Difficulties with Regulation of Emotions, Self-Defeating Behavior, Self-Understanding and Relationships

In life, we sometimes encounter challenges which cause us to feel confused, conflicted, lost, alone, or out of control. Such experiences and impasses can take the form of a quiet internal struggle or a longstanding behavior pattern that has disrupted opportunities and relationships.  An individual’s recognition that he or she has encountered such a moment may cause him or her to seek greater understanding of his or her familiar patterns of struggle.    

Dr. Rowan may use Process-Based Cognitive Behavioral Therapy approaches and she also specializes in Dialectical Behavior Therapy, or “DBT”, which is evidence-based and a branch of Cognitive Behavioral Therapy. DBT combines theory and techniques derived from Western behaviorism, Zen Buddhism, Hegel’s Theory of Dialectics, and feminist psychology. DBT teaches a comprehensive curriculum of skills, with the core skill being mindfulness, which may be used to address various forms of suffering that arise as we go about achieving the life we want.

Individuals who regularly engage in DBT with the assistance of a trained, licensed healthcare provider may achieve numerous positive results. In particular, DBT may guide individuals through a comprehensive analysis of the problems they face, including the contributing factors, functions, and consequences of such problems. From this comprehensive analysis, individuals may learn skills to expand their capacity for awareness and attend to the connections between their sensations, thinking patterns, and emotions. They may find more balance in how they care for their bodies and minds. They may engage in emotional exposure exercises to address patterns of emotional and relationship avoidance. They may hone a “wise-minded” intuition which enables them to better decipher the validity of their emotional experience given the facts of specific situations. They may learn to identify and engage in clear and effective responses to their day-to-day problems. They may also enhance their cognitive flexibility and expand their repertoire of active problem-solving skills and thinking strategies. In doing so, they may expand the variety of potential courses of action available to them in any given situation. Further, DBT teaches “radical acceptance” skills which individuals may use to accept unfortunate realities and move forward in life when faced with an unsolvable problem, unsurmountable limitation, personal loss, or chronic condition.

As an Affiliate Psychologist at Two Brattle Center in Cambridge, MA, Dr. Rowan provides adherent individual DBT therapy as well as DBT Case Consultations.

Eating and Exercise Disorders and Imbalances Presenting in Athletes and Performing Artists

Some athletes and performing artists have learned to work against, rather than with, their bodies. They may find themselves shifting between extremes of self-deprivation and over-indulgence and be unable to find relief while caught in an increasingly out-of-control cycle. Short-term gains have amounted to long-term breakdowns.

Dr. Rowan uses Mindfulness-Based and Cognitive Behavioral Therapy approaches to treat distinct eating and exercise imbalances and eating disorders presenting in athletes. Challenges can be heightened for performing artists, athletes in the “Aesthetic Sports” (e.g., gymnastics and ice skating), and athletes the “Weight-Class Sports” (e.g., wrestling and rowing). Efforts to manipulate weight and shape frequently result in a cascade of performance and health consequences, including Relative Energy Deficiency in Sport (RED-S). With Dr. Rowan’s assistance, in partnership with a sports dietitian, such athletes and performers may learn to optimize their energy flow through enhanced intuitive eating and exercise patterns.

As team culture can often perpetuate poor body image and disordered eating and exercise practices across teammates, Dr. Rowan also conducts evidence-based eating disorder prevention and body image enhancement workshops.

Trauma-Related Distress

Traumatic experiences can leave an individual with visible or invisible marks or cause an individual to detour away from his or her values, self-respect, performance goals, artistic development, or connection to others.

Traumatic reactions can occur following a variety of adverse and stressful experiences. Some individuals have experienced traumatic physical or emotional injuries or varying degrees of interpersonal abuse or sexual boundary violations by someone in power, including in their own family. Others may have experienced intimate partner violence or identify as adult children of alcoholic or dysfunctional families. Others may identify as having complex trauma (or C-PTSD). Traumatic reactions can also follow an experience of witnessing or learning of someone else being seriously harmed. In addition to a process-based CBT approach, Dr. Rowan may use empirically supported narrative and exposure-based trauma treatments, including Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Prolonged Exposure for Post-Traumatic Stress Disorder (PE and DBT-PE). Clients may learn skills which can be used to stay in the present moment, regulate fear response, and increase self-compassion. Clients often seek support in steadying the nervous system so that they can successfully approach and process difficult memories. Their treatment goals may include reducing a persistently heightened fear response, increasing accurate expression of emotions, and/or clarifying inaccuracies in their feelings and beliefs about themselves, other people, and the world at large. As treatment progresses, clients may begin to approach previously avoided situations and activities with the aim of reducing their traumatic reactions to such situations and activities. In doing so, they may increase their feelings of joy, establish (or re-establish) a value-based life direction, and enhance assertiveness and creativity.

Couples & Family Therapy

It takes vulnerability, courage, and skill to honestly and directly address our desires, needs, and limits within our closest relationships.

Individuals in couples and family therapy may be guided through transactional analyses of relationship and communication patterns. They may be offered instruction and coaching in a variety of mindfulness, emotion regulation, and non-violent communication strategies. Dr. Rowan may introduce skillsets including emotional validation, non-judgmentalness, compassion, and reality acceptance in the context of relationships. Among other approaches, she may utilize DBT Family Therapy techniques. She may assist individuals in implementing skills required for setting and respecting of healthy limits and boundaries in relation to their loved ones. Individuals may be encouraged to engage in critical self-reflection and maintain an openness to new experiences. In couples or family therapy, individuals may learn skills to recognize and more effectively work with their own thoughts, emotions, urges, and needs as these things may impact their relationships. Individuals within a couple or family may be coached to try new patterns of behavior in relation to their loved ones and may also be assigned out-of-session practice to generalize new learning in their home lives. At any point during or prior to couples or family therapy, it may be recommended that individuals participate in individual therapy work with a different provider to, for example, better clarify individual desires, thoughts, limits, and goals or to otherwise improve their capacity to effectively engage in couples or family work.