November Membership Meeting Write-Up — Douglas Green, LMFT

Therapists and Medical Issues: What You Need to Know and Why

Presented by Jaelline Jaffe, PhD, LMFT

About midway through her excellent presentation, chapter member Dr. Jaelline Jaffe, PhD, LMFT posed a simple question to the SFV-CAMFT chapter audience: “Anybody here have a head that’s separated from your body?”

Silly as that might sound, her question encapsulated “Therapists and Medical Issues: What You Need to Know, and Why!” beautifully. Her lecture concerned the number of ways medical and psychological issues overlap, and in particular a number of situations where one is mistaken for the other. And how wrong, and even dangerous, it can be for doctors and therapists to ignore how connected our minds and bodies are.

Dr. Jaffe has worked as a therapist for over four decades, but her practice was changed forever when she developed a rare condition which left her legally blind and robbed her of her energy. After endless misdiagnoses, one doctor at last correctly determined the situation, and she’s been able to get by with regular difficult treatments (but no cure) for years.

Pun fully intended, this opened Jaffe’s eyes to a plethora of cases where people with medical issues are diagnosed/accused of psychosomatic, factitious, or malingering disorders, instead of the actual problems they’re suffering. She calls them “Invisible Disorders,” invisible largely because doctors either don’t know about them or choose not to believe their patients’ reports of them (she referred to a list of these at Disabled-World.com). So, clarifying her positivistic view, she renamed her practice Lemon-Aid Counseling, offering her suffering clients to turn their “lemons into lemonade” through therapy.

Jaffe’s presentation went into detail about “Embarrassing Conditions” — which she defined as any medical issues involving “private parts” — and how a therapist can help clients deal with their emotional pain while they get treated for such “unspeakables” as STDs, bowel disorders, Crohn’s Disease, or Leaky Gut Syndrome (which literally sends toxins into the bloodstream and thereby into the brain, making an awful situation exponentially worse). And she pointed out how Lyme and Mold Diseases, because of their symptoms of fatigue, sleep loss, or memory-impairment, are often misdiagnosed as psychological in nature.

But the majority of her presentation was on her area of greatest expertise, Sound Sensitivity Disorders. These include Tinnitus (where the person chronically hears a specific sound), Hyperacusis (where one’s sensitivity to certain frequencies or volumes can make them irritated, uncomfortable, nauseous — or, at its most extreme, lose their balance and fall over), and Misophonia (where hearing a particular sound can send one into extreme fight/flight mode).

Predictably, such disorders create enormous psychological/emotional distress. While Dr. Jaffe is an internationally-known expert on, and well-versed in the physical treatment of them, it’s the therapeutic ramifications she most wanted to impart here — how to help someone who, for example, can’t tolerate sitting at a dinner where forks are scraping on plates.

While she worked her audience into a state of tearful empathy (all therapists, after all), she also offered tools to help such clients, mostly under the umbrella of a concept she borrowed from DBT, teaching the concept of Radical Acceptance: accepting what is, and, at the same time, seeking change.

As tools for this, she suggested such activities as Paced Breathing (Exhaling more than inhaling changes the oxygen/carbon dioxide ratio in the brain, which switches from the adrenaline-based sympathetic system to the more restful parasympathetic one), using the Serenity Prayer as a basis of having clients write out lists of what they can and cannot control in their lives, and the Japanese concepts of Kintsukuroi (that a repaired item is actually more beautiful than it was originally) and Wabi Sabi (the beauty and morality of imperfection). She even will assign her clients to purposely create imperfections in their homes, to help them get out of perfectionistic (or OCD) mindsets.

But Dr. Jaffe was clear, the overall point of her lecture wasn’t as much to teach us about these specific ailments as to shift our mindsets about how we view our clients, to reduce our judgmentalism and keep our minds open to what we may not know. As she relayed in a quote from Ritchie Shoemaker, M. D., "The diagnostic approach that assumes that previously made assumptions are correct is best described as Ass squared (Ass2) medicine."

Douglas Green, MA, MFT, has a private practice in Woodland Hills and West Los Angeles, where he specializes in helping children and teens live lives they can be proud of. To find out more, you can contact Doug at 818.624.3637, or DouglasGreenMFT@gmail.com. He's also often at our chapter meetings, serving as the volunteer coordinator. His website is www.DouglasGreenMFT.com.