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Vancouver Integrative Counseling Blog

Trauma Informed Yoga

We are excited to announce that we will be offering a four class trauma informed yoga series in early September. These classes will be held by our new clinician, Natasha Salemme LMHC, who specializes in yoga therapy. This four class series aids in releasing stress and trauma held in the body while teaching participants how to use movement in their daily lives to reduce stress. This series combines yoga philosophy, neuroscience, mindfulness, and asana (movement) while teaching skills, including meditation, mindfulness/grounding tools, along with breathing exercises to calm the body and mind.

For more information:

**Please note that this four-class series will also be held at our Portland location. Refer to the Integrative Trauma Treatment Center website for more information.

Art Therapy Workshop for Dissociative Identity Disorder February 20th!

Vancouver Integrative Counseling is hosting our next Art Therapy Workshop for those with Dissociative Identity Disorder.  

This is our third workshop and each one has been very fun and safe for participants (and for the facilitators!).

The intention behind the workshop is the offer an opportunity to externalize the internal experience, to share with others, and to have a visual reference.

Contact if you are interested in reserving a spot!


When Scary Things Happen – Part 2: 6 Ways to Help a Traumatized Child

Part 1 of this series covers the common symptoms/behavior children experience following a traumatic event. Knowing what to look for is important, and so is knowing what to do when parents and caregivers are faced with handling behavior and symptoms that do not respond to typical parenting approaches. Below are 6 key ways that parents and caregivers can help their children through difficult trauma-related symptoms and behaviors.

1. Take a deep breath.
Being more calm and composed will help your child cool down sooner. Children with trauma-related symptoms and behaviors usually exhibit them when they have been “triggered” (or reminded) of their trauma, starting a chain reaction in their mind and body that we call the “fight or flight” response. When this response occurs their actions are more controlled by fear than logic and reasoning. The quickest and most effective way to get them out of the fight or flight response is to cool down their anxiety. Children learn how to cool down by example. Keeping your cool models for your child that they can also cool down.

2. Give your child a positive physical outlet.
Once the fight or flight response is on, it produces a significant amount of energy (thanks to a massive dump of cortisol in their body). If children remain still, the energy will have no place to go and the difficult symptoms and behavior will persist. When symptoms arise do something physically active with your child that is fun and positive (running, outdoor games like hopscotch, jumping on a trampoline, swinging, Wii sports, etc.). It will help expel the energy and it provides positive bonding time (which a traumatized child needs in abundance). Provide daily exercise to help reduce the flight or fight response from becoming as intense.

3. Have a weekly schedule and build in bonding time.
Children who have been traumatized often feel that their world has become unpredictable and scary. One of the most beneficial tools for children is creating a sense of predictability through schedules (with plenty of built-in free time), and through strengthening the bond between child and parent/caregiver. Parents and caregivers are the anchor and compass in a child’s life, and trauma can cause some distance in this relationship (as well as in other relationships). Short and intensive bonding activities can help repair the damage trauma caused to relationships. Activities that focus on the child  in short spurts (5-15 minutes) every day can accomplish a great deal (check out these activities: family bonding activities, 150+ bonding activities).

4. Don’t ask “why?”
Asking children to reason through and rationalize their actions and symptoms is difficult for any child. The part of our brain that helps us reason through our actions as adults is not fully formed until our early 20’s. Children who are traumatized have even less of an understanding of their behavior and actions when they are triggered. When faced with difficult behavior or symptoms, adults naturally want to ask “why?”, however, this question can often escalate situations. Instead focus on using these three steps: cool down, calm down, and follow through.

5. Cool down, calm down, follow through.
Cooling down using physical exercise is effective, though some children cool down best when they can hide. When children have cooled down (identified by relaxed bodies) they then need time to calm down (having relaxed minds). This can take from 90 minutes to a few hours after they have cooled down, and sometimes can be weeks long. Don’t rush this process by discussing the behavior before they have calmed down, or it may restart the difficult behavior or symptoms. After they are calmed down, then follow through with a conversation about what to do differently next time. Make suggestions or have the child identify what would be more helpful ways to cope with difficult situations that trigger difficult behavior and symptoms.

6. Remember, every behavior meets a need.
If your child is having difficult behavior or symptoms it is their way of communicating to you that they have a need that isn’t being met. During follow-through conversations children will be more able to use words to express those needs (often by explaining how to get that need met), but in the heat of the moment their behavior is their primary way to express themselves and they often don’t have the capacity to do so with words. Reframing a child’s behavior as communication can help you stay calm and for your child to cool down sooner.

Parents and caregivers are powerful people in the lives of children, and are the first source in helping children learn how to cool down, connect, find stability, express their needs, and find more positive ways to handle triggers.

If you have tried all these steps and still have continued concerns (or unsure how to implement them), child therapy can help find alternative ways to help relieve trauma-related behavior and symptoms.

Live in the Vancouver/Portland area and want to discuss your child’s needs? Please contact me at, and we can set up a free 30-minute phone consultation.

When Something Scary Happens – Part 1: How to Know When to Seek Therapy For Your Child

It is likely that most people will experience at least one scary situation in their lifetime. For some, these events roll off their back and they continue on with their life with few to no effects. For others, they will have a hard time moving past it – for those in this category such events are no longer scary but traumatic. They often experience a variety of unsettling symptoms that can pop up immediately after or months/years later.

Children can experience trauma like adults, but children do not often have the words to tell adults about it or the skills that adults have to cope with it. Child therapy is a safe and effective way for children to work through their trauma and move on with their lives.
As parents/caregivers, it is helpful to be aware of the signs and symptoms that a child may exhibit after a traumatic event. If these symptoms go untreated by a child therapist they can become exacerbated. The following is a list of common symptoms, but is by no means exhaustive or exclusive to trauma symptoms:

• a change in how your child handles everyday life (i.e. Things no longer roll off their back, every change/stressor is difficult to navigate and may cause crying outbursts or angry outbursts)
• easily frightened, when previously showed fearlessness
• difficulty falling asleep, refusal to sleep by themselves, and waking up in the night
•wetting/soiling themselves though they were previously and successfully potty-trained (NOTE: parents should always seek medical help for children if this start occurring before seeking counseling for their child)
• increased frequency of nightmares
• more angry, aggressive, whiny, argumentative, or increased lying behavior

It is important to note that some children cannot remember their trauma event, even though the parent is aware that it happened, but still experience these and other symptoms.

If your child has experienced a scary event and you are concerned about new behaviors or symptoms, therapy can help relieve those symptoms and get your child back on track.

Therapists with experience working with children and have a trauma-informed practice can provide the best care for your child.
If you are unsure whether you should seek out therapy for your child, consider having a conversation with a pediatrician.

Live in the Vancouver/Portland area and want to discuss your child’s needs? Please contact me at, and we can set up a free 30-minute phone consultation.

4 Myths About Child Therapy

There can be a lot of mystery surrounding child therapy, as well as fear and apprehension for parents and/or caregivers. Below, are 4 myths about child therapy that cause concern for parents/caregivers, and the truth about them:

1. Child therapy is only for children who get in trouble all the time.

Children from ages 3 and up (though some therapists work with younger ages) can benefit from therapy when the following concerns arise:
• referrals, FYI’s, and suspensions from school
•ADD/ADHD symptoms, having a hard time with transitions or a new change in their life, having a hard time making friends
• tantrums, meltdowns, fits, or outbursts that occur one or more times a day (for ages 3 and 4 the tantrums, etc. last longer than 10 minutes), especially if they tend to be aggressive.
•experienced trauma (prolonged separation from parent(s), medical trauma, abuse, witness of a terrifying event, etc.) and is experiencing nightmares, frequent worries, easily cries, and/or physical symptoms of anxiety (stomach aches, headaches, wetting or soiling themselves, etc.).
•Has a hard time being apart from parent(s) or primary caregiver(s) at night and during the day.
•making negative statements about themselves a few times a week or more (“I’m stupid,” “I can’t do anything,” “no one wants to be my friend,” etc.)
•and most importantly if they have any of the follow symptoms or behavior: stating they wish they were dead, hurting themselves (head-banging, hitting or slapping themselves), rapid changes in mood that are extreme (i.e. happy to deeply sad to very angry), and seeing, hearing, or smelling things that are not there.

2. Children meet with the therapist alone.

Children make the best progress when their parents/caregivers are involved in therapy sessions, learning and practicing with their child, and then guiding their child in practicing at home. Children learn best when surrounded and supported by family. That isn’t to say that there are not times that children may benefit from a few minutes one-on-one with a therapist, but children also need family involvement.

3. Child therapy is all talk.

Children naturally communicate through movement, art, and stories, and struggle with expressing their inner world and thoughts through talk. Child therapy meets children where they are at, using movement, art, stories, and sometimes even song, to help children express themselves and learn tools and skills.

4. Child therapy is all about parenting.

Most of child therapy is working with the child, though parents and caregivers may also need some support in how to approach their child’s needs differently. Typical parenting approaches do not work with all children and a child therapist may have some different approaches. However, focus is always on the child’s needs in therapy.

Live in the Vancouver/Portland area and want to discuss your child’s needs? Please contact me at, and we can set up a free 30-minute phone consultation.

Finding purpose in our pain: What keeps us moving?

I am offering a four part blog series on finding purpose in pain and invite you to use as it prompts to journal or chat about during the week. It’s great food for thought about what makes up keep moving through pain, how do we think of pain, process and indicators of healing, and can provide you some insight on internal strengths and capabilities you may have overlooked.


Therapy is often hard work and to some degree painful. The healing process often challenges us to a depth that requires us to focus on internal reserves and supports to sustain the discomfort in the beginning phases. While we can identify safe ways to explore sensitive areas of life, feelings that emerge may incite us to hesitate or question the process at one time or another. In my practice, we open this dialogue to be careful not to internalize doubt as a reflection of self or competence, but frame it as a normal response when challenged.


When we reflect about our life, we can likely identify numerous times wherein skepticism about our capacity felt like a giant rock blocking the entry to somewhere we wanted to be. Thoughts such as, “can I really do this” may have entered your mind when faced with a job opportunity, a leadership role, a performance sport, or physical rehabilitation. The act of challenging self often runs parallel to feelings of angst and uncertainty.


In terms of emotional healing, we may contemplate our abilities somewhat longer as we are engaging in work that challenges us to move inward toward emotional discomfort rather than out of it. Like a physical injury that requires a degree of pain to foster healing, in therapy we are asking ourselves to move toward what has hurt us. Naturally, that is uneasy to sit with and contradictory to our automatic responses to avoid pain as well as certain cultural messages of “fast fixes.” It is in those moments when we may begin to question, though with any process, we know that feelings of uncertainty does not determine outcome, they just mean you’re human.


So, if we go back and remember a time when doubt crept in, we may also remember when we continued to move to get beyond where we were standing. Carefully, and maybe with the help of other trusted hands you moved beyond your edge. Maybe you moved because you had hope, determination, bravery, resilience, or maybe another purpose, but you moved despite discomfort. The human condition though bent for caution is also very much discernable with the ability to do hard things.


In entering the recovery process I encourage you not to minimize feelings of apprehension, but rather normalize and expect them with the work. But, may you also be mindful of the values and beliefs that can sustain your capacity to heal. When we can identify these, or even one, we can utilize them to keep moving in the moments of pause and contemplation. In this interaction we not only extend ourselves from what we thought we could do, but also enter the experience healing from our pain.


Things to think (or chat) about:

-Take a personal peek at how you perceive pain; is it bad, can I sit with it, when I feel it what do I do?

– Think of that last time you healed from an injury; were there stages, was there a process, did getting better involve moving toward the injury, how may that be related to emotional healing?

– What helped you keep moving when you last faced a challenge; what values and beliefs helped me keep going; what was the self-talk attached to my vales and beliefs, do I have more examples of this; are there other things that helped me?

-How did you feel when you moved beyond through feelings of hesitation; stronger, empowered, capable, braver, curious, hopeful etc. Remember to celebrate every small victory so even if you felt “a little relieved” or “safer than I was” it still counts!

-Moving is hard work. How are you engaging in daily self-care to make sure you’re providing yourself a recharge and don’t forget to be creative; exercise, taking a drive, watching the river, adequate sleep, art, being mindful of eating habits, giving yourself a compliment, reading, music, a 10 minute stretch session at work, eating with loved ones, swinging with your kiddos, taking your full lunch break at work, hugs, hikes, practicing deep breathing, getting a massage, saying “yes” to me, silence and meditation, sitting in sunshine, or being around a good friend….. I digress.


Next monday I will continue to discuss the subject of finding purpose in pain using creative modalities and build upon this weeks topic, we will chat then:)

Facebook, Friends, Family, and Trauma; Navigating Social Media as a Survivor

Social media has become so interwoven into the details of our lives, turning our private (and occasionally mundane) thoughts into public domain.  In order to remain connected not only socially, but professionally, Facebook and other forms of social media are less optional than subtly compulsory.  Not surprisingly, Facebook is a topic of conversation in therapy for many clients.  Navigating the cultural expectations for continuous connection and unbridled access to each other is a challenge for everyone; trauma survivors are confronted with another layer of consequences for communication (or a lack of communication) on social media.

Posts from “friends” can at times be insensitive, passive-aggressive, attention-seeking, or offensive. They can also pull a community together, offer inspirational quotes or commentary on what’s important in life. Politics and religion are handled far less delicately than in the past (perhaps because the discussion isn’t between people but rather Facebook can be a platform for expression).  Handling polarized world views in a public forum gracefully is a skill that is currently under construction; we are building the foundation for this form of connection from the ground up.

Challenges that arise in therapy (or outside of it for that matter) include how to ignore or decline a friend request from someone, what the consequences may be in accepting it (i.e. bosses, colleagues, friends of enemies, family members, former romantic partners).  Posting something on Facebook or Twitter has occasionally landed people in hot water with friends, family or partners; sometimes with intention and other times inadvertent.  Navigating social media does require some degree of thought and attention for all of us; at least those of us concerned with minimizing strife.

Survivors of trauma are confronted with nuanced challenges under the social media umbrella.  Filial relationships (particularly if the family of origin had members who were the source of trauma or failed to protect) are challenging outside of the Facebook context as well as within it.  Questions surrounding which relationships to maintain, which to let go of, how to let go, and how to remain connected to some family members but not others is a topic of regular conversation (something to be discussed in Integrative Trauma Treatment Center’s “Surviving Survival; Picking up the Pieces after Trauma” support group!).  For those whose perpetrator was not a family member but was someone they new (this is more common than random crimes),  should one “unfriend” all of those who surround the perpetrator? Does this empower the perpetrator and disempower the survivor? One of the quandaries here is that every time a friend “likes” or “comments” on a post of the perpetrator, this can be visible to the survivor.  Facebook can be a source of trauma triggers while simultaneously being a source of social support and connection; a classic PTSD Catch 22.  How does one remain connected and protected simultaneously?

A lot of the work we do in the recovery process surrounds boundaries.  Sometimes I tell my clients that if this part of the work is done well, a sense of safety increases to the extent that symptoms decrease.  The problem with social media is that it, almost by definition, makes it extremely difficult to have any boundaries. There is a sense that in setting limits or choosing not to engage social media, requires an explanation is and yet trauma is often so private.  So….what to do?  There obviously is not a clear answer.  However, the skill of being less permeable without apology or explanation could be a potential focus.  It is okay to say no to “friend” requests, to “unfriend” those who are not healthy connections, to “block” those who are not safe in the inner circle.

It could be argued that while social media is a connective tissue that threads through the fabric of our culture, some of it’s concepts are great for setting limits around who has permission to be in our lives. Imagine if “unfriending” someone was as easy as clicking a button? Or, if someone wanted to connect with us who wasn’t safe, that we “ignore” or “hide the request” from our awareness? What if we could just “block” those who have caused us harm or are connected to those who have caused us harm?  These are actually fairly solid strategies for maintaining boundaries.  Our vision can get clouded by people. If we can listen to our gut, be clear on who is safe and who isn’t, who has something to contribute to our lives and who should have permission to witness the details of our days, social media could potentially offer a bit of clarity around boundaries.  “Unfriending,” “blocking,” and “hiding requests” for friendship are strategies we could perhaps apply to relationships in “real life.”  If someone who wants access to us or has access that is not safe, has broken our trust, caused damage or is a conduit for others who cause harm, Facebook boundaries may be a viable protective strategy; the challenge is giving ourselves permission to say “no” and to say “good-bye.”

Teens, Self Harm & Art Therapy

For most understanding adolescents is a challenge at best, and the adolescent who is suffering from psychological stress is an even greater conundrum. The physician treats the physical problem but often puzzles over where to find therapeutic treatment for this age group. Teenagers are sensitive about their image, particularly with their peers, and often put themselves at emotional risk rather than confess that they need help from.  Furthermore, their view of the “talking” psychotherapies has been shaped by the movies, and they often think that these therapies are only for serious “mental” cases. In contrast, they come to art therapy without such preconceived ideas, this form of therapy has proved very effective with adolescents throughout my years as a therapist.


Imagery taps into a person’s earliest way of knowing and reacting to the world; therefore, it is not foreign to the experience of learning. Art as a language of therapy, combined with verbal dialogue, uses all of our capacities to find a more successful resolution to our difficulties. In art therapy, the client is asked to make a collage, make some marks on paper, or shape a small piece of clay to illustrate the difficulties that have brought them to therapy. The art therapist does not interpret the art piece, and the clients are free to share as much of the meaning of their art as they choose. Adolescents, in particular, are attracted to making symbols and graphic depictions; therefore, they are more attracted to using art as language than to verbal questioning. When the negative behavior is illustrated, it is then external to the individual, and the behavior thus becomes the problem, not the individual.

Pregnancy & Birth Trauma

Pregnancy and birth mark one of the larger transitions in life. With change comes uncertainty, vulnerability, as well as possibility. Generally our assumption is that this is a happy time and of course, for many people it is! However, it pregnancy or delivery does not always go smoothly and there can be complications for baby as well. Below is a link to an article about pregnancy & birth trauma:

Welcome to VIC!

Vancouver Integrative Counseling is a young and progressive organization the provides mental health treatment to a variety of populations. Our mission is to approach this work with creativity, enthusiasm, compassion, and we view our clientele as experts in their own process. A little bit of humor and art always helps as well!

Continue reading “Welcome to VIC!”