have invited me into their lives.  There is some light in having felt the truth of the human spirit's capacity to save itself in the face of the unspeakable.

Tips for parental response to community-based trauma

In response to the shooting on Tuesday (12.11.12) at Clackamas Town Center, one of my staff, Jessica Boldt, LICSW, wrote an article on ways in which parents can help their kids & teens recover.  I have cut and pasted it below:

Traumatic events, such as the tragic account at Clackamas, impact all of us in unique ways including children and teens. Parents are often worried regarding the affect it will have on their child and are unsure as to how to help them. We hope that this information will assist parents feel relieved in having concrete tools to assist support their child during this time, and know the one may exhibit that indicate a need for greater resources.

An important thing to remember is that youth are often highly resilient even after extreme duress. A child or adolescent’s reaction to stress, even catastrophic, is usually brief in duration and symptoms of trauma are often a healthy indicator of one’s efforts to stabilize. Parents should also consider that the impact may affect teens in a unique way as the mall is often viewed as a safe place for youth, and one that represents belonging and socialization.  It’s likely helpful for teens to process with other peers and discuss how this event likely altered the perception of this meeting place they find comfort in. Teens should be encouraged to visit the mall when they, and parents feel stable enough to cope with the “triggers” of the event. Teens are also likely to feel strong and secure in numbers, so going to the mall with another teen may be encouraged. Also, making “baby steps” into this environment is something that may assist a teen with feelings of anxiety. For example, making the first trip with friends to one store may be more manageable for a teen that wants to go to the mall, but is having some reservation.  It’s also important to note that teens may want to go directly back into the mall environment, which may be their way of healing. Whatever process your child feels comfortable in, make consistent efforts to monitor behavior and mood and discuss their best efforts to move forward.

Directly following trauma, it is expected that children and teens may exhibit agitated or confused behavior.  They also may show through behavior, play, or in verbal communication intense fear, helplessness, anger, sadness, horror or avoidance. Parents may experience their child having increase in behavioral outbursts, mood swings, fear of being alone or “clingy” behavior, or isolation. While seeing your child in these states can be difficult, these are indicators that one is working to process the event.

While a parent cannot “make the event go away,” a parent can assist the child work through their feelings by maintaining the child’s structure. The child needs to regain their sense of safety and parents are the best at doing that. Parents are able to do this by:

·      following the household daily routine

·      gentle encouragement to participate in their normative activities to assist them regain normalcy

·      engagement with positive supports such as family and teachers, 

·      practicing self-care for themselves to assure emotional and mental stability with them, providing positive outlets to discharge some of the energy following trauma such as talking a walk or a bike ride,

·      limiting exposure to pictures or adult conversations of the event,

·      monitoring stimulus (maybe reconsidering attending some of those holiday parties),

·      doing mood “check ins.”  Parents may do this via a play activity with small children where the family to family charades to explore moods and prevent focusing on “negative” moods.

·      discussing the event if your child chooses. For smaller children, it’s important to use age-appropriate language, and pictures or play maybe most appropriate.

Parents want to make sure to follow a child’s lead in the conversation to avoid them from getting overwhelmed. Teens are often more able to verbally communicate though may feel agitated when a parent asks to many questions. As a parent, you likely know what your child has needed from you most to feel comforted in the past when they have been hurt. It’s wonderful to glean information from these previous experiences to assist them manage the current event.

Though stress reactions are usually brief and recover without further problems, a child or adolescent who has experienced a catastrophic event does have the possibility of developing posttraumatic stress disorder (PTSD). Signs that your child may be having difficulties include the following behaviors occurring for more than two weeks or if they increase in severity: 

• loss of interest in activities and isolation
• ongoing physical symptoms such as headaches and stomachaches
• ongoing extreme emotional reactions and sudden shifts in moods
• ongoing problems falling or staying asleep                  
•  problems concentrating or new school related concerns
• ongoing regression of age or intense fear of being alone
• ongoing increased alertness to the environment or inability to adapt in new environments
• repeating behavior or play themes that reminds them of the trauma
• worrying about dying or others

If your child exhibits these signs it does not necessarily indicate that your child has PTSD. However, it is recommended that parents and their child meet with a qualified professional to best assist in area of assessment and providing families increased tools to mobilize your child from a place of fear to happiness. 

Written by: Jessica Boldt, LICSW

Jessica Boldt is a licensed clinical social worker specializing in trauma related work and clinical work with children and teens. She currently practices at  Integrative Trauma Treatment Center with locations in Portland, OR and Vancouver, WA. 

 

Trauma Center is Open!

Finally, all has come together and we are good to go.  I have two amazing staff people, Jessica Boldt, LICSW and Drew Prochniak, LPC who share my passion for working with survivors and who definitely keep me on my toes.  Our website is up and running (and is gorgeous-I must say)~the address is www.traumacenternw.com.

I wanted to create a place that is warm and has a non-clinical atmosphere and that works from an authentic place of respect, honor and optimism.  I also wanted to have a micro and macro perspective on the work that we do, specifically in treating people individually but also expanding to national and international disaster relief and trauma treatment.  I also want to continue to develop our community partnerships, to provide advocacy, and education to the community.

Some upcoming offerings likely this winter:

Street Yoga for Survivors
Relapse Prevention for Survivors
Seeking Safety Group

and we'll see what else!

The DID Debate (Dissociative Identity Disorder)

I know...I am entering shaky ground here...

The debate surrounding the existence of DID continues.  So many of those I work with who present with this diagnosis doubt their own perception and the "truth" of their experience.  On the contrary, people who come in with depression, for example, don't have an argument with themselves about whether or not they are indeed depressed; people with anxiety are generally fairly certain of their experience.  In the case of DID, I wonder how many folks would have pervasive doubt if it weren't imposed upon them?  I can't think of any other circumstances where someone comes in for help, tells their therapist or psychiatrist "these are my symptoms" and they are met with "those symptoms do not exist" or "I don't believe in those symptoms" or "you are faking it."

So, let's ponder that for a moment.  A few questions come to mind.  First and foremost is why is it that clients who present with DID talk in the same way?  It's a very idiosyncratic way of referencing both the self and the world.  Additionally, why is it that the organization of their internal family is very patterned and very similar.  The types of alters, the types of conflicts between alters, the kinds of voices they hear that are not necessarily assigned to an alter~I could go on and on.  Why is it that many people with DID often have what appears of a sort of veil over their eyes~something quite distinctive?  And I guess finally, why would someone fake this particular disorder?  Why not something else?  And how would they know how to do it in a way that is so similar to other people who present with the same disorder?  And let's say it's true, that the disorder isn't "real."  In considering the response to someone who presents in a particular way, how therapeutic is it to dispute their truth without investigation or curiousity? What does that do, exactly?  And with the dispute of the diagnosis, what is offered in its' place~a different diagnosis?  

Just a few things for pondering...

Link to my article on dissociation: The Escape Artist

 http://www.goodtherapy.org/blog/dissociation-escape-trauma-recovery-1022124

Enjoy!

Opening my Trauma Center!

I have been fairly quiet on my blog lately, primarily because my attention has been pulled towards preparing to "open" a trauma~focused treatment center hear in the Pacific NW.  We are almost there...we have a name registered in our area, so I suppose that makes it official!  Integrative Trauma Treatment Center (ITTC) is currently accepting new referrals.  I have two superstar therapists that I've hired; both of whom I am humbled by and proud of, and whose passion for trauma treatment parallels mine. 

Since stumbling out of grad school, my interest in trauma treatment has been unyielding.  My approach to survivors and to the work is one of optimism and trust in human beings to heal themselves and heal each other.  The assumption behind my work is that our bodies and brains know what they are doing; that our symptoms related to trauma are not only adaptive but could be viewed as what we latch on to for the healing process.  Symptoms feel bad but do not have a bad intent; if we understand them then we can harness the information they hold and utilize it for recovery.  This is the philosophy that I hope to develop and work from in the center. 

So, hopefully my time will be freed up a bit in order to reconnect with my writing.  Please keep following! 

Here is the link to Part II of Anthropomorphizing PTSD Symptoms: The Private Investigator.

http://www.goodtherapy.org/blog/ptsd-symptoms-triggers-hypervigilance-0712125

My Latest Article on Trauma...a little bit of a different way of thinking about it

http://www.goodtherapy.org/blog/ptsd-symptoms-normalization-flashbacks-0613125

"Anthropomorphizing PTSD Symptoms: Part I: Flashbacks and Nightmares"

Enjoy!

A link to my article on childhood abuse and the non-offending parent

http://www.goodtherapy.org/blog/nonoffending-parent-childhood-abuse-0515124/

Confusion & the non-offending parent

It has been a while since I have posted...Sorry!

The theme in my office lately seems to be in trying to wrap our heads around childhood trauma within the family system and how a parent who, while is not abusive, also does not protect or intervene.  I find myself aligned with my clients in the confusion around this component of the work.  I too, feel perplexed by the failure to protect and don't know exactly how to categorize this.  As I consider it further, I wonder if the question lies in the answer-meaning this is indeed a complicated aspect of recovery.  How do we think about and recover from the fact that there was someone who could have rescued a child, especially when that person who may have been loving on occasion, but didn't intervene?  How do we juxtapose a loving parent who didn't protect or stop something awful from happening?  Are they abusers or are they victims, or something in between?  I don't have an answer but feel it important to acknowledge the layers of recovery-to think about how we understand what happened and to derive some sort of meaning from it.  These are my thoughts today...

Link to my article on pregnancy/birth trauma

http://www.goodtherapy.org/blog/pregnancy-birth-trauma-expectations-0409125/.

"Am I Crazy? Because I feel crazy...."

In working with trauma survivors (as well as other presenting challenges such as anxiety or depression) the symptoms themselves often make clients feel crazy.  "Why am I living in the past?  What am I so scared/angry/sad right now-nothing is happening that is making me feel that way?  Why do I keep thinking about these things or having these thoughts over and over again?  Why can't I stop?"  These are questions, often presented in a state of exacerbation, that are posed to me regularly.  My response is "no, you are not crazy you are healthy!" I know that I have said this in different ways at various times, but I do view PTSD symptoms, in particular, as somewhat functional in that it seems to be the brains attempt to digest overwhelming material.  I think this could apply to other challenges in mental health as well.  For example, if we are struggling with anxiety, the symptoms (typically physical and coincide with a particular thought set) lead us down our treatment path.  The symptoms tell us precisely where the work lies; the identified fear (once it is identified by therapist and client; this can take a while sometimes) can also provide specific information about the person and their history.  In a larger sense, I wonder if many of the mental health issues that bring people into treatment fall under this umbrella-perhaps they are the body's attempt to recover and can tell us specifically what needs to happen to heal from old wounds.  Sometimes, with depression for example, these symptoms can occur following an injury to the body.  Clearly it is distressing to have our bodies hurt and this in itself can present something for us to chew on, but I also wonder if depression forces us to rest so our bodies can heal?  This is just a thought but I have this pressing curiosity about the function of our psychological ailments and what they tell us.  So, when PTSD symptoms overwhelm us, or anxiety or depression, I would argue that it is typically a sign of health and an attempt to heal.  The symptoms themselves may be trying to do that (a previous poster alluded to this concept as well).  If we had a non-response to something terrible, that would be a problem that would concern me far more than flashbacks, nightmares, hallucinations, multiple personalities, or other constellations of symptoms.  So, no, you're not crazy at all :).

What is the most important aspect of trauma treatment for you?

There are several treatment approaches employed by therapists in the treatment of trauma, and I am curious to hear from survivors what actually matters most to you?  We (therapists) often assume that whatever modality we use, our skill set and our experience are the most significant, but I wonder what do you look for in a therapist?  What has worked for you?  What hasn't?  Is it most important to feel connected to the therapist as a person or is their skill set more valuable?  Do they need to specialize in the issue that brought you in for treatment?  Is geography what you care about (i.e. their office needs to be close to your house or the therapist needs to offer services remotely)?

If you have been in treatment before without success, what clearly has not worked for you?  Are there modalities that were ineffective or you didn't care for?

I am curious to hear your responses!  Thank you very much!  ~Athena

The Superpowers of Survivors

A lot of the work in therapy surrounds not just the "problems" the client presents with, but also the view of the problems.  Clients often feel they are "crazy" or too sensitive, and even mistrust their recollection of events.  The symptoms themselves are the source of frustration and are used as evidence against self (i.e.: "if I am reacting to things from the past rather than what is in the present, something is wrong with me"). When someone has been triggered into a flashback, is plagued with redundant nightmares or invasive thoughts, these difficulties are used as evidence of poor mental health.  I have a different perspective on survivors and symptoms.  "Hypervigilance" (a diagnostic requisite for PTSD) could be viewed as something like a sixth sense, for example.  Survivors often know, far before anyone else does, that there is something awry.  There seems to be an accuracy in predicting which people are safe and which are not (the challenge here is listening to intuition).  Survivors sensory systems are often on high alert and thus they pick up on environmental cues with greater acuity than most.  This is not an argument to attach to PTSD symptoms because it is exhausting to manage that kind of perpetual awareness for long periods of time and places a lot of pressure on the psyche.  However, it seems that there is likely a degree of functionality associated with how PTSD presents itself; there are reasons for increased responsiveness and awareness of external subtleties.  Perhaps the symptoms of trauma are an effort to prevent future injury; our triggers are telling us to be wary and pay attention.  Nightmares and flashbacks help navigate healing in that they clarify the most disturbing aspects of trauma; they tell us where the work is and what needs to be resolved.  I propose that symptoms will relax a bit when we listen to them, try to develop an understanding of their function and act on them.  Essentially, viewing the way PTSD manifests in someone allows us to use the specific symptom set to resolve the trauma.  The superpowers are helpful in healing and unnecessary once it is resolved.

Things my clients taught me this week...

One of my favorite models to use in my work is Internal Family Systems (IFS).  When we talk about how parts of ourselves sometimes clash, want different things for us have direct conflict with each other (i.e.: a part of me wants to go outside in the sun but my responsible part won't let me), this approach makes this way of relating to ourselves fairly literal.  In developing a relationship with each part of our internal composition, the way we feel towards who we are can shift and change.  What I begin to notice is that depending on what has brought someone into therapy, there seems to be a theme in what kind of parts are most influencial in the person's life.  For example, with anxiety, there is often a strong perfectionistic part of a person that is trying to ensure that everything is taken care of exceptionally well in order to mitigate anxious feelings.  On the opposing side is another part that just tries to manage the anxiety in the moment, sometimes with compulsive behaviors, sometimes with drugs or alcohol, sometimes with avoidance.  Underneath of both of these parts is the fear; a part of self that has trauma or who carries specific beliefs surrounding acceptance and capacity for lovability (as an example).  Addiction has a common internal dynamic where one part gets really frustrated with addiction and can be self-loathing while on the opposing side is the part who gives permission to use.  Underneath of both is often a part of self that is experiencing a lot of emotional pain.  The part giving permission is trying to numb the pain and the frustrated part is trying to get the person to stop using.  If we view all parts of ourselves as working on our behalf, it can shift how we respond to things we typically have disdain for.  But, these polarizations are painful to clients and it seems that a lot of initial work surrounds addressing (and honoring) these parts.  In sum, honoring and clarifying who we are and what we are doing seems to be integral to mitigating shame and opening the door to curiousity and internal kindness.

What helped you get through therapy?

I often hear from clients that the process of therapy (trauma treatment in particular) is very isolating.  I am wondering if there might be thoughts from those either in the midst of the muck or who have completed their process as to what helped get you through it?

Creativity & Trauma

I am preparing an article that has got me thinking about creativity and trauma.  There seems to be an assumption out there that creativity is motivated by pathology, which would imply that artists are pathological in some way.  Some artists have trauma and some don't so in a simple way that idea is challenged immediately, but I thought I might explore it a little bit further here.  I wonder if really what happens is creativity is an asset that someone brings to their recovery process.  This isn't to imply (and I wouldnt' assume) that all artists want to use their art to digest their trauma, however perhaps it may occasionally be an expressive tool for some.  Frida Kahlo comes to mind; her art was so closely linked to her trauma to the extent that she did art amidst trauma and it was clearly reflective of what happened or was happening.  There was an aggressive quality to her work as well in that her paintings weren't always pretty but were generally disturbing.  Survivors are confronted with a certain kind of darkness that one almost feels compelled to both look at and avoid simultaneously.  It seems that the work can be reflective of repetitive thoughts of traumatic events that are reported by people; artists may be doing this for themselves as well as to share with others what happened.  And sometimes I wonder if the creative product has nothing to do with what actually happened but perhaps the process of painting, writing, dancing, acting etc. is really the most important thing.  Maybe it acts as an emotional conduit and allows unspent feelings to go somewhere in order to be manageable.  The process of creating is in itself dissociative; it can feel like a departure from the here and now in order to indulge the work.  This too is likely functional (it offers a break from pain).  I suppose what I am challenging is the idea that artists are different because they are unhealthy but rather they are different because they are healthy.  The ability to be creative, I am assuming, is a resiliency factor in the process of trauma recovery as well as just in life.  It is a place for people to go during stress and is reliable in a way that sometimes people aren't.

Trusting in Self & Perception

So many of people I have worked with both and without trauma often share that they don't trust what they  have experienced to have been accurately perceived.  There is this sense that it (whatever it is ) didn't really happen the way it is remembered or that perceived motivations in others for their boundary violation probably isn't right.  If there aren't distinctive memories about the past but a feeling that either the absence of memory means something or that an event(s) happened that can't be recalled, then distrust in self and reality seems to be even stronger.  Some of the ways this can effect us in the present might be that because we don't trust our own perception, our boundaries can be a little softer, opening up room for more injury from others.  Sometimes there is a mistrust in what is happening in the moment and thus we don't feel strong enough internally to make a statement to someone that our boundary has been violated.  There can be an array of reasons for struggling to put limits around self, but one of them might be that there isn't enough internal trust to foster the assumption that one is worthy of limit setting.  Essentially, I wonder if establishing trust in perception and in self would foster a comfort with asserting what is seen, noticed, and responding to it with clarity.

Things my clients taught me this week...

The prevailing thought I have this week surrounds the abatement or even abandonment of authentic "wants" that can offer us both connection to ourselves and direction for our lives.  The kind of want I am describing should be differentiated from things that serve to make us feel better, numb our pain, or help us avoid discomfort.  What I am focusing on is the idea that if we listen to what we want, or become more skilled in identifying that internal pull towards something it can help us achieve goals that fit us, nurture us and challenge us.  Many of us are inclined to either be dismissive of what we want or we think we shouldn't be allowed to feel that way in the first place.  Sometimes we don't know what we want, which is particularly true for those who have experienced developmental trauma.  How can we know what we want when we aren't sure about what we feel, whether or not those feelings are real, and when our focus is pushed outward?  Trauma survivors can be very skilled at reading others and interpreting their environment but sometimes struggle to articulate their own internal experience.  I just wonder if we started there...started with what feels true and right and used that as a catapult, what might happen?  Where might we end up?

Things my clients taught me this week...

There is so much learned in working with people.  I recognize what an honor it is to be invited into their inner lives and in doing so gain new insights that I hadn't had before.  I hope to use my blog as a place to share new perspectives gained through the therapeutic process.  This week, what my clients taught me is how little I know, actually.  I rely on my training to guide me throughout sessions and in doing so perhaps place myself in the role of expert unknowingly.  It is in the moments of assuming I know more that I make mistakes (I think).  I may have access to information or ways of thinking about mental health, but only the individual has full access to themselves.  Humility and curiosity are likely a more palatable approach, but then, here I go assuming I know something again :).....

Please post your responses anonymously :).

I will put this up somewhat regularly, but just a reminder to please post any responses anonymously if you would like your words published.  This is to protect privacy and I won't publish if your name or information is visible.  Thank you so much!

Support group fro trauma survivors going through treatment

Clients going through trauma treatment often talk about how isolating the experience of getting better can be; their partners don't understand, they can't really discuss it with friends, and sometimes family is the source of trauma, leaving them with a feeling of having nowhere to turn for support.  I am considering starting a support group for survivors and the title of it reflects the experience of going through treatment:

"Trauma Treatment Sucks!  A support group for survivors in the midst of Healing."

Participants would obviously need to be in treatment and I would require coordination of care with the therapist as part of the work.

I am curious what the response might be if there seems to be people who would benefit from this kind of forum?  Let me know!

Some of the things trauma can offer to survivors...

My most recent article for goodtherapy.org.  Enjoy!

http://www.goodtherapy.org/blog/gifts-of-trauma-survivors-0201124/

An article discussing the downsides to trauma treatment (from the perspective of a survivor)

http://www.goodtherapy.org/blog/trauma-treatment-and-recovery-problematic-0106114/

Article with a positive spin on PTSD symptoms

Please click on the link below to view this article that I wrote for goodtherapy.org.  Enjoy! The Externalization of Trauma: A View of PTSD Symptoms as Healthy    

http://www.goodtherapy.org/blog/externalization-trauma-ptsd-symptoms-healthy/

Welcome!

Welcome to my blog!  My goal here is to provide information and support to both clients and colleagues.  I also hope to combine my love of writing with my commitment to providing quality treatment to all of my clients.  For the purpose of protecting privacy, I will moderate the blog and will only publish anonymous posts.  However I certainly encourage everyone to share experiences, thoughts, trials, and tribulations as well as responses to articles that are published.  Thank you!  ~Athena