Back in my second year of graduate school, I felt that I had a pretty good idea of the type of student I was.  Put me in front of a lecture with my book and notes, ask me to do a few presentations or projects, and I’m golden.  Despite a preference for small settings, I have to say to anonymity in a group of people created a sense of safety conducive to my learning.  When my group therapy class was offered either in-person or online, I elected to do the class in person rather than the self-teaching that online classes would entail.

As I arrived for the first class expecting to review the syllabus and hunker down into familiarity, I was informed that the class would be conducted slightly different than what my 19 years of being a student had been like.  “Set your books and papers aside, let’s circle up the chairs.  This class about group is going to be run in the format of a group”.  Wait, what?  What does that mean?  What did I sign up for? How am I supposed to learn without my lecture, books, and paper?  Tugging at my collar, I decided to open my mind to the experience.

There were awkward silences, uncertainties, and adjustments.  Slowly, we settled into the format and found a cadence for interacting in this learning environment.  I found myself seeing my peers differently, trying to impress my instructor, and using my brain in ways that I had never previously done to learn something new.  Hmmm, I thought, what is this about?  I leaned into anxiety, payed attention to my behavior towards people, and found confidence in myself as a student.  In the end, hands down, my group therapy class was the most influential class I have ever taken.  Interestingly, I never took a single written note.

The way that my class was taught would be an example of a psycho-education group.  In this group format, members are given direct education and skill-building on a specific topic in a relatively structured way.  Members use the information for personal development and growth and incorporate it into their lives.  Examples of psycho-education therapy groups would be a parenting skills group or social skills group.  The group leader takes on the role of the teacher in these groups and then leads discussions among group members.

Another type of therapy group, often referred to as processing or counseling group, provides support to its’ members to help resolve difficult problems in life.  Process groups have a high emphasis on the interpersonal process, which is experienced through group members supporting and challenging one another.  They may be created based on a specific diagnosis (such as anxiety or post-traumatic stress), a shared characteristic (like age or gender), or a life struggle (such as divorce or grief).  Here, the group leader is less direct and more of a facilitator of the process.

Some groups may blend psycho-education and processing styles together.  Group members receive information or interventions and then go into a discussion about how it applies in the context of the group.  Group members give their support and feedback using the education they are receiving in the group.  They also will hold their peers accountable for change or push one another to the edges of their own awareness.

Regardless of the type, all group therapies are led by one or more licensed professionals.  There is an emphasis on self-exploration and intention towards making changes in one’s life.  Group members stand to benefit from learning about themselves in a way that no other format provides, much like my group class experience.  Most importantly, the validation and understanding received through shared experience is powerfully therapeutic.

If you are considering seeking out or joining a therapy group, I encourage you to speak with a professional to find a group that is right for you.  If you decide to join, my #1 tip is to open your mind and just show up!

Leanne Christian is a Licensed Professional Counselor and a facilitator of groups at The Chrysalis Center.

Imagine for a moment the most intense itch you have ever had. The burning sensation of discomfort screaming at you to just scratch for sweet relief. For whatever reason, you are unable to scratch this itch. Maybe you can’t reach it or maybe it is in a less-than-conspicuous spot. But you are forced to sit with that powerful fiery itch. Nobody can know that you have this itch. If you touch it, you won’t be able to stop yourself. Soon, you’ll spend countless time and energy on taking care of all the itching that ensues. It seems like there is no other way to take care of this itch than to just suffer in silence. This is the closest comparison to what it feels like to have a body-focused repetitive behavior such as hair-pulling (Trichotillomania) or skin-picking (Excoriation).
Body focused repetitive behavior (BFRB) is a term that describes any type of compulsive grooming behavior that results in damage to the body. Trichotillomania is a disorder characterized by the behavior of pulling one’s hair from the scalp, eyelashes, eyebrows, or any other parts of the body. People with excoriation repetitively touch, rub, scratch, or dig at their skin often in attempt to improve it. Despite efforts and devastating consequences, these individuals cannot stop their behaviors. Avoiding common activities such as haircuts or beach days is commonplace for those with body-focused repetitive behaviors. It is rare as a clinician that somebody enters my office and asks for help with the seemingly uncommon problem of pulling their hair or picking their skin. Often, individuals who suffer from these disorders do not seek treatment out of shame or embarrassment.
What is surprising is how common these disorders are. The best research suggests that over 3% of the population live with a BRFB. They typically come about around puberty and affect both males and females, although it is estimated that females outnumber males 9 to 1. There are several theories about what causes hair pulling or skin picking. What has been established is that there is an inherited predisposition that in combination with other factors—such as environment or temperament—lead to people engaging in these behaviors. While some may think that this is a form of self-harm or self-mutilation, the reality is that the behaviors are more to relieve stress or receive gratification (much like your insatiable itch).
There is a lot left to be understood about these disorders, the TLC Foundation for Body Focused Repetitive Behaviors ( offers the most up to date information and research from experts working in the field. Treatment entails a combination of Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Dialectical Behavioral Therapy, Habit Reversal Training, or most recently the Comprehensive Behavioral Therapy Model.
If you are suffering from a Body Focused Repetitive Behavior, you do not need to suffer in silence. Change is possible! Please feel free to reach out to schedule an appointment with one of our clinicians.


Leanne Christian is a Licensed Professional Counselor with continuing education training in the treatment of Body Focused Repetitive Behaviors.


Hypnosis is popularly understood as a form of entertainment—stage hypnotists use focused attention combined with suggestions to have the willing act in often embarrassing ways to excite and amuse audiences.  If you have ever attended or witnessed a stage hypnosis act, you may have made certain assumptions, had skeptical questions, or perhaps even walked away scratching your head at what you had just experienced.  Common inquiries of those who have been on stage may include “What did it feel like?  Were you really hypnotized?  Do you remember anything?”.  Skeptics may search for clues that the entire performance was a fallacy and make comments such as “I saw you crack a smile” or “That wasn’t real”.  Still others may leave feeling mesmerized, ironically a term named after an early contributor to hypnosis, Franz Anton Mesmer.  Regardless of observer response, the fact remains that individuals participating in stage hypnosis perform according to the suggestions given by the hypnotist.  Stage hypnosis demonstrates the power of the mind to create change.

In fact, hypnosis is scientifically verified as an effective technique that can promote human change.  In a treatment setting it is used for issues such as anxiety or stress reduction, improving motivation and confidence, addressing fears and phobias, resolving grief and loss, changing habits, and increasing self-esteem. With hypnosis, we can create desired changes in behavior and encourage mental and physical well-being.

So what does hypnosis look like in therapy?  There are often myths to debunk that have emerged from theatrical depictions or misunderstandings.  The truth is that most people enter a trance state on a daily basis- think about the sensation of losing track of yourself while driving, watching television, or brushing your teeth.  There is no mystical loss of consciousness, giving over control to a hypnotist, or getting stuck in a hypnotic state.  A hypnotist cannot force somebody to do something against their moral code or will.  Even those participating in a stage event do so willingly with the expectation they are going to act silly.  Hypnosis is not sleep; the person being hypnotized is under full control of himself/herself.

Hypnosis in therapy guides clients into a naturally-occurring, wonderful relaxed state where one is much more able focus than in the normal waking state.  After inducing a trance, a hypnotherapist may then use imagery, relaxation, or processing depending on the goals of the client.  As an integrated tool in therapy sessions, the therapist and client work together to explore the subconscious mind.  People usually emerge feeling relaxed and energized.

Hypnosis is not a substitute for therapy!  It is an intervention used by a trained hypnotherapist who is also a licensed professional.  Throughout history and across contexts, hypnotic strategies have been employed by famous therapists including Sigmund Freud, Alfred Adler, Carl Jung, and Carl Rogers as effective tools to help people reach their goals and promote emotional, cognitive, and behavioral change.  In the words of Milton Erikson, “You use hypnosis not as a cure but as a means of establishing a favorable climate in which to learn”.

If you are considering using hypnosis to help you reach your treatment goals, take steps to ensure that you are working with a qualified provider who has been trained in the use and limitations of clinical hypnosis.

“When you have exhausted all possibilities, remember this: you haven’t” –Thomas Edison

Leanne Christian is a Licensed Professional Counselor.  She became a Certified Hypnotherapist by the National Guild of Hypnotists in September 2015.  She uses Hypnotherapy in conjunction with other evidenced-based interventions to help her clients reach their treatment goals.

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