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December 17, 2019

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Nature-assisted Therapy and Brain Development

Dr. Lorraine Freedle Travels to Taiwan

Pacific Quest’s Clinical Director, Dr. Lorraine Freedle was recently invited to speak for the Taiwanese Society of Wilderness in Taipei.  Dr. Chun-lin Cheng, a Psychiatrist, Jungian Analyst and officer of the Taiwanese Society of Wilderness (SOW) learned that Dr. Freedle was visiting Taiwan to teach sandplay therapy workshops and thought it would be an ideal opportunity to collaborate.  

Dr. Lorraine Freedle in Taipei

Dr. Cheng is the Medical Director of the Psychiatric Unit of the Far Eastern Hospital in Taipei.  Dr. Freedle had the privilege of touring the hospital and seeing first hand the incredible gardens of their Horticultural Therapy program, where patients have the opportunity to spend time in the garden in the large courtyard.

The main goal of the SOW is to connect people with nature for preservation. Dr. Freedle’s lecture, entitled, “Nature-assisted Therapy and Brain Development” emphasized how to use a growth-focused approach, environmental design, and nature-based activities to target brain development and assist young people to connect more meaningfully to themselves, others and the natural world.   

The audience was made up of  Horticultural Therapists, mental health professionals, and conservationists.  Dr. Lorraine took them on a “virtual visit” to Pacific Quest, where they learned about our program and how students acquire coping skills to manage stress.  Dr. Freedle notes, “We had a great response! People were very excited to learn more about Pacific Quest and nature-assisted therapy. The group had a lot of questions and were very interested in our new property and how we utilize our gardens therapeutically.”

Dr. Freedle with the Society of Wilderness in Taiwan

The SOW motto is ‘Wilderness is where life begins’ and it was evident the efforts being made to connect people with nature and the importance of utilizing nature in the healing process.  Dr. Freedle continues, “It was an amazing experience to be an international ambassador and to collaborate with a group that shares our values in connecting kids to the environment. All of our lives depend on protecting and sustaining our environment, and fostering that connection locally and globally.” 

October 5, 2018

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Clinical Spotlight: Dr. Lorraine Freedle

Lorraine received her BA in Social Work from Pennsylvania State University and her Master of Social Work from the University of Hawai’i in Honolulu. She also holds an Educational Specialist graduate degree in School Psychology from the University of Northern Colorado, and a Master of Arts in Psychology and a Doctor of Philosophy in Clinical Psychology, with a specialization in neuropsychology from Fielding Graduate University. In addition to earning board certifications in social work, school psychology and neuropsychology, Lorraine completed advanced training and certification in the Neurosequential Model of Therapeutics (NMT) through the Child Trauma Academy. She is also an internationally certified sandplay therapist and teacher who has conducted award winning research in this modality. Lorraine is the founder of Black Sand Neuropsychological Services, where she conducts neuropsychological evaluations, consultation services, and sandplay therapy.

Lorraine Freedle, LCSW, Ph.D., ABPdN, ABSNP, CST-T

Five years ago, Dr. Freedle stepped into her role as Clinical Director, and was immediately drawn to the evolution of students’ process at Pacific Quest and it’s direct correlation to neurological therapeutic development. “A lot of programs talk about such an approach, but PQ actually harnesses the power of nature and practices complete wellness, with qualified staff working together on every aspect. PQ works because it is an individualized, comprehensive and neurodevelopmentally-informed approach. Everyone’s brain works differently. At PQ we can design strategies that reach our students and move them through a deep and lasting change process.”

VIDEO: Learn how PQ utilizes and integrates NMT throughout our entire program.

Since then, Lorraine has successfully elevated our program and clinical department to a new level. Working with The Child Trauma Academy, we are now site certified in the Neurosequential Model of Therapeutics (NMT). Lorraine provides Sandplay training/supervision, EMDR training/supervision, Art Therapy training/supervision, “Aloha Cohort” therapist team consultations, Referral Source consultations, admissions examination and collaboration, and psychological testing services. A renowned international speaker, she has shared her knowledge and passion extensively at a variety of conferences, workshops and tours. Dr. Freedle has published numerous professional journal articles and book chapters on a variety of issues in children’s behavioral health, including neuropsychological perspectives on trauma treatment, reducing critical incidents in residential care, research on sandplay therapy and the applications of NMT to Outdoor Behavioral Health. And if that wasn’t enough, Dr. Freedle volunteers her time working directly with local Hawaii families to provide much needed therapeutic services.

“We are honored to have Lorraine on our team. She has raised the bar for all of us professionally and personally. One rarely meets a person so passionate and accomplished, and still so warm and genuine,” Suzanne McKinney said.

 

May 15, 2018

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Oprah puts Dr. Bruce Perry and NMT in the Spotlight

By:  Kristen McFee, MA, LPCC

Kristen McFee, MA, LPCC

As Dr. Bruce Perry sat down to an interview with Oprah on 60 Minutes, we watched in anticipation as April marked two years of Pacific Quest being Site Certified in the Neurosequential Model of Therapeutics© (NMT).  As Founder and Senior Fellow of the Child Trauma Academy (CTA). Bruce Perry, MD, PhD has expertise in child and adolescent psychiatry, neurodevelopment and traumatology.  Dr. Perry is highly respected internationally and has done extensive neurobiological research on the effects of trauma in young people.  He has led the Pacific Quest team into certification and maintenance of the NMT.

The Neurosequential Model© integrates neurodevelopment, developmental psychology, traumatology, sociology and other disciplines to understand individuals and the family.  Pacific Quest uses this model to inform program design and individualize interventions. Initially, the focus of treatment is developing regulatory capacities to support neurodevelopment and to optimize learning.  Next, students strengthen relational health and problem solving abilities.

Our trained clinicians use the NMT assessment process to collect developmental history, assess current functioning and inform clinical decision making.  This approach guides treatment through a selection of interventions and program design.

To support brain development Pacific Quest utilizes a “bottom up” approach following Dr. Perry’s sequence of engagement:  “Regulate, Relate and Reason.” This is the process of moving from the bottom of our brain (brainstem) up to the top (cortex).  The sequence is very important. When a person is regulated or feeling emotionally and physically settled, they are more able to relate or feel connected.  When a person is connected, they are more able to reason and engage in higher level executive functioning, which is critical for problem solving, prediction, perspective taking, etc.

At Pacific Quest, the garden lends itself to many opportunities to regulate. Regulation involves patterned, rhythmic, repetitive activity.  This includes digging, weeding, breaking apart lava rock to make room for new gardens, building rock walls and clearing land. Regulation also includes daily exercise, expressive therapies such as art, quiet breathing meditations or cooking, chopping and stirring in the kitchen.  Our integrative team works hard to build rapport and relationships with students so they can support and challenge them in their daily goals, living skills and group engagement. Through this regulatory and relationship support, students practice reasoning. Reasoning skills include being a camp leader and having to schedule an entire day and hold peers accountable to camp expectations. Students often create garden projects or legacy projects in which they have to plan, organize and problem solve allowing for a natural method to practice executive functioning.   Students often process and reason in their therapeutic work as they reflect, come into awareness and work to shift from their old story (negative behavior) into their new story (healthy behavior) . But first, they have to tell their story.

In a 60 Minutes Overtime report, Oprah reflects on her experience of doing this story with Dr. Perry. She described the process as “Life Changing” for her and expressed a hope that this story of trauma informed care will be revolutionary. Dr. Perry and Oprah expressed the importance of connection and having a sense of value.  Oprah emphasized the importance of sharing our story and asking the question, “What happened?” She explained, not only is this an important question for those who have experienced trauma, but it is the most important question we can ask of anyone.

To continue and share our work, Dr. Lorraine Freedle, Clinical Director and Travis Slagle, Horticultural Therapy Director will be presenting at the Neurosequential Model International Symposium in Banff, CA, June 13-15, 2018.

https://www.youtube.com/watch?v=dF20FaQzYUI

https://www.youtube.com/watch?v=gqu54ZlhINc

May 7, 2018

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Expressive Therapies Summit – A Playful Event

Dr. Elnur Gajiev, Mike Sullivan, Dr. Lorraine Freedle and Dr. Dan Siegel in LA

Carl Jung said, “Often the hands will solve a mystery that the intellect has struggled with in vain.”  This quote captures the essence of the Expressive Therapies Summit, a recent gathering of international clinicians interested in the role of play and art in healing.  The conference provided workshops in sandplay, poetry, nature art, role play, drawing, and more. It was a powerful way to release ourselves from the tug of war in the prefrontal cortex (our most complex executive functioning parts of our brains that tend to “overthink” things) and tap into the lower more relational and regulatory parts of our brains (our “lizard brains” as Dan Siegel calls it).  Needless to say, the conference was experiential education at its finest, replete with play and activity.

Pacific Quest’s Clinical Director and renowned sandplay expert Dr. Lorraine Freedle presented “Play as Archetype and Agent for Transformational Change.”  Audience members enjoyed learning about the Neurosequential Model of Therapeutics and the neuromechinisms involved with play, symbolic expression and healing.  Play isn’t just a human activity, it exists in many species of animals, and remains a critical component of social, emotional, and cognitive development. Dr. Freedle engaged the audience with interactive art, videos, and case studies, allowing participants to develop a felt sense for the power of play, and the important role it plays in transformational change.  Being that sandplay is Dr. Freedle’s specialty and her background is rooted in Jungian psychology, she brought her travel sand tray from Hawaii, and offered insights into the value of sandplay specifically.

The keynote address stands out as another highlight.  Dr. Dan Siegel, leader in the neuroscience field introduced themes from his new book, linking tools and insights related to decreasing chaos and rigidity, and increasing flexibility, adaptation, coherence, empathy, and stability (F.A.C.E.S.).  Dr. Siegel’s plethora of books remain favorites among the Pacific Quest team, and Dr. Elnur Gajiev, Dr. Lorraine Freedle, and myself were lucky enough to be present for his keynote address. Even better, we were able to chat with Dr. Siegel following the presentation and he was kind enough to give us a photo.

The Expressive Therapies Summit did not disappoint, and will remain a priority for continuing education in years to come.  Thank you Dr. Freedle for contributing your expertise to the event, and thanks to all the participants for making it a truly interactive and educational event.

April 12, 2018

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The ‘Sustainable Recovery’ Model of Care at Pacific Quest

By:  Mark White, LMHC – CDC II

“Life has always seemed to me like a plant that lives on its rhizome. Its true life is invisible, hidden in the rhizome. The part that appears above ground lasts only a single summer. What we see is the blossom, which passes. The rhizome remains.” (Carl Jung, Memories, Dreams, Reflections)

Mark White, Primary Therapist

Jung theorized that human beings – like plants – seek to grow whole.  At the outset of our lives and through the lived experiences of childhood we send our roots out into the world and find what nourishes us and what doesn’t.  At a young age we inherently come to know the wisdom of playing more and touching the hot stove less. Our learning is largely instinctual; with knowledge found through trial and error.  As children, our brain’s Limbic system largely guides our exploration of the world and our place in it – we thus ‘fight, flee or feast’ in response to our making contact with our environment.

In a similar fashion, a germinating seed reaches out through the darkness of the soil seeking nourishment – sending it’s initial roots toward water and nutrients and away from rocks and other stressors.  It finds what makes it grow and seeks more of that.

As childhood gives way to adolescence and young adulthood we continue to explore and grow.  We have a series of firsts – a first crush, first time driving a car and for some of us our first use of alcohol and other substances.   Our Limbic system continues to guide us as the pleasure receptors in our brains feel the ‘high’ of the first buzz’. Our primitive brains tell us to do more of this (feast) and we oftentimes do – especially as the executive/consequential thinking function in our Prefrontal Cortex may not yet have fully developed.

For some youth, the process of addiction begins.  Tolerance increases and we need more of the substance to produce the same amount of pleasure.  Our focus becomes narrowed as we seek to find, procure and/or otherwise obtain our drug(s) of choice.  We spend growing amounts of time and energy thinking about and seeking the substance and less time engaged in pleasurable activities and familiar relationships we once enjoyed.  Essentially, as we send our roots more and more toward our drug(s) of choice and the behavioral patterns of addiction take hold.

At Pacific Quest (PQ) we utilize Horticultural Therapy (HT) to understand the equivalent of the human process of addiction in plants – a condition commonly known as ‘root bound’.  When a plant becomes root bound it has grown to the point where it exhausts the available nutrients. In an effort to thrive, the plant begins to consume itself to stay alive. At this point, if the plant is not transplanted it will inevitably suffer and is likely to meet an early demise. In our knowledge of addiction we understand that without intervention, a young person developing the behavioral patterns of addiction may unfortunately experience similar outcomes.

At PQ young people are both educated and empowered to become aware of how the process of addiction has impacted their growth and are supported in engaging in the process of Recovery.  Within our Sustainable Recovery tract students begin to actively send their ‘roots’ -time and energy- back toward the relationships/activities/values in their life that nourish them. Caring for the gardens, exploring the Big Island and all its rich diversity and engaging in sober fun with peers are all part of the growth process – in addition to Recovery-focused clinical services.

Our unique clinical process invites students to become mindful of their personal behavioral patterns of addiction and become both knowledgeable and skillful in preventing relapse into these old behaviors.   Recovery programming includes personalized Recovery coaching as well as HT-based clinical interventions that empower each student to learn effective relapse prevention skills to address their own, individual circumstances.

Students also engage in a weekly Recovery Group and become knowledgeable of practical ways to make meaningful behavioral changes to support their personal Recovery.  In addition to group and individual therapy, through our active daily schedule students are supported in making these life changes at PQ. Learning to actively manage peer and other social pressures, awareness of relapse triggers and cues and use of effective coping skills are all growth opportunities students have each day.  Our active approach to care ensures students partake in intensive preparation for sustaining important behavioral changes post-treatment. Additionally, for students also interested in learning about a 12-step approach, access to an on-campus ‘PQ- only’ meeting is available as is individualized ‘step study’ work as well.

Last and perhaps most importantly, our Sustainable Recovery model of care invites students to affirm who they are in this world and their opportunities and responsibilities in Recovery– a deep sense of knowing that for many of our alumni has served as the ‘rhizome’ for their sustainable growth into adulthood.

About the author:  

Mark White is Recovery Coordinator and a Primary Therapist at Pacific Quest.   Mark has a passion for wilderness rites of passage work and integrated healthcare.  He has worked with young people and their families since 1999. Mark believes Pacific Quest provides an unparalleled healing and growth experience.  

February 2, 2018

Written by:

Breathing Life Into Relationships

Pacific Quest’s Young Adult Family Program: Breathing Life Into Relationships

By: Dr. John Souza, Young Adult Family Program Therapist

Ohana

In Hawaiian culture the taro plant symbolizes family or “Ohana”.  The word Ohana itself comes from the taro.  The “Oha” are the new growth emerging from the corm, an underground storage organ that is the foundation of the taro.  Adding the word “na” pluralizes the Oha, thereby creating a group growing together or an “Ohana”.

Dr. John Souza

Within the word Ohana are the words “Ha” and “Hana”.  “Ha” is the sacred breath of life carried by all and which joins us.  “Hana” is the work into which we breathe our life; and in which we engage with joy knowing it is through our shared work that we make our family relationships healthy and vibrant.

Breathing Life Into Families

Pacific Quest’s Young Adult Family Program has become a haven in which families come to practice joyfully breathing life into their relationships. In 2017, our Family Program had the privilege of hosting 316 students and caregivers. With over 90% of our students participating in Family Program, PQ is an Outdoor Behavioral Healthcare (OBH) program that continues to emphasize integration and diversity, something the garden teaches us is essential for resiliency.  In a time of environmental and social stress, the opportunity for families to have such a place of respite is essential for them to engage in what we call the Corrective Relational Experience.

The Corrective Relational Experience

The Corrective Relational Experience (CRE) is about rebuilding trust and increasing mutual empathy. During Family Program the CRE is achieved by students, parents, and staff embracing two main responsibilities: Practicing Differentiation and Congruence.

Differentiation is being able to separate one’s own thoughts and feelings, both intra-personally (i.e., within one’s self) and interpersonally (i.e., between one’s self and someone else). Additionally, differentiation involves the ability to enter into or exit from a given emotional relationship by choice. Differentiation means not losing one’s emotional self in a relationship, yet also not cutting one’s emotional self off from a relationship: to stay flexibly connected, yet separate.

Congruence is how reflective your values/beliefs (intra-personal) are in a given relationship (interpersonal). That is to say how closely does what you say reflect what you actually want, need,, and feel in a given relationship? For example, if you don’t like a behavior, do you say, “I don’t really like that” or do you only think that, but actually verbalize, “That’s great!”? To be congruent increases authenticity, a critical component of trust and accurate empathy, the heart of the Corrective Relational Experience.

Professional to Personal: Being Part of a Larger Change Process

As a research-informed clinician, I often wonder about the application of research in practice and practice in research. What I’ve found is that the research on Wilderness Therapy and OBH that continues to point to the importance of family involvement in the development and maintenance of gains made by youth in such programs is spot-on. These gains are being supported by the development of mutual trust and empathy between parents and their sons and daughters. Moreover, for me as a clinician, being able to work with entire families in person only enhances the sense of shared trust and empathy within the therapeutic/clinical relationship (between therapist, student, and parents), itself a major predictor of successful therapeutic outcomes.. This mutual influence between clinician and client becomes the nucleus of a much larger change process.  As I the professional, experience greater trust and empathy, it becomes part of my personal experience, which I take home to my family and to my community. As parents experience this CRE, they too take it back to their families and communities. In this way we become like the taro or Ohana, breathing life into our relationships, born of the same source of trust and empathy.

Having Your Own Corrective Relational Experience: Breathing Life Into Your Relationships

There are many ways to have a Corrective Relational Experience. Below are just a few suggestions of specific skills PQ families have used to foster their own CRE’s. Feel free to modify these or make up your own!

  • Breath: It sounds simple, but this rhythmic, sensory-based activity will help keep you regulated and better able to relate to another person. I like to inhale for four counts, pause for one, exhale for eight, pause for one, and repeat. Feels great!
  • Listen: Again, it sounds simple, but really listening to someone with total openness and suspension of judgment or an agenda is challenging. Try inviting someone to share with you for five minutes while you listen; fully open yourself up to hearing whatever they have to share. Be sure to thank them for sharing!
  • Reflect: This is a great skill to use in tandem with listening. However, try to limit your reflections to only those words used by the speaker. Not only will this minimize you inadvertently inserting your own opinions or judgments about what the speaker was sharing, but will also let the speaker know the correct message was conveyed and received.
  • Share: Related to listening and reflecting (and essential for building trust and empathy) is the art of sharing your own struggles. This involves knowing if you need to share more or if you need to share less. If you need to share, be sure that what you share is focused on the relationship in the present moment and involves feeling words such as happy, mad, scared, confused, etc. If you need to share less, let the listener know that you’re practicing creating more space for them to share.
  • Ask for Feedback: A great way to not only practice vulnerability, but also truly honor your relationship with another person, is to ask them for feedback on the relationship. Ask them to share how they feel in the relationship, if there are realistic ways they see that you could more effectively support the relationship, if they have ways that they want to better support the relationship. The key is to remain curious and focused on improving your bond with the other person. Should you find yourself struggling to do either of these two things, repeat the above skills, beginning with breathing or simply request to take a break and return to the conversation at an agreed upon time in the not-too-distant future.

The most important element in any CRE is a genuine desire to improve the relationship. This includes listening, sharing struggles, and setting clear boundaries.

I wish you and your relationships all the best.

A Hui Hou (until we meet again)!

For more information on Pacific Quest’s Young Adult Family Program, please email drjohn@pacficquest.org.

January 13, 2018

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Why is Group Therapy Important?

By:  Genell Howell, Primary Therapist

Every week, therapists at Pacific Quest lead two group therapy sessions with students in the field.  Why is this form of therapy important?  This setting allows for greater accessibility of students to share some of the issues that they’ve been holding on to as well as develop greater trust within the group.  In addition, it helps students develop a psychoeducational understanding of some of the areas they struggled with at home.

Genell Howell, MA, CSAC

I recently led a session with an adolescent Kuleana group, where we began to examine the concept of our life narrative through art therapy depicting peaks and valleys.  In this group, we used pastels and paper and drew mountains to signify the wonderful aspects of our lives, and valleys or gulches depicted the more difficult times. Students were given creative reign and interpretation to create as many canyons, rigid cliffs and elated peaks within their artistic depictions. We discussed how the peaks represented the high points of their life and the valleys the more challenging times.  Once students created their masterpieces we processed the experience of creating our images, as well as interpreted what they signified to us.

By creating a narrative that allows students to reflect on their life story they build greater emotional resiliency, introspection, and rational detachment. Instead of staying stuck in limiting beliefs such as “it will always be this way” or “it will never get better” students reflected on the ebb and flow of life as well as ways to modulate the highs and lows through healthy coping strategies.  Some of the initial coping strategies that we discussed was what worked to pull one through the harder times in their lives prior to attending Pacific Quest, and what they were using now that they were in the program. Some of the new strategies included working in the garden, incorporating mindfulness, and learning how to play the ukulele.

Due to the forming aspect of the group we were able to incorporate some of Dr.Brené Brown’s psychoeducational research on shame resiliency.  According to Dr. Brown, “shame is the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of acceptance and belonging.”  Dr. Brown’s shame resiliency theory bases the ability to gain connection by practicing authenticity within healthy prosocial communities. In the art of developing shame resiliency there is greater movement towards compassion and self empathy and movement away from fear, blame and disconnection.   Students were able to define how they often hide their emotions and life experiences due to the shame of feeling different or the fear of rejection.

In addition, we discussed the importance of being in a prosocial community where one can feel heard, authentic, and have a sense of belonging, which is a vital component to the healing process. The seed of vulnerability was planted as an area of growth as they continue to form a positive peer group throughout their stay, which is a vital part of the program.

See Dr. Brené Brown’s Ted Talk here:

The Power of Vulnerability

November 15, 2017

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Letting It Out, Letting It Go

By: Theresa Hasting, LMHC, Clinical Supervisor

As students come and go in waves, I have seen an upsurge in students experiencing complicated grief issues.  Mostly recently, I’ve worked with four students within a six month period who have experienced the loss of a parent; through long-term sickness, suicide, and unexpected accidental death.  What these students have in common is they had not previously experienced their grief and instead turned to unhealthy coping skills to express their emotional responses. Each of these students had experienced this loss several years prior to their enrollment at Pacific Quest.

Theresa Hasting, LMHC
Clinical Supervisor

As we work with each student in their journey, we have many tools for the expression and healing of grief.  One of the most successful interventions for this is using nature.  Through the life and death cycle of plants in the garden, students can safely relate their own experience.  As students explore this cycle in the safety of the garden, they are also working to care for the land and given tasks of nurturing untended garden beds.  Through this nurturance they are able to find a motivation for self-nurturance, which allows the defensive walls to tumble down, exposing the vulnerabilities they have covered with maladaptive coping skills and letting out their anguish.

Once in this place of vulnerability, we further utilize our setting to process and memorialize their experience.  Students have created memorial beds, worked in the compost, and used ceremony/Rites of Passage as ways to concretely mark their process.  In additional to the work on the land, I have seen tremendous work happen around grief in our Sandplay trays, where students are able create their inner experiences using symbols and the sand, where words have previously failed them. Having personally witnessed these students, it is amazing to me, each time, the healing power students are able to access through their work in nature and in relation to others as they let it out and let it go.

November 10, 2017

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Metamorphosis and Transformation

By: Danielle Zandbergen, Therapist

“If the fires that burn innately inside our youths are not intentionally and lovingly added to the hearth of community, the youth will burn down the structures of the culture, just to feel the warmth.”

-Michael Meade

Before transitioning into the clinical team as a primary therapist, I began my journey at Pacific Quest as a program guide. I worked many weeks in the rite of passage portion of the program, Huli Ka’e, where our students step into a “threshold” experience and begin to “end their old story” and “begin stepping into the new story.” I’ve always viewed this phase similar to a metamorphosis or transformation that we often see in nature.

PQ_therapist

Danielle Zandbergen, MA

During one of my shifts in Huli Ka’e, I was working in the plant nursery with a student.While we were planting seeds together, we both noticed a cocoon on one of our growing papaya trees. We then began to bear witness to the cocoon cracking and opening up to a new life, as we watched the once known caterpillar morph into a beautiful monarch butterfly. As the student and I watched in awe, there was an intense emotion that welled up between us, to the point where we looked at one another silently and began to smile and cry at the sight of this rarely seen transformation. In so many ways, it was much like a student’s experience when participating in a rite of passage.

In grade school I remember learning about metamorphosis through the lens of a physical transformation many animals experience, where a caterpillar hatches from larva, then stuffs itself with leaves, grows plump and through a series of molts sheds its own skin. The caterpillar stops eating, hangs from a twig or leaf and spins a silky cocoon around itself and sometimes molts into a shiny chrysalis. It is then that the caterpillar experiences a radical transformation and eventually emerges as a butterfly. Tadpoles go through a similar transformation, where an egg mass is laid, cells grow into a tadpole, and the organism lives completely underwater, while a hormone in the tadpole’s thyroid gland initiates their metamorphosis.  Then the tadpole develops into a frog, and all the organs and physical features transform in order for it to live outside of the water and learns how to adapt to a completely new environment.

Metamorphosis in the natural world is very much like the transformation our students experience as they embark on their own Rite of Passage, and in the grand scheme of things, what many of us experience throughout our lifetime. At Pacific Quest, we set the stage for a meaningful and transformative rite of passage that many teenagers never fully experience in their lives. Often named “liminality,” the threshold experience is paramount to the rite of passage and in a lot of ways, a student’s experience at Pacific Quest is seen as a “liminal” or threshold event. Liminality may involve a significant challenge, ambiguous features and sometimes disorientation between the “old and the new.” This often looks like a pattern that is no longer serving the individual, thus inducing a need to “sever from” and begin a transition into something new in order to get those needs met, or adapt to a new way of living.

Our students often “stand at the threshold,” between the two worlds, in which we hold ceremony and ritual spaces to represent severance and incorporation. However, oftentimes a student needs to fully sever from certain behaviors, thought patterns or addictions in order to step into their new intention. Without this significant threshold experience, many teenagers and young adults seek various alternatives to mark this transition. Some resort to substances, buy lottery tickets or cigarettes, some engage in sexual activity, where some may engage in all of the above in order to feel as if they are stepping into their adulthood, but may not engage in the important ceremony and ritual that creates a meaningful experience for their transition.

Although at first glance it may seem that these are unhealthy manifestations of a mental health issue, and subsequently may lead to even more unhealthy choices, there is also an element to these behaviors and choices that represent a child’s search for that threshold; signifying meaning and purpose in their lives. Our society tends to hold a lot of weight (and responsibility) over “ages,” such as turning 16 and being able to drive legally, or 18 when one is expected to move out, get a job, and continue college. Although all of these represent a form of rite of passage, over time they have come to be an expectation that has negated the entire meaning behind ceremony, ritual and celebration that is so much a part of a rite of passage.

One of our goals as a program is to facilitate and provide this experience to our adolescents and young adults. One of my goals as a therapist, guide, role model and caregiver, is to help our students find meaning in their life and recognize that what they are worth is only as much as they value themselves and their experiences in life. It is all of our jobs to celebrate these important marks of transition and develop intentional and positive ceremony around reaching these important life stages so the legacy can continue on.

September 27, 2017

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Hawai`i Hosts International Sandplay Therapy Congress

By:  Dr. Lorraine Freedle, Clinical Director

Sandplay therapists and researchers from 24 countries gathered in Kailua-Kona this summer to explore the latest trends in Jungian Sandplay Therapy and to participate in the 24th Congress of the International Society for Sandplay Therapy (ISST).

With support from my Pacific Quest ohana and the Hawai`i sandplay community, I served as the primary conference organizer and host.  After two years of planning and anticipation, we were excited to realize that the conference surpassed all expectations!

Kahu Kauila Clark offered lessons in Hawaiian culture and ceremony, providing grounding each morning while eight PQ therapists participating in this advanced training opportunity spread the Spirit of Aloha with our visitors.

Research was presented on the effectiveness of Sandplay Therapy in treating individuals with anxiety, trauma, parental distress, and co-occurring disorders.

Neuroimaging data revealed how people access and reprocess memories through Sandplay and also provided evidence for neural synchronization between the therapist and the client during Sandplay Therapy.

I presented original research on the neuropsychology of Sandplay Therapy and the role of Sandplay in the treatment of adolescents and young adults with co-occurring trauma and substance use disorders.

Sandplay Therapy is offered to students at Pacific Quest. This nonverbal method has roots in Jungian psychology, play therapy, and eastern contemplative practices.  Touching the sand, using symbols for self-expression, and entering a state of mindful presence activates multiple brain systems for healing.  We have found that Sandplay Therapy complements our holistic approach and helps our students to express and resolve emotional and personality issues that may be inaccessible in verbal therapies alone.

On September 29, 2017 twelve therapists on our team will begin a year-long intensive and experiential training in Sandplay Therapy.  This series not only allows me to provide STA/ISST-certified training at Pacific Quest; it also improves quality of care for our students and helps my team practice self-care and grow stronger together.

Dr. Lorraine Freedle, Pacific Quest’s Clinical Director is an international sandplay teacher (STA/ISST), serves on boards of the Sandplay Therapists of Hawai`i and the Sandplay Therapists of America and is the Research Editor for the Journal of Sandplay Therapy.

For more info, visit:

International Society for Sandplay Therapy (ISST) https://www.isst-society.com/

Sandplay Therapists of America (STA) http://www.sandplay.org/

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