Alison Smith, MFT

By the time I met Alison Smith I had already discovered, three years prior, that my condition has a name («body dysmorphia», an OCD spectrum disorder), and I had been on high doses of SSRIs ever since. The expert who diagnosed me said that, given the severity of my condition, I would likely need to be on meds for life. Therapy would help too, he said. But in my experience, therapy and meds were just getting me by and healing wasn’t part of the equation.
Still, I went to therapy, sometimes more sometimes less, because going was better than not going. Over 20 years (pre & post diagnosis) I’d met with at least 8 different mental health professionals, all with varying degrees and practices but basically the same «cognitive behavior therapy» (CBT) orientation. Alison’s approach includes CBT, too, but I found it unique in ways that I’d like to explain. Because for the first time in 20 years in and out of therapy, I was no longer merely coping with OCD/​BBD/​addiction — I was healing deep wounds, improving my relationships, replacing self-​abuse with self-​nurture, and finding joy in the process and practice of healing. And all that sans meds.
CBT sounds great in theory (easily Google-​able), but before Alison my experience of CBT lacked attention to the emotional component. In short, it seemed that my former therapists thought that if they could just change my thoughts and alter my behaviors with the usual OCD techniques (e.g. cognitive restructuring, exposure and response prevention, behavior modification), I would stop feeling bad. And I usually did feel better in the short term. I left sessions feeling lighter having talked. I implemented suggestions and modified behaviors (e.g. less «mirror checking», a common BDD compulsion). But in the long term, my money and relationship problems continued, depression cycles worsened, and my brain found ways to replace one overcome-​compulsion with another.
Alison’s approach was sort of the opposite — instead of trying to «fix» my thoughts and behaviors, we focused on underlying feelings (through bodily awareness and relaxation) that were triggering the thoughts and behaviors. She incorporated mindfulness, was influenced by Brené Brown, and hipped me to attachment theory. Ours was a process of developing an awareness, education, and healthy experience of difficult feelings, e.g., grief and shame (who knew there was a healthy way?) It took awhile for me to get to a place of recognizing and releasing feelings in a HEALTHY way, but I did, and I came to recognize that BDD/​OCD and addictions were my default UNhealthy methods of [not] dealing with them.
Isn’t it ironic? Most folks associate therapy with dealing with «feelings» and yet it seems that many therapists don’t know how to get in there and really work with them. I now understand good therapy as a sort of re-​parenting that, on one hand, provides the nurture, attunement, and emotional validation that so many of our stressed-​out, working parents weren’t equipped with; on the other, it helps us understand our stress and better manage it. Eventually, we integrate what we experience in therapy and learn to regulate our own thoughts and emotions, while developing compassion for ourselves and others. Through experience, Alison Smith taught me all this and so much more.
FTR:
I have been successfully off psych meds for almost 4 years now; successfully, meaning I am no longer ruled by obsessions, addictions, depression and anxiety. I now have tools, a practice, and I can self-​regulate; I am empowered. I saw Alison weekly for 3 years, after a breast cancer diagnosis presented a whole new level of stress and seemingly impossible circumstances. During that time, my life was a revolving door of crises, and Alison helped me turn each stressor that arose into an opportunity for growth and true power.
Before we dug into consistent weekly work, I saw Alison sporadically and was impressed by several qualities from early on: I felt comfortable because there was no power trip in her professionalism, no perceived distance between us; she drew helpful links between current stressors and past experiences; she recalled things about me and my past, even when considerable time had lapsed between our visits; her knowledge on addiction and emotional avoidance in relationships led to useful insights and changes.