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Warm Virginia landscape near Richmond, where Harlan Therapy sees patients by telehealth

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Birth Trauma Therapy for Richmond

Richmond is a capital city with a large medical and professional workforce, which means a good share of the women I see here work inside the systems that other people are frightened of. Some of them were frightened inside one themselves.

When You Know Too Much

There is a particular difficulty in having a hard birth when you understand exactly what was happening. You could read the room. You knew what the change in language meant, what the extra people meant, what the speed meant. You did not have the mercy of confusion.

Afterwards that knowledge keeps working. You can construct the clinical rationale for every decision that was made, and you can do it so convincingly that you talk yourself out of your own distress. It was appropriate. It was indicated. Given the situation, it was the right call. All of that can be true and you can still have been terrified, and the terror does not resolve just because the care was defensible.

The Clinician Who Is Also a Patient

I work with therapists, physicians, nurses, midwives and residents. There is a shared set of obstacles.

The first is that you are the one who holds things. Being on the other side of it feels wrong in a way that goes deeper than pride. The second is competence anxiety in the session itself: you know what I am doing while I am doing it, and part of you supervises rather than participates. The third is confidentiality, which for people in a professional community that overlaps is not paranoia. Richmond is a city with a big workforce and small circles inside it.

None of that disqualifies you from the work. It changes how we start. I will usually name the supervising part early rather than let it run underneath, and Internal Family Systems is well suited to that, because it does not require the observing part to leave. It just asks it to make room.

Burnout Sitting on Top of the Birth

For clinical and professional mothers here there is very often a second layer. You went back into a demanding job while unprocessed. The job asks for exactly the capacity you no longer have to spare, and you meet the ask anyway, because that is what you do. Compassion fatigue and an unresolved birth reinforce each other, and treating only the burnout tends to buy a few good months and no more.

Logistics

Sessions are by secure video, which for Richmond patients often means an hour between clinic and pickup. Some patients here prefer an intensive: four hours of concentrated work with a ninety minute intake beforehand and a thirty minute close afterwards, which can be easier to protect than a weekly slot inside a rotating schedule.

I am private pay only, which means nothing is submitted to an insurer, which for people whose professional standing is tied to a license is often the deciding factor. A superbill is available on request and I cannot guarantee reimbursement.

I am licensed in Virginia only. My office is in the Tri-Cities, so in person is possible for some Richmond patients as well as video.

What the First Session Is Like When You Do This for a Living

I do not perform therapy at colleagues and I will not pretend you do not know the mechanics. If you notice yourself narrating your own process, say so and we will use it. The observing part of you is usually one of the most protective parts you have, and it has good reasons for staying awake.

What tends to be a relief for clinicians is that Brainspotting does not depend on articulate self report. You can be extremely fluent about your own history and still have never actually gone near the thing itself. This is a route that does not run through fluency.

Beginning

Start with the free consultation call, and use it to ask the specific questions you would want a patient of your own to ask.

What Richmond Patients Most Often Come For

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