The Curious World of Intuition in Psychotherapy Private Practice

The Curious World of Intuition in Psychotherapy Private Practice

One of the things I’ve noticed in the therapy world is that, whether you’re interviewing to work at a group practice, or you’re simply describing your therapeutic approach on your private practice ‘About’ page, people are looking for and want to know which evidence-based therapeutic modalities you are most competent in and in which you base most of your work. This is spectacular, because I believe that using evidence-based modalities (meaning, modalities that have been implemented in double blind clinical trials and have strongly demonstrated that they produce the intended outcome) is inseparable from operating ethically as a therapist. This is because people are coming to you for a certain kind of help, and it is your ethical duty to ensure that you know that what you are offering is not some kind of hocus pocus or charlatanry. Rather it is clinical help, backed by science, and state-of-the-art. State-of-the-art, and scientifically backed, are the only descriptors that I would ever want to apply to approaches that I implement in service to people who come to me looking for, and needing, help.

Having said that, I have noticed something a bit curious in the way that I work with people in my private practice. I have been trained in all of the classical therapeutic techniques like Motivational Interviewing, Cognitive Behavioral Therapy (CBT) (which can work wonders for symptoms of depression, anxiety, or even panic attacks), and in some Control Mastery and Dialectical Behavior Therapy techniques. I also integrate into my approach everything I have learned from working with children and adolescents who have endured all kinds of trauma, and attachment loss, so that I bring a very dialed-in trauma and attachment lens to my work with people of all ages (think: Trauma-Focused CBT). So far, all of these things check out as far as the evidence-based approach officials are concerned.

Here’s where I differ, and here is what I have noticed: Each person who comes in to see me is bringing me a unique package of stories, feelings, concerns-of-the-moment and concerns of the past (as it relates to the moment) in each session. And instead of whipping out my CBT cookbook, as it were, and going through steps 1, 2, and 3, I find that I am completely in the flow in each moment of therapy, and I am fully present, tracking my clients as their unique process unfolds before me. Getting into this flow state in session (for lack of a better way to describe it), allows me to not impose a step 1, 2, 3 kind of approach, but rather to draw on my evidence-based therapy training intuitively, in real time, in the moment. I get a sense of which aspect of my training to draw on at each juncture of a given session in the same way that I would get an intuitive hit. For example, “Oh, okay, right here I just noticed some thoughts that we could unpack and question, from a CBT perspective,” or, “Okay, now I’m getting a sense of the attachment style, and a way to mention the attachment style I’m noticing gently and appropriately.” When I do this, the response I usually get is, “Yes!!!” or something to that effect. I have noticed that when I let go into this kind of intuitive flow in session, the sessions are more powerful and transformative.

I don’t think this makes me special. I think we are all deeply tuned in when we want to be. It does require a kind of letting go into the unknown, in each and every session. Why? Because I have no idea what any individual will bring to me on any particular occasion. There is no script for me to follow. Just a perfect, relaxed trust in the flow of the session, and the assisted unfolding process. I believe that this is probably what a lot of therapists do. On the other hand, having a script or a really clearly defined structure for the kind of “treatment” you are providing seems like a way to not exactly meet people where they are at, and to safely avoid letting go into the unknown of the moment-by-moment living process in the therapy room. I believe really good therapy truly does require a kind of letting go into the unknown on more than one level. On another level, it is not my role to bring people out of their subjective perspective and into mine. Rather, my role is to get into my client’s perspective, with them (as much as I possibly can), even if they are feeling like they are forty leagues under the sea. If that is the case, I get under the water with them, rather than offering encouraging words from up above. From there, we can join our perspectives and hopefully reach a new, somewhat more objective perspective together, one that expanded both of our previous, subjective worlds. We are both transformed.

It gets even more interesting. In my career, I have had the good fortune to meet and learn from other clinicians, therapists and healers who identify as empaths (this is sort of like being a highly sensitive person, with a bit more of an intuitive bent— these are the people who will say things like, “There was a feeling in the room and I’m not sure if it was my feeling or theirs.”). I have heard some of them say that it is normal to notice somatic sensations in therapy with certain individuals, and often the somatic sensation is located in the same part of the body, session after session. These sensations are valuable data. If they are noticed, in session, out loud, it often becomes a gateway into exploring something that has been in the room the entire time, and into hearing what it has to say. Beyond somatic sensations, I have heard another great therapist say that however another person is making you feel is usually a pretty good indication of how they themselves are feeling. Well, where do we usually notice feelings, if we really try to describe what that feeling feels like? Usually, in the body. Sometimes the feeling is really loud in the chest, or it can be in the solar plexus area, in the throat, sometimes it feels like it is in the forehead, sometimes it is a burning in the face or around the ears. When we notice it and try to describe it (maybe with a color, texture, location, shape, or other quality), bringing the light of awareness to it, it begins to shift immediately. It always has something to tell us. When it comes up in session, it usually does so for good reason. In my clinical work, I have noticed a unique somatic feeling signature, more pronounced with some individuals than with others, and I intend to get better and better at bringing this into the room.

I will continue to explore and write more about this. Until then, I want to offer to any other clinicians or healers reading this: Our field is based in healing work that dates much farther back than Sigmund Freud, and spans many other cultures, and it is a field that is continually evolving. Yes, mentioning the word “intuitive” in a job interview might get you looked at like you have snakes growing out of your head, but I dare say it won’t always be like this. Your sessions are more fun and transformative when you can let go into the unknown like this. You know what to do 🙂


The word, “awake” has a proto-Germanic root, “weg,” which means, “to be strong, lively.” “Weg” is also the root of the word, “witch”. That’s right: “awake” and “witch” share the same root. How is it that “strong and lively” comes to be associated with “witch”? Let me put it this way. When activist, author and entrepreneur Marianne Williamson spoke on women and religion at the 2015 Parliament of World’s Religions, she said, “. . .[W]e must remember that passionate, free-thinking women have never been deeply appreciated by the great religions of the world, because passionate, free-thinking women raise passionate, free-thinking children, and passionate, free-thinking children grow up to be passionate, free-thinking adults, and passionate-free-thinking adults are very difficult to manipulate, and almost impossible to control.” To my mind, the ranks of women characterized as “witch” (or “strong, lively”) and the ranks of passionate, free-thinking women, just may have overlapped quite often and to a great degree.

Throughout world cultures as we know them today, for reasons vaguely or very much in line with what Marianne said above, women’s voices are silenced. When a little girl or a woman displays any signs of being passionate, free-thinking or creative, she is silenced by the culture with particular ferocity. And this is because passionate, free-thinking women represent a threat to the fabric of the institutions upon which the the modern world as we know it has been built. Within these institutions, women are meant to stay in line and know their place, OR, if they want “a place at the table” with the men, they, in many ways, must stuff themselves into a man-suit, and deny or hide the uniqueness of their feminine cleverness and strengths. The world still does not know how to fully accept, embrace and welcome all that a woman is in her uniqueness and her fullness. And Lord knows, when you allow women to think for themselves, they will raise children who think for themselves, and well, we just can’t have that, can we?

I read ‘The Dance of the Dissident Daughter’ by Sue Monk Kidd several years ago at a turning point in my life. In it, she describes what she calls her “feminist spiritual awakening,” a sort of detoxification of the unhelpful institutions, values, and beliefs that cut her off from her own authentic knowing, from her body, and from her own unique spirituality. This awakening came to Kidd in a series of strange and serendipitous situations which caused her to suddenly see with what was at first painful clarity, the ways that she and her daughter were both disenfranchised, treated as though their bodies were public property, and inadvertently forced by political and religious institutions to disown their own wisdom and unique relationships to the transcendent, and their inner authority.

I believe this happens to all women on some level. There is a sadness that women feel, that is often difficult to understand. It seems, for women, being cut off from their own voices, wisdom and knowing is inextricable from a process of becoming dissociated from their bodies, and alienated from their instinctual nature, authenticity, and calling. Sometimes this process is experienced as mounting mental health symptoms of anxiety, panic, depression, dissociation, depersonalization and derealization.

I chose the word, “Awake” not to allude to some appropriated idea of enlightenment, or anything of that sort. It is my passion to help women find their own still, small voice, or the voice of their soul, or whatever you want to call it, and to honor that voice as the utmost sacred authority in their life. For women, this process is often very much tied to coming back into their body fully, and hearing the wisdom of their body, and to looking inwards with compassion. When a woman wakes up to this, she can reclaim her story and her life, and can carry herself with dignity and reverence. Women’s voices are needed on the planet today like never before, and I consider it part of my work to help women reclaim their voices and use their voices courageously.

There is a lot that goes into choosing the name of a business, including but not limited to doing google searches and vast database searches to ensure no one else is already operating a business under the same name. During that process, I stumbled upon a book, written by Dr. Tererai Trent, a woman from Zimbabwe who overcame seemingly insurmountable challenges to becoming educated, and eventually earning a PhD, after having been sold for the price of a cow to her abusive husband’s family and bearing five children by the age of 20. The book was called, ‘The Awakened Woman’. As it happens, Dr. Trent was recently interviewed on Sounds True by Tami Simon, and I listened to the interview this morning. Dr. Tererai Trent’s immense strength and unswerving commitment to her dream of earning a PhD, not just for herself, but to set an example for her daughters, and to be of service to the community, reminded me why I have chosen this work. When women step into their power, they become forces for good and healing and inspiration. When women look beyond the easy path that the world has laid out for them, and listen to what they know, what they know is possible for themselves and their communities, they become forces of grace, and they walk on the earth with loving feet.

I feel moved to include that it seems to me that the masculine and feminine energies, when in their healthy, wild, instinctual state, were meant to work together as partners, in the individual and in the world. I also love the wild masculine, and believe that it too, is essentially on life support in the culture, and I love and celebrate men who are doing the work of reclaiming their own true, wild nature. This could be a topic for another blog post. But on the individual level, this leads me to my final reason for choosing the word, “Awake”. Many of the old fairy tales were meant to serve as allegories, or teaching devices, for instructing us on the nature of various processes of psychological transformation, wherein each character represents a certain aspect of the psyche of one individual. I love the idea of the Sleeping Beauty fairy tale, if we think of it from this perspective. In this context, the woman who is awake is the woman who has found a way to wake herself up, from within, and with true love.

It is not always easy to stay awake. It takes practices, daily reminders. I will close with a poem, written by curandera Elena Avila, included in her book, ‘Woman Who Glows in the Dark,’ which I think illustrates this:

Woman Who Glows in the Dark

I woke up to my illusions,
And now I can’t sleep.

I have no desires,
and now I can’t eat . . . what you dish out to me.

I’ll stay awake forever if
I have to.

I live in the crack of an egg —
in the space between galaxies and earth mud. Along the thin borders   of enlightenment and darkness.

I saw through the smoky mirror, and my third eye winked at me!

Time is an illusion,
and eternity lives in the cracks of everything
that is dualized.

I like living
in the middle of
either/or; and gray is my color in black/white. I’m cozy in the nucleus of past/future and . . .

I am the ember seed in
  I am Woman who glows in the dark.

I’ll stay awake forever
                           if I have to.

                    -Elena Avila