Karen's Psychotherapy Blog

Why a Blog?

The reason to write Karen's Psychotherapy Blog was because I get such amazing information from so many places almost everyday.  

And Just Like That... and the Unavailable Love

The 2021 reboot of Sex and the City ; And Just Like That...

'And Just Like That' takes place after the pandemic.  The sex in the city 2021.  reboot,  as the two main characters Carrie and Big are finally married living their happily ever life. Big dies suddenly!The audience is mortified and Carrie loses Big the last and final time. He has a heart attract and dies! The scene takes place with the background Music played in the  first part of the episode and again at Big's memorial service.Todd Rundgren - Hello It's Me (1972)


Sleep is a SuperPower!

This is a facinating Ted Talk Done by Matt Walker a Sleep Scientist.I highly recomend it. Discussions of memory and cognitive decline.

Health Insurance 2018 !

Frustrated 2018 Health Plans! High Deductibles! High Co-Pays!

Let Us Help!

It is a hard time to use your health insurance for Behavioral or Mental Health Services. Many Plans have high deductibles or co-pays! We can bill your insurance so you get working on your deductible or see you at a lower fee ! Take a look at our sliding scale! 

The Need to Have a Voice

Sounds of Silence done by Disturbed is so compelling because The Simon and Garfunkel's original song  is taken to its deepest meaning for the human condition. Most people are angry when they are not heard. The rage of not having a voice is so relatable. I also cannot stop listening to it. Karen Chambre, LCSW Psy.D candidate. 

Evaluating Needs For Medical Evaluation in
Clients Presenting for Mental Health Services

1. Evaluation of symptoms and distinguishing the best medical referral.

Patient evaluations and assessments are an initial and on-going part of treatment. Knowledge of physiological psychology can aid the therapist in evaluating possible biochemical issues that may be contributing to their symptoms.

2.  Helping clients to better understand, medications, possible physiological causes for symptoms and behavior.

3.Assisting patients cope with chronic diagnoses and advising them when they need to see their physician.

4.Helping family members understand more about the patient’s illness and methods which they can be helpful to the patient

Patient evaluations and assessments are an initial and on-going part of treatment. Knowledge of physiological psychology can aid the therapist in evaluating possible biochemical issues that may be contributing to their symptoms.


A clinician must have knowledge of both physiological and psychological symptoms to make accurate diagnoses and treatment plans. Knowledge of physiological symptom enables the clinician to refer a client for a medication evaluation or hospitalization. Major depression, anxiety disorders, bipolar disorder, schizophrenia, PTSD, ADHD, OCD, and panic disorder are among the diagnoses that require a clinician to be aware of the symptomology for a referral be made to a psychiatrist for medication evaluation


Evaluating memory issues and having the ability to assess the problem is a result from anxiety or depression or is more severe and needs more evaluation by a neurologist. Other issues can include Headaches, Chronic Déjà vu experiences which can be seizures, balance issues and issues regarding learning challenges; as well as many other issues.

Another critical area is the understanding the symptoms related to Autism spectrum disorders as well as issues of problems with intellectual functioning.


One of the specialty area in my practice is eating disorders. I have often seen people who continue to gain weight even if their diet and exercise are reasonable. Often there can be a thyroid or other endocrine issues that need to be evaluated.

 Patients symptoms of depression, mania, or lethargy may also be connected to problems with hyper or hypo thyroid. Many women present with issues related to premenstrual dysphoric disorder or experience symptoms characteristic is peri or post menopause.

 When clients seek treatment for problems with sexual issues being able to determine when hormonal or other biological issues may be involved is also extremely valuable. 


Autoimmune Disorders/Rheumatology 

When patients present with certain symptoms such a joint pain, flair ups of virus like symptoms, experience perceptual sensitivity and or chronic lethargy being able to identify the possible need for these symptoms to be evaluated by a Rheumatologist can be paramount in helping patients. Some autoimmune disorders can have better outcomes with early treatment. Specifically, those with severe autoimmune issues such as lupus or MS.


Discussing patient’s symptoms and knowing a bit about fertility issues and knowing when to suggest patients see a fertility specialist can be invaluable. I have also seen many patients with these issues and getting them to the best medical professionals can be relieving for them.

4. Assisting patients cope with chronic diagnoses and advising them when they need to see their physician.

Over the years’ have been practicing I have been fortunate to find some extraordinary physicians. While a clinician can always refer a client to their primary care physician, understanding some of the physiological symptoms enabled me to refer them directly to these professional. Often these physicians have been able to diagnose problems that patents have been dealing with for years and have never had a diagnoses or treatment that has been effective.

Theories that Influence My Style of Psychotherapy

My favorite theorist have been John Bowlby Attachment theory, Donald Winnicott British Object Relations School , Heinz. Kohut Self-Psychology and Robert. Stolorow Intersubjectivity theory. All these theories have researched and continued to develop psychodynamic  and developmental theories.

I tend to gravitate to theories that focus on the infant maternal/paternal dyad. As well as address and the early needs developing infant/ child fulfilled by the empathy, attunement and the quality of the relationship that gives a child a foundation to deal with life's joys and difficulties.  More Recently I have been interested in the work of Daniel Siegel.


Daniel Siegel research on Mindfulness and Neuroplasticity is  the next logical step in understanding psychodynamic psychotherapy, because the mind or the brain was never discussed in detail in the theoretical perspectives mention above.  

Amazing the brain can change in psychotherapy as well as other similar experiences given certain environmental circumstances. The research suggest the brain changes to help a client get to their goal, the ultimate intervention. It appears that neuroplasticity , mindfulness in an interpersonal setting , may indeed give us some answers to treat clients with much more efficacy.

I intend to gain more information about Dr. Siegel's research. One of the reasons I am so passionate about being a psychotherapist is because it is unmasterable. There is always more to learn and grow!

Neurobiology of Dreaming and How Dreams Can
Contribute to Psychotherapy

 The Science Behind Dreaming-8/16/2016

New research sheds light on how and why we remember dreams--and what purpose they are likely to serve

By Sander van der Linden on July 26, 2011, 23

The article discusses research done by research teams at the University of Rome led by Christina Marzano. The team used EEG/s and MRIs in two different studies.

 In the first study, the brain waves were measured during each stage of sleep. One of their findings included participants exhibiting low theta activity in the frontal lobe during REM sleep remembered their dreams more frequently than others. Additionally, the theta waves during dreaming in the frontal lobe appear similar to those of an individual in a waking state.

Apparently, the frontal lobe in a theta state is an area of the hthat programs and collects autobiographical memories during the waking state. The researchers suggest since these neurophysiological occurrences are the same during a dream state. Therefore, there is a high probability that individuals experience the similar memories during the dream state as well as in the recollection of their dreams.

The same research team used MRIs to explore the parts of the brain that were involved in dreaming.  Their conclusions included dreaming was associated with amygdala and hippocampus.

Research has shown that the amygdala is a main contributor to processing the memories of emotional reactions to events. Additionally, research on the hippocampus has shown its involvement in the merging of information from the short term memory to the long term memory.

The author concludes that dreams allow individuals to process memories. She adds that the content of the dream may not be real, however, the emotions attached to the dream experiences are authentic. She elaborates that the content of dreams takes emotions out of particular experiences by creating memories of them. The importance of the separation of the memory from the feelings helps people who have difficulty processing their negative emotions and increased anxiety.

 This article allowed me to gain an explanation of ways dreams are helpful in psychotherapy. Specifically, by separating emotion from experience. The article has also helped me understand possible neurophysiology related to the discussions I have with clients related to anxiety as I usually explore both signal and disintegration anxiety related to the dangerous emotions such as anger or extreme sadness.

Additionally, this article has also given me a neurophysiological explanation of the way I use in dream interpretation in psychotherapy. Intuitively I work with clients to identify the emotions connected to the story and symbols in a dream and explore these emotions in their present life. Using dreams in this manner as well as getting clues from the dynamics in dreams seems to help clients think of situations in their lives or recall memories that they have not processed. So amazing to see some research that has a biological basis for dream work that developed intuitively.


Bullying    9/3/201 Two Sources Los Angeles Times- via the Internet 9/3/2013 http://www.latimes.com/health/la-he-0831-school-fears-20130831,0,7364022.storyCNN (US.) via the internet 9/3/2013http://www.cnn.com/2013/09/02/us/connecticut-teen-suicide/

Summary of Two Articles

The first article in the Los Angeles Times was concerning Parents worrying about ailments that might happen to their children from their experience at school. The main part of the article focuses on bullying and how being bullied puts children at likelihood of becoming depressed possibly to the point of being suicidal. In this article Susan M. Swearer, a professor of school psychology at the University of Nebraska, Lincoln, and co-director of the Bullying Research Network advises parental involvement both about how they are being treated at school and to be informed about who their children are talking with on the internet. She continues to recommend that parents watch for symptoms which may be a result of bullying. These include depression, anxiety or medical symptoms such as chronic headaches and/or stomach aches.

Dr. Swearer, also urges that parents who suspect bullying speak with the school administration and insist upon interventions so that children are safe at school.

I chose to include a second article because on the same day in a story online (CNN) There was a story about Friends of a 15-year-old boy who committed suicide by shooting himself with a shotgun after he had suffered from bullying. The actual event occurred on August 27th  2013.

The 15-year-old boy living in Connecticut was from Poland. He was a tall boy who spoke with a polish accent.  The friends told the reported at CNN that the boy was bullied because of his height and accent.  It seemed he was a kind boy who had friends who cared for him.

The family told reporters that the boy had been bullied for many years. As in the psychologist in the article in the Los Angeles Times recommended, The family had inform the school and district many times.

The Communications director of the school district told reporters that an investigation of the entire history in the school district was being examined.

Both the school district and police did find posts on google plus and other sites. At this point they have found several posting by the fifteen-year-old that he was suicidal. 

Resource for Bulling Problems 

Creativity and Psychotherapy

My Interest in creativity and psychotherapy continues to grow. It is just amazing. Clients bring in writings, songs, or talk about movies, TV shows. Together we go through the material line by line and we almost often find that the client has chosen something that helps them cope with their current stuggles. Sometimes they are astounded because the meaning of the piece is often unconcious to them.

Coping with the Estangement of an Adult Child

A mothers love is very unique. It is the purest love that one can ever experience. This type of love is a double edge swoard. When your children are excited to see you, invite you into their world, make you part of their friend group it can be the greatest joy one can ever experince. 

On the other hand if your child acts out in ways that are dangerous or rejects you the pain can cut like a knife. The loss of a child can be a paing that seems that it will go on forever. ln addition to the excruciating pain, guilt and shame tend to follow. What could I have done to warrent my child cutting me off. 

It is worth taking a looking within to see what might have gone wrong. What you might have done differently and even apoligisng to your child it you have a chance. There are many times parents cannot figure out what they have done. Sherry A Mc Gregor has written a very helpful book for the estranged parent.