What to do When you Are Feeling Lost.
By: Zander Keig, LCSW
The Gender Therapist
A Gender Therapist is a licensed professional behavioral health practitioner who specializes in working with individuals, couples and families navigating a Gender Transition. A Gender Transition consists of medical, social and/or legal steps taken by an individual. A medical transition consists of taking cross-sex hormones for the purpose of developing opposite sex secondary characteristics and undergoing surgical treatments to reconstruct the body. For example, a natal (genetic) female taking testosterone would develop facial hair, deeper voice and fat redistribution. A social transition involves selecting particular clothing, hairstyles and mannerisms associated with the opposite sex. For example, a natal male wearing female clothing. A legal transition occurs when an individual acquires a Court Ordered Gender Change or obtains a US Passport or a Birth Certificate with an opposite sex designation. The Gender Therapist can work with you manage your emotional and physical developments through those transitions.
Many individuals who desire to undergo a Gender Transition experience Gender Dysphoria. Gender Dysphoria is a felt incongruence, which exists when the expected Gender Identification associated with the designated Birth Sex does not align. For example, a person designated female at birth who grows up to be a man will experience Gender Dysphoria to varying degrees from mild to severe prior to embarking on their Gender Transition.
The Role of the Gender Therapist
The Gender Therapist’s role is to apply, at a minimum, the World Professional Association for Transgender Health (WPATH) Standards of Care for the Health of Transsexual, Transgender and Gender Nonconforming People (SOC v7). Per WPATH “[M]ental health professionals should have familiarity with gender nonconformity, act with appropriate cultural competence, and exhibit sensitivity in providing care (pg. 21, SOC v7).” In addition, mental health providers working with individuals, couples and families navigating a Gender Transition must exercise a “basic general clinical competence in the assessment, diagnosis, and treatment of mental health concerns (pg. 22, SOC v7).”
How Can a Gender Therapist Help You?
As your Gender Therapist, I will assess your Gender Dysphoria, provide you with social, legal and medical transition information, diagnosis any co-occurring conditions, advocate on your behalf, and recommend you for cross-sex hormone therapy and top surgery. I am also available to conduct assessments for those seeking genital reconstruction surgery once you meet criteria, per WPATH SOC (v7). In addition, I will assist your loved ones who are navigating their own transition as you shift from son to daughter or wife to husband, etc.
Zander Keig is a CA Licensed Clinical Social Worker (LCSW) with over 20 years of experience working with transgender individuals navigating a Gender Transition. He is an appointed member of the National Association of Social Workers (NASW) National Committee for LGBT Issues; a designated NASW, US Veterans Affairs and Department of Navy Transgender Subject-Matter Expert, published author/editor; and sought-after Diversity & Inclusion trainer/speaker/facilitator.
Sasha Ginsburg, LCSW
~ the executive director and founder of WestsideDBT talks about dialectical behavioral therapy, its applications and the programs offered by WestsideDBT.com. Learn more about these powerful tools to enhance emotional, interpersonal and behavioral regulation...
How it started
The Westside DBT center was founded by friends and colleagues License Clinical Social Workers Sasha Ginsberg and Erin Lotz. Their doors opened almost 6 years ago. They were initially a small clinic set up to treat those people suffering from interpersonal and behavioral dysregulation as well as people with chronic and persistent suicidal thoughts or behaviors. They have grown in size expanding their practice to 2 locations and now treat all people ages 13 and up in need of emotional support, skills training to manage their emotions and cognitive support to help retrain the persons self-perception. Sasha says they help people "build lives worth living".
What is Dialectical Behavioral Therapy (DBT)?
DBT is a therapeutic approach designed in the mid-1980's by psychologist Marsh Linehan. It was initially designed to treat people with Borderline Personality Disorder. Borderline Personality Disorder is marked by a sabotaging pattern of behaviors often stemming from an extreme or unrealistic fear of abandonment, born out of an "attachment break" early in one's emotional life. The DBT skills training approach allows these people to learn to manage the extremes of their emotions and implements mindfulness and self-soothing techniques in order to allow them to live lives with more emotional stability and emotionally healthier interpersonal relationships. For as much as DBT is still the "go-to" method for helping people with Borderline Personality Disorder, it has been demonstrated to be helpful to people with less clinically significant symptoms, allowing more people to access the method to reap the benefits of the skills training to help manage life's problems and relationship discord.
Dialectical Behavioral Therapy originated in Cognitive Behavioral therapy (CBT). It helps alleviate problems with regulating emotions, thinking patterns, and behaviors that cause misery and distress. DBT combines both cognitive-behavioral therapy (Western principles and practices) and mindfulness approaches (Eastern principles and practices) to help people understand ,accept and change, patterns of living that are causing them suffering. In understanding this approach one can see how many people can benefit from these skills.
Who Benefits from DBT?
(From the Westside DBT website)
DBT may help if you are experiencing the following symptoms:
- Heightened emotional sensitivity
- Quick and intense emotional reactions
- Slow return to normal mood
- Chronic problems with depression, anxiety, anger or anger expression
- Repeated suicide threats or attempts
- Self-harm behavior such as cutting and burning
- Relationship difficulties including hypersensitivity to criticism, disapproval, intimacy or fear abandonment
- Impulsive and potentially self-destructive behavior in areas such as binge eating and purging, alcohol or drug abuse, sexual promiscuity, and gambling or spending sprees
- Extreme (black or white) thinking
- Difficulty with problem-solving and decision making
- Unstable self-image or sense of self
- “Detached” thinking, ranging from mild problems with inattention to episodes of complete dissociation
4 Modules of Dialectical Behavioral Therapy
DBT is designed to teach
1. Mindfulness Skills
2. Interpersonal Effectiveness
3. Distress Tolerance
4. Emotion Regulation
How is the therapy implemented?
Dialectical Behavioral Therapy is implemented through a combination of group and individual sessions over a set number of weeks. A person can extend their treatment if necessary, but it is best effective when a person initially participates for the designated weeks of both individual and group sessions.
How to connect with the Westside DBT Team
Call: (310) 772-8118
Julie Goldstein Grumet, Phd
~ Director of Prevention and Practice at the Suicide Prevention Resource Center speaks about the many programs and resources available via SPRC.org
The Suicide Prevention Lifeline is available 24/7 at 1-800-273-8255 (suicidepreventionlifeline.org)
The Veterans Crisis Line is also available 24/7 at 1-800-273-8255 Press 1 (veteranscrisisline.net)
September is Suicide Prevention Month
Suicide is the 10th leading cause of death in the United States – AND it is preventable. September is suicide prevention month. The International Association for Suicide Prevention (IASP), collaborates with the World Health Organization (WHO) and the World Federation for Mental Health, to host World Suicide Prevention Day on Sept. 10, 2015. ‘Preventing Suicide: Reaching Out and Saving Lives’ is the theme of the 2015 World Suicide Prevention Day (WSPD). This year’s theme is designed to encourage all of us to consider the role that offering support may play in combating suicide.
Suicide touched my own life in a profound way when my youngest brother, Scott, took his own life on July 1, 2007. I witnessed his struggle for many years. I talk more about this experience and how my family grieved in the accompanying episode of The Coaching Through Chaos Podcast, but for this post, I'm going to stick to facts that I want to share. As most of this information is cut and pasted from relevant sites dedicated to suicide prevention and research, credit is given accordingly.
Why do we Need Suicide Prevention Education & Resources?
General Statistics (as posted by save.org)
• Suicide is the 10th leading cause of death in the US for all ages. (CDC)
• The suicide rates decreased from 1990-2000 from 12.5 suicides per 100,000 to 10.4 per 100,000. Over the past decade, however, the rate has again increased to 12.1 per 100,000. Every day, approximately 105 Americans die by suicide. (CDC)
• There is one death by suicide in the US every 13 minutes. (CDC)
• Depression affects 20-25% of Americans ages 18+ in a given year. (CDC)
• Suicide takes the lives of over 38,000 Americans every year. (CDC)
• Only half of all Americans experiencing an episode of major depression receive treatment. (NAMI)
• 80% -90% of people that seek treatment for depression are treated successfully using therapy and/or medication. (TAPS study)
• An estimated quarter million people each year become suicide survivors (AAS).
• There is one suicide for every estimated 25 suicide attempts. (CDC)
• There is one suicide for every estimated 4 suicide attempts in the elderly. (CDC)
The Suicide Prevention Resource Center (SPRC.org)
If you knew someone who was suicidal, or you work in a community where there were no active suicide prevention programs, would you know where to turn? Today’s episode features Julie Goldstein Grumet, Ph.D., who is the Director of Prevention and Practice at the Suicide Prevention Resource Center (SPRC.org). The SPRC is the nation’s only federally supported resource center devoted to advancing the National Strategy for Suicide Prevention. They provide technical assistance, training, and materials to increase the knowledge and expertise of suicide prevention practitioners and other professionals serving people at risk for suicide. They also promote collaboration among a variety of organizations that play a role in developing the field of suicide prevention.
Who does SPRC.org serve?
The SPRC website can be a reference guide for both Professionals in the community (teachers, care givers, therapists, first responders, etc.) and individuals (teens, parents, survivors of suicide, etc.). There is even state-specific information on programs and community resources. From their website they specifically serve:
• Suicide prevention grantees: Garrett Lee Smith Suicide Prevention Grantees funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) to support suicide prevention work in Campus, State, and Tribal communities.
• State suicide prevention coordinators and initiatives: individuals and groups in the state with the lead for statewide suicide prevention.
• College and university staff involved with suicide prevention efforts on campus.
• American Indian/ Alaska Native communities: Individuals working with native populations to support suicide prevention and mental health promotion.
• Health and behavioral health care providers who play a role in identifying and helping individuals at risk for suicide.
• Professionals providing social services in their community and organizations that can help reduce suicide rates among the populations they serve.
• Members of the National Action Alliance for Suicide Prevention, the public-private partnership dedicated to advancing the National Strategy for Suicide Prevention
Risk Factors for Suicide (as posted by SuicidePreventionLifeline.org)
• Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders and certain personality disorders
• Alcohol and other substance use disorders
• Impulsive and/or aggressive tendencies
• History of trauma or abuse
• Major physical illnesses
• Previous suicide attempt
• Family history of suicide
• Job or financial loss
• Loss of relationship
• Easy access to lethal means
• Local clusters of suicide
• Lack of social support and sense of isolation
• Stigma associated with asking for help
• Lack of health care, especially mental health and substance abuse treatment
• Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
• Exposure to others who have died by suicide (in real life or via the media and Internet)
The Suicide Prevention Lifeline and SPRC feature the following as Warning Signs of Suicide:
The following signs may mean someone is at risk for suicide. The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change. If you or someone you know exhibits any of these signs, seek help as soon as possible by calling the Lifeline at 1-800-273-TALK (8255).
• Talking about wanting to die or to kill themselves.
• Looking for a way to kill themselves, such as searching online or buying a gun
• Talking about feeling hopeless or having no reason to live.
• Talking about feeling trapped or in unbearable pain.
• Talking about being a burden to others.
• Increasing the use of alcohol or drugs.
• Acting anxious or agitated; behaving recklessly.
• Sleeping too little or too much.
• Withdrawing or isolating themselves.
• Showing rage or talking about seeking revenge.
• Displaying extreme mood swings.
What should everyone know?
- Suicide is preventable. Recent research is beginning to show a correlation between suicide prevention programs and decreases in suicides in those areas.
- Most people that are thinking about suicide absolutely feel hopeless and wish for feeling better, not necessarily to die. The wish to die often is born out of the despair and hopelessness.
- If someone verbalizes a suicidal thought, you should absolutely take it seriously. It’s imperative to share that thought with someone who can intervene and assess futher. You might feel uncomfortable about that, or your friend may ask you not to tell anyone, but jeopardizing your relationship is much wiser than pleasing them in that moment.
- Talking about suicide, or asking someone if they are suicidal will not cause them to become suicidal. There are some people that “just get depressed”. While that may hinder their life and their well-being, they don’t move into a suicidal state. On the other hand, there are other people who may not even present as outwardly depressed but have suicidal thoughts when problems develop in their life. If you are concerned about someone you know, ask them if they have suicidal thoughts. Whatever answer you get will be better than never having asked.
Be part of the conversation - show your support on social media!
The people at Suicide Prevention Lifeline ask that when sharing about suicide prevention to use the following tags to support their campaign to raise awareness for suicide prevention: #BeThe1To (help someone else)
and for Veterans: #JoinThePowerof1
The National Suicide Prevention Lifeline: 1-800-273-TALK (8255): You can call this number 24/7 to speak to someone about how you are feeling or to get help for yourself or someone you care about.
The Suicide Prevention Resource Center - SPRC.org : The nation’s only federally supported resource center devoted to advancing the National Strategy for Suicide Prevention. They provide technical assistance, training, and materials to increase the knowledge and expertise of suicide prevention practitioners and other professionals serving people at risk for suicide. They also promote collaboration among a variety of organizations that play a role in developing the field of suicide prevention.
SuicidePreventionLifeline.org: Not only can you call them at 1-800-TALK, but you can life chat with someone online, get information specific to helping young adults and veterans as well. They also provide resources on bullying, how to get help in your area and have other information you may need when feeling suicidal. Their online resources are also provided in Spanish.
Save.org : The mission of SAVE is to prevent suicide through pubic awareness and education, reduce stigma and serve as a resource for those touched by suicide.
Zero Suicide Program - zerosuicide.sprc.org : This is an SPRC program designed and committed to preventing suicide in health and behavioral healthcare systems. The approach of Zero Suicide is based on the realization that suicidal individuals often fall through cracks in a fragmented, and sometimes distracted, health care system. To do this, Zero Suicide requires a system-wide approach to improve outcomes and close gaps in the systems for better preventative care.
The National Strategy for Suicide Prevention - A Report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention
The National Action Alliance for Suicide Prevention - The public-private partnership advancing the National Strategy for Suicide Prevention