48 – Latines Embracing Mental Health: Shattering Therapy Taboos with Dra. Mildred Ortiz

Today’s toxicity ripe for dismantling: the stigma around therapy. Brown people prefer not to air their dirty laundry with strangers, but bury their mental and emotional distress for fear of being labeled weak or crazy. All that does is create a cycle of pain that becomes harder and harder to break with, and is passed on to future generations.

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Enough! You owe it to yourself to take advantage of therapy if it’s available to you, or use free community resources—even if you think there’s nothing wrong with you, there’s plenty wrong with the society you live in and are shaped by. 

This week’s guest Dra. Mildred Ortiz is the child of immigrants, and has dedicated her career to providing clinical support to individuals from diverse backgrounds, including monolingual Spanish speakers, in Los Angeles, CA. 

In this episode, she’ll explain:

  1. how to shop for a therapist
  2. how to vet a therapist: questions to ask at the beginning of therapy
  3. how to end therapy successfully

About Dra. Mildred Ortiz:
Dra. Mildred Ortiz is a Clinical Psychologist (PSY28287), licensed in the state of California. Dra. Ortiz is native to Los Angeles and a child of Immigrant parents. She has worked in the mental health field for nearly 20 years and has  grown in her professional experiences serving diverse communities nationally, working with adults, couples, children and families. Dra. Ortiz has provided clinical support and guidance to patients of different walks of life, experiences, cultures and traditions, including monolingual Spanish speakers. As a psychotherapist, Dra. Ortiz has helped people faced with overwhelming life stressors, trauma, anxiety, and depression. She has provided therapeutic support to individuals feeling troubled by recent life transitions, grief and loss, and relationship issues involving intimacy and communication. In the years serving as a clinical psychologist, Dra Ortiz have come to appreciate and value the human desire and need to relate to others in healthy ways, while maintaining a sense of autonomy. She strives to help clients create healthy boundaries for themselves, while taking great care in exploring, identifying and preserving cultural and traditional value systems within their relationships. Dra. Ortiz is Founder and CEO of Buena Vibra Psychological Services, Inc., a psychotherapy group private practice located in Cerritos, CA. She is also host of her own Podcast, Buena Vibra with Dra. Ortiz.

Find her online at:

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[00:00] Paulette: Buen día, mi gente, and welcome to La Vida Más Chévere, the place where Spanglish speaking, child free Latinas y Latines are learning to dismantle the toxic cultural bullshit we all grew up with. I’m your host, Paulette Erato.

And today, the toxic cultural bullshit we’re going to try to dismantle is our attitude towards therapy. There is such a stigma in Latinidad against airing your dirty laundry and not seeking mental health help because it’s a sign of weakness and all that is a toxic idea. Not treating mental health problems only serves to perpetuate cycles of generational trauma and each of us has the ability to stop that cycle in our own lives right here.

That’s kind of the reason you listen to this podcast, right? Honestly, everyone can use therapy. Even if you think there’s nothing wrong with you, because there’s a lot wrong with the world we live in, this modern society of ours. So by simply existing in it, you are being shaped and taught to accept a lot of bullshit that’s not healthy.

In this interview today, I’ll reveal my own experiences with therapy, both for myself and with my husband. And you’ll hear me explain why I highly recommend it to everyone, especially if you’re considering marriage. So let me tell you about today’s guest, a Latina therapist I met back in Los Angeles. Her bio is long, so you can find it on the extended show notes, but here are some highlights.

Dra. Mildred Ortiz is a clinical psychologist licensed in the state of California. She’s a native to Los Angeles and a child of immigrants. She’s worked in the mental health field for nearly 20 years and has provided clinical support and guidance to patients of different walks of life, experiences, cultures, and traditions, including monolingual Spanish speakers.

She’s provided therapeutic support to individuals feeling troubled by recent life transitions. Grief and loss and relationships involving intimacy and communication. She strives to help clients create healthy boundaries for themselves while taking great care in exploring, identifying, and preserving cultural and traditional value systems within their relationships.

Moreover, today she’s going to walk us through how to find a therapist, how to vet them for your specific needs, and even teach you how to end the therapeutic relationship. Yeah, you’re gonna learn how to break up with a therapist. In this episode, we’re also going to reference an earlier one on self care.

We’ll also touch on grief, a topic I explored in a full essay you can access on the Substack, along with a bunch of resources for coping with it. As a bonus, I’ll show you what it means to pre grieve much more successfully than Roman Roy. All of these links will be in the show notes, along with a link to show merch and other ways to support the show to keep it ad free.

Let’s go meet Doctora Ortiz.

Amiga. Doctora Mildred Ortiz is here today. Hi, how are you?

[03:03] Mildred: Buenas tardes. I’m doing well, thank you.

[03:07] Paulette: So, talk to us, Doctora Ortiz, about what it is like to own your own practice, because you’re a psychologist or a psychotherapist?

[03:16] Mildred: I am a psychologist. It’s interchangeable, but if we want to talk about it more formally and the way that I, I can identify myself for the state of California, I am a psychologist, psychotherapist. I refer myself as that as well. That’s anyone who provides psychotherapy, no matter what their title is.

It’s really nice. I love being a business owner, and that was not always the case. So, being the owner of Buena Vibra Psychological Services, we’re still in our infancy. We are turning one in August. Congratulations! Yes, And we are really excited about it. Prior to this, I was working as a solo provider, just under my name. And it’s just myself and I was happy with that. And then COVID happened and there was an influx of people just interested, wanting, needing the services.

And a lot of people that hablan español, wanting services en español. Or at least someone who understands it and who they can speak Spanglish with. And then I realized I can’t duplicate myself. There’s not enough hours in the day for me to like, realistically be able to accommodate everyone that is calling me.

And that is how Buena Vibra was born. And it’s been a journey, so far. Huge learning curve, and I’m still learning. Definitely a lot of insecurities along the way, lots of lessons learned. I like using that term over failures. Lots of highs and lows and learning to be a leader because even with that, my plan was just to hire one other person and it was someone that I had talked to, another therapist, my colleague, Justine Collazo, and that was it.

And then we decided like, yeah, beginning of 2024, we’ll hire more. And so now we’ve grown to four.

[05:25] Paulette: Oh, wow.

[05:26] Mildred: Yeah. So we have another therapist on board and we now have an assistant. Yes. We just grew within the year when we’re about to turn a year. And so it’s been a journey and I’m really excited about it.

Yeah, I don’t know that I would have foreseen this a year ago when I formed the corporation. Yeah.

[05:50] Paulette: So to back up, and people will have heard your bio, but Buena Vibra is an LA based practice, correct?

[05:57] Mildred: Correct.

[05:58] Paulette: You and I met at Latina Fest in March earlier this year, and you were at the first table. When I was really excited about in talking with you, your energy is great.

I have a thing about energy. I keep mentioning it in podcast interviews now, but I think that there’s something there like you gel with a person very easily. You were very easy to talk to, which I think is very important in your profession. Somebody who is trustworthy. And when I relaunched this podcast, I was talking about self care we could do for ourselves.

And part of that is looking for support in one’s life. The self care that you can offer might also look like mental health care, but that it’s important to have mental health care providers who look like us, who understand the nuances of our culture and who speak the language, whether it be Spanish or English or Spanglish, like we do on the show.

And so you were the first vendor I saw, and I was so excited because you were all of those things. And then I start telling you about the podcast, you start telling me about your podcast and I’m like, we need to work together. So it’s very exciting what you’re doing and the service you’re providing. And clearly there is a need for brown therapists.

[07:15] Mildred: Oh my gosh, such a need.

And I’ve known all along, so I’ve been working in the mental health field for nearly 20 years at this point. And went into private practice, so just the private practice set up in 2016. Prior to that, I worked in community mental health and, and also worked for the county of LA, which is obviously different than the private sector because now we’re talking about the underserved communities.

There’s a lot of people of color that are being served in community mental health that are being served by the county of LA. And the majority of the people that I worked with look like me, or shades of me. So when I went into the private practice sector, I noticed that there was a huge shift at that particular time.

Still, there weren’t a lot of people that looked like me that spoke the language. And when I’m referring to private sector, I’m referring to people who have private insurance. So the HMOs and the PPOs, as well as those that are willing and able to pay out of pocket. And so it was a very different demographic.

So yes, I was established from the very beginning in LA County, Cerritos, California, to be exact. That’s like, for anyone who isn’t familiar with Long Beach, Downey. And so what I started noticing was that my name alone, now my name is interesting because it’s Mildred, which is a very old school American name. But my last name is Ortiz, so just the last name alone just got my phone ringing, and do you speak Spanish. And I had a website too, so people are Googling, and they see that, oh, there’s a page on her website that is all in Spanish. And and at that time, that was all, that’s all that I had was a website, I had my name on a directory.

So I was centrally located where people were willing to drive out to Cerritos to come see me and meet with me in person and access the services. So you are absolutely right when you are saying that people are looking for therapists that look like them, can speak the language, who at the very least can understand.

Because, for most of us, we live in homes where we speak variations of Spanish and English, and if our parents don’t speak English… Then my clients are coming in and they’re talking to me and they’re talking to me in Spanish about what their parents would be saying to them. And then they’re like, do you understand?

Of course. Yes. And then the influx of that during and after COVID, now post COVID.

[10:05] Paulette: So you started Buena Vibra. A year ago, and prior to that, you were in private practice for how long?

[10:14] Mildred: We can say 2015. I started off with a, with a friend, colleague, peer of mine, can I do a shout out to Dr. TK? She’s huge on Instagram.

She had been pushing for me, like, come to private practice, come, I’ll help you and, and, and we’ll do this together. And she had a group practice at that time. So I started off with her. And then in 2016 is when I jumped into it on my own. That was her plan all along. Let’s get you established. So I’ve been in private practice since 2015, on my own since 2016.

And yes, Buena Vibra formed in 2022, August, but we didn’t start actually seeing clients until November of 2022.

[11:03] Paulette: That’s a journey.

And it’s really great to hear that you are inundated with patients, not because our people need the help, but because they’re seeking the help. I think that is so healthy and I’m, I’m very excited to hear that.

And clearly the need is there and whatever stigma might exist in Latinidad around airing your dirty laundry or seeking help, those generational boundaries or whatever are being dismissed in favor of getting the necessary help. I’m so happy to hear that. That makes, that’s a very good trend. I have never had, uh, a Latina therapist, all of my therapists have been white, even the marriage counselor I saw with my husband.

And now that I’m reflecting back on that, by the way, I think marriage counseling is the best thing in the world to do before you get married. I’m a huge proponent of it. I’m just going to slip that in there, but I credit it with establishing a foundation for me and my husband to not only survive being locked up together for two, two plus years, five years into our marriage, but also enjoying each other’s company during that time, because I know not all marriages made it.

[12:16] Mildred: There were so many separations, divorces, breakups during that time. Absolutely. And there was an influx in domestic violence. There was an influx in just violence overall, substance abuse and just a lot more conflicts in the home environment. And it wasn’t something that I was just seeing in my anecdotal work with my own clients. But also, insurance panels.

So like now I’m contracted with just two insurance panels, Kaiser and Health Net, but they started to see the trend. These big corporations started to see the trend and started to create some flexibility for couples to access services too. And I know that like for Kaiser, they still are offering it and have extended a lot of their resources out to just the general public as well, not just their recipients.

But yeah, I agree with you. Even as you’re saying that, I’m also reflecting back on the times that I’ve been in therapy too, because it is important that I have to keep my own stuff in check.

[13:22] Paulette: Yeah.

[13:22] Mildred: And so I’m an advocate for psychotherapy. I should be, considering that I’m a psychotherapist myself. It would only make the most sense.

And historically, yes, the therapists that I saw have been white or some descendants of Caucasian some way, somehow. There are really good providers out there that are Caucasian, that are attuned with the differences, who are able to talk about the cultural differences that exist within the therapeutic setting.

The responsibility stands on both though. Like as a therapist, I have a responsibility to address those differences, and I do. And as a client sitting on the other end, I also took it upon myself to address the differences as well. And even with clients that speak Spanish, that like speak Spanglish, that look like me, I never assume.

I never assume because we may speak the same language, we may look similar, we may have some similarities, but I don’t know your background. I don’t know how you grew up and what are some of those traditions and values that exist outside of like the general spectrum. So I still have those conversations with my clients that identify as Latino or, or, or more specific to a specific Spanish speaking country.

[14:51] Paulette: Yeah. Yeah. But it wasn’t until I was doing the research for the podcast episode where I talked about seeking mental health help that I realized I’d never had a therapist who wasn’t white. And I’ve had some very good therapists, but I’ve also had some very bad ones. I think it’s, it’s again, a process of finding what fits, but it released this memory from the vault, I guess, about a conversation I was having with one therapist.

And she really could not understand the scenario I was painting for her of family dynamics. And I was so confused as to why she couldn’t because I was in my 20s and she was in her 50s. I’m like, you have so much more life experience. How have you never experienced this? And I can’t tell you what the specifics of it were anyway, but thinking back on it, I’m realizing, well, maybe it’s because she lacked the cultural awareness.

And I don’t think that unless someone points it out to us, that we know to seek it out. Cause I would not have thought to find a Latina therapist again, before I did that research. That research was six months ago.

[16:00] Mildred: Yeah. Yeah.

[16:01] Paulette: I’m in my forties now. I mean, it’s always made sense to me to try to get a woman doctor. I know men are dismissive of certain things that women can, and I just don’t want to put myself in that situation. I’m not saying all men or all doctors. I’m just saying I’d rather speak with a female doctor. It’s funny how you end up making those connections. And from this point forth, I think I will always try to seek out someone who looks more like me because of those little nuances.

And like you were saying, we’re not a monolith. We don’t all have the same experiences, but there are cultural variances that we’re a little bit more sensitive to.

[16:37] Mildred: And that I agree. Because, like I said, in the start of me just being available in, in private practice. A lot of the clients that I started to see were Latino, and almost to the T, the initial start was, it’s refreshing to talk to somebody who understands me.

I have been seeing someone and they just didn’t understand. Or, there’s also, people come, therapists, I mean, we all have different schools of thought, meaning theoretical backgrounds, and there are some therapists who do have like this blank slate or come across as like, quote unquote, this blank slate.

They don’t want to taint the therapeutic process in any way. They want it all to be the work of the client who comes in. But Latinos, generally speaking, we are dynamic, meaning that we like to have conversations. We like to know who you are and where you come from, and we like to have dialogue conversations.

And that was the other experience that a lot of clients have spoken to me about even now, that it didn’t seem like the therapist was engaged. They never said anything to me, or it felt like they were falling asleep on me. So many things on the spectrum and then feeling again, that sense of like, it’s refreshing to be able to talk to someone and you actually talk.

Yeah, I do.

[18:12] Paulette: Yeah. Yeah. Now thinking back, yes, I would do most of the talking and just get a head nod or a hmm. And I’ve been in therapy for like it on and off for the last 20 years, but I’m not saying that my experience is obviously the only one that makes sense. In speaking from my experience, I’m like, Oh yeah, yeah. There’s another aspect of this I wouldn’t even have thought of.

[18:32] Mildred: I think it’s so important to find somebody that you mesh well with. It’s like anything else, right? You’re looking for that perfect shade lipstick, right? And that red, right? And you’re not just going to get the very first red because you’re at CVS and that’s the brightest red that you see.

You’re going to shop around until you find the ones that you really are looking for. It’s the same thing with therapy. You should really shop around for the therapist that you feel the most comfortable because it’s supposed to be a safe space. And I’ve had those experiences as well. I’m not for everybody and I don’t want to be for everybody.

[19:11] Paulette: So, in that vein, how do you recommend that someone shops for their therapist? Do you Google them? Do you set up some consultation appointments? Is that something that is done?

[19:23] Mildred: Well, one of the things that I tell clients, when you’re searching for a therapist, you have to do it for yourself, not because anybody else is asking or telling you that you need to go to therapy.

Because when you go to therapy, the first thing they’re going to ask you is, so what do you want to work on? What do you want to gain out of therapy? And when you’re done with therapy, what are the tools you want to leave with? So it’s got to be something that you want to do, that you are ready for. And then it’s really paying attention to like, are you looking for someone who is a man, a woman?

I know you said you prefer women doctors. And so paying attention to those levels of comfort as well. It’s also important to also pay attention to whether the person has certain levels of openness or levels of expertise working with particular populations as well. So, if you identify within the LGBTQ plus community and you want your therapist to be understanding of that, then you search for someone who is open and understanding of that.

If you are closely connected to your spirituality and you’re looking for a therapist who has that knowledge and incorporates spirituality into the therapeutic process, then that’s something that is going to be important to you. So being aware of what you’re looking for. And then oftentimes people are hung up on like, oh, CBT, EMDR, psychodynamic, and all of these other jargon type therapeutic approaches.

At the end of the day, you may want like, Oh, I’m looking for a CBT. Okay, great. But Chim, you don’t know whether that’s actually going to work for you. You may be more of a process type of client. And what I mean by that is you just want to talk. And if that’s really what you’re looking for is just to have a conversation and in you talking it out and processing coming to your own conclusions and self awareness in that way, then CBT is not the one for you.

So I think people get hung up on these therapeutic approaches. And it’s really about giving the therapist a little bit of that control. Let them guide you and use their therapeutic tools based off of how you’re coming into the therapy process. So that’s the other thing that I say is let’s not get too hung up on like the therapeutic approaches.

I think it’s more the relationship. At the end of the day, it’s a therapeutic relationship. How comfortable, how safe do you feel when you’re meeting with this person? If culture is something that is important, being able to talk about certain traditions and make that clear. I think as therapists, people assume that we’re psychics too, like we know it all and we’re able to like read your mind and no, we’re not.

So if there’s something specific that you’re looking for in a therapist, it’s your responsibility to communicate that to us because otherwise we don’t know. We only work with what you give us, what you’re communicating to us.

And as far as searching, there’s so many different ways to approach it. If you have insurance and you want your insurance to pay for it or to pay a portion of it, go through your insurance, call your insurance, log into your insurance portal.

You can search directories. They kind of function like a Facebook where there’s a picture, a profile. Popular ones are, here’s another shout out for Latinxtherapy. com is a big one, if you’re looking for a therapist that speaks Spanish or is of Latino backgrounds and culture, ethnicity. There’s also Psychology Today, you can Google as well, word of mouth too.

So if you feel comfortable talking with certain peers or family members about your interest in accessing therapy, or you know someone who is, and you feel comfortable having those conversations, ask around.

[23:19] Paulette: Is it okay to tell your therapist that you’re looking, you’re shopping around, so to speak, that maybe you might go to one or two sessions with other people?

[23:29] Mildred: Yeah, absolutely. I think it’s important to be honest and be your most authentic self. I think another way to look at this too is, at least for myself, when I meet with a client for the first time. I’m also determining that, too. Am I able to work with you based on what your presenting issues are, because I may not have the level of expertise to be able to work with the particular issues you want to work on, so I am also doing the very same thing.

So it goes both ways. And so those are conversations that are important to have. And it opens up dialogue for like, okay, so what are you looking for? It helps the therapist also normalize that process as well, because this kind of service is voluntary. It’s not like anybody’s telling you you have to— unless you’re court mandated.

As I mentioned to you earlier on, therapy should not be sought out if your partner, your siblings, any family member, your friends are telling you that you need to go to therapy. It has to come from you. So, have those conversations and if you’re using your insurance, check in with your insurance and make sure that they’re okay with that.

Because some insurances will not cover all of the different therapists that you’re talking to and so you may have to pay out of pocket for some of it as well.

[24:47] Paulette: And that is kind of one of the barriers of entry to receiving health care in the mental health field, which is unfortunate because not everybody has the means, but like you were saying, there are county programs that fill the gap.

[25:01] Mildred: I’m glad you mentioned that because therapy is a process. It’s not like going and seeing your doctor, your medical provider, your primary care physician, where you go, like, once a year, once every six months, check up, okay, all good, great. Therapy is intended to be like a weekly thing, at least an hour a week.

And what the bureaucracy of insurances has created is another system where therapy now is watered down. It’s not the same process that it was in the earlier years of the psychotherapy process. Insurance has opened up this resource for many who would not be able to, is the upside to it. But the downside to it is that, especially in community mental health or for the county, they want you to use evidence based practices, which means some of their programs are manualized.

So let’s go through like a manual and work through the issues that you’re presenting and let’s go through a series of steps or a time frame, like, okay, let’s see if we can get this all in down and settled by like the end of six months or a year or so. So, that’s what I mean by watered down. It’s not the same process that it used to be.

I, let me knock on wood here, I haven’t encountered that yet with the insurance panels that I’m under. They do allow for flexibility. I have seen clients that have been, actually I just recently ended with a few, that I’ve seen since the start of me in private practice, and there has been real work done.

It’s not just like, Le estas pagando doctora.

[26:54] Paulette: For the office space, right?

[26:56] Mildred: No, like we’re talking about real issues. And that’s what I mean. Therapy is intended to be like an extensive process. It’s not intended to be like these brief processes. And it doesn’t mean that all clients will be in therapy forever, either.

It is possible to end therapy within like a six to eight month range as well, because I have, and successfully too, because that’s the other thing. I always tell my client, at the start of therapy, when we’re developing therapy goals, I want to know what we’re working on, I want to know what the goals are, because I’m already thinking about the last day of therapy.

When you no longer need it. And the goal of therapy is not getting rid and eliminating the issues, or getting rid of anxiety. It’s just learning how to manage it. Because the reality is I don’t know how to get rid of trauma. It’s not possible. So instead, it’s let’s figure out healthier ways to cope. And while also understanding that you may experience moments where you’re triggered, but now you know and understand what’s going on for you when that happens.

And now here are the tools.

[28:04] Paulette: That was very interesting how you put that. You can’t fix trauma. It’s not going to go away. You’re providing the tools for managing it. Which is, I think, something that people really need to hear in that you’re not going somewhere to be fixed. You’re going somewhere to learn how to manage your specific situations, quirks, scars, but you’re not removing the scars.

You’re not a magician.

[28:30] Mildred: No, and I don’t want to! And let me tell you why. Because things like trauma, these are devastating, very horrible life experiences that people go through that they shouldn’t, and unfortunately, they do. And even within the experience of their trauma, there’s opportunities to grow and to learn about themselves and their strengths. And through their suffrage, really being able to see how they’re survivors, not victims, but survivors.

And without those life experiences, we don’t get that. There’s a book “Man’s Search for Life” by Viktor Frankl. And he talks about it beautifully. It’s a, it’s a very popular book, small pocket sized type of book written in many languages, including in Spanish. And Viktor Frankl is, is a psychotherapist himself in the era of the Holocaust. He was a Jewish psychotherapist, psychoanalyst in the Freudian era. But he talks about that, how we grow and we flourish from suffrage.

So why would I want to take that away from somebody?

[29:47] Paulette: That’s a huge perspective shift for most people. So instead of being defined by your trauma or your scars or the things that have happened to you, you get to use them as a jumping off point for your strength.

[30:02] Mildred: Absolutely. Absolutely. That’s really the stance that I’ve been working off of.

I learned very early on about myself as a therapist that I want to look at people’s strengths. I want to help people find their light. I want people to feel empowered. Really focusing on their personal strengths and looking at their suffrage. Yes, grieving it, processing all those emotions that come with it, as well as looking at it from the stance of, and so how do we grow from here?

How do you want to view yourself and what can you take away from that experience? You get to define yourself, not by this trauma, but however you want. So giving them autonomy in that as well.

[30:53] Paulette: Thank you for sharing that. We’ve gone through the journey of finding a therapist, connecting. How do you determine when therapy has ended?

I originally was going to ask how do you break up with a therapist, but that could be a mutual goal. I mean, it sounds like you do. You’re talking about the last day of therapy. Your job is to usher someone up into the next stage so that they don’t necessarily need you anymore. But sometimes that is a proactive agreement. And sometimes it is a reactive situation. So…

[31:24] Mildred: Oh yeah.

[31:26] Paulette: Let’s talk through this.

[31:28] Mildred: So I mentioned earlier treatment goals, a therapist who doesn’t talk about the goals of therapy is a therapist who is just… I don’t know what that is. You want to know what you’re working on. Um, you don’t just want to go with the waves, go with the breeze, shoot the breeze in therapy.

That’s, that’s not helpful.

[31:45] Paulette: Right. You’re not there to be a friend.

[31:47] Mildred: Yeah, no, I’m not there to be a friend. I’m not there to be your mentor. I’m not there to be your Jiminy Cricket. I am there to help guide you, to help to challenge you, to give you perspectives, but ultimately the client has to make their decisions.

They’re the ones that are taking the lead on this, not me. I’m not the ones that have to live their lives, so I’m not the one who’s going to be making decisions for them. And I have to communicate that to clients. No, I’m not doing that.

[32:19] Paulette: Boundaries!

[32:20] Mildred: Boundaries!

[32:21] Paulette: You must be an expert in boundaries. We’re going to talk about that next time we have you on. We’re going to do a whole thing on boundaries.

[32:27] Mildred: Yes, yes, yes, yes. But yeah, once you establish what the treatment goals are, then we are periodically going back and reviewing the goals. Okay, where are we in this? And I’m constantly using that as our basis for like what the progress is. And every so often in the therapeutic process, I am taking the time to reflect on like, not just how are we doing, how are you experiencing me?

Is there anything you need to talk about with me? Because I tried to provide that open space for them as well. It’s okay. Clients get mad at me all the time. And that’s something to process. And I don’t take it personally because at the end of the day, it’s not really about me. And, and, and maybe sometimes it’s if, maybe, you know, um,

[33:10] Paulette: I love that you’re so self aware.

[33:11] Mildred: No, you know, I’m human, you know, but yeah, so we reflect, we talk about treatment goals. We’re constantly assessing and seeing where they are. And then the approach that I have with them too, is more likely than not, I’m seeing them on a weekly basis. Once they hit a certain milestone, all related to the treatment goals, then I have conversations with them about like, should we go bi weekly?

Then once they hit another milestone, then let’s go once a month. Because I want them to gain that confidence in themselves that they don’t, quote, unquote, need me. They’ve never needed me. That’s the reality. These issues existed before I existed in their minds.

It’s really just applying something new to work on the issues that they’ve been experiencing for who knows how long. So I want them to build on that confidence and that self autonomy. And when we start transitioning over to the once a month, I give them a heads up. Like, look. If we’re moving to once a month, that means we have three sessions left and this is what it’s gonna look like and this is what we’re gonna do.

[34:27] Paulette: Hmm.

[34:28] Mildred: It is my responsibility. I know what the therapeutic process is. They don’t, it’s my job to communicate that to them, so I do my best to always give them insight into that and prepare them for that. That’s my approach, though. I don’t know how other therapists do it. And then, we talk about it. It gives them opportunities to really process their worries, their fears, but what if I need you?

What if something happens? Well, life happens. And if it happens while we’re in this process of ending, we’ll process it, but it doesn’t necessarily mean we’re going to continue. So I give them that insight.

[35:04] Paulette: Because by that point, they’ll have some tools where they can manage that, right?

[35:09] Mildred: They’ll have the tools, yes.

[35:12] Paulette: So they don’t necessarily need you, even though at the beginning they might think that they do, because that sounds like a scary thing in the future.

[35:19] Mildred: It is a scary thing in the future, and that’s why the tapering off is really helpful. Because after three weeks of not meeting with me, and then they’re like, yeah, I went through these little incidences and I did experience anxiety, but then I did this and I did that and I was okay.

So there’s this level of readiness and they’re seeing it themselves. And by that second session into like the three sessions, I asked them, should we go one more? That’ll be the last one. And I want to say like seven out of ten will say, yeah, let’s go that last one. And then there’s three that will say, you know what, Dr. Ortiz, I think we’re good here.

So giving them that opportunity. And if we think about it, it’s not a breakup, it’s a ending. Like the end of a chapter of a book, the end of the book.

[36:15] Paulette: It’s kind of like physical therapy in that you go in, you have an acute issue. So maybe it’s not as acute with a patient going to a mental health therapist, but with a physical therapist, like I’ve hurt my arm, I had been in therapy for my other arm when that happened.

And he’s like, basically, you’re going to take all the tools I taught you for this one and apply it to this one. But I was glad I was in therapy so I could hear him tell me that because it wasn’t the same thing that happened on each side, but it turns out that the treatment was the same. But if you approach it thinking like it’s physical therapy, you are being treated so that you can then live your life without physical therapy so that you are stronger and still have full use of your faculties.

That sounds a lot less scary.

[37:04] Mildred: Yeah, that it’s a process and it’s just a chapter in your life and it doesn’t have to be a breakup because I think the breakups come with so much anxiety and emotional highs and lows. And let me tell you, breakups do exist. Sometimes they come from me. Very rarely do they come from me, but it has happened.

But usually it’s the other way around. I haven’t had a lot of clients who have broken up with me or who have ended therapy with me because they are not happy with my approach. Like I said, I’m not for everybody and that’s okay. I don’t take it personally. And if you just aren’t feeling comfortable or you don’t like the approach, it’s okay to say thank you, but no thank you.

I think I, I need to find someone else who is going to approach the issues that I’m addressing in therapy differently for me. I’m looking for something else and that’s okay. I appreciate that. I think it’s the ghosting that I don’t like.

[38:06] Paulette: So that right there, do not break up with your therapist by ghosting them.

[38:09] Mildred: And the reason why is it just highlights your issues. It highlights your issues. And if you tend to do that, oh, I understand what you’re doing. You, this is what you do.

[38:22] Paulette: Same old pattern.

[38:23] Mildred: Same old pattern. But what it does for me is like, do I keep you open or not? Like, are you going to respond to me or not?

And I need to close out your case because if you’re not my client anymore, I don’t want to keep your case open, so it’s out of courtesy. Just like it’s out of courtesy if like, you’re not interested in the person you went out for a meetup or a date or whatever. Just out of courtesy. Thank you, but no thank you. I’m looking for something else.

You can use the same sentence for the breakup.

[38:54] Paulette: Do you prefer it in a text or on a phone call or voice mail?

[38:58] Mildred: I’m traditional in that sense. Talk to me about it. Talk to me about it. I’m not going to bite. I’m going to appreciate your honesty and your openness. And it’s also a corrective experience for them to know that I’m not going to yell and tell you off because…

[39:15] Paulette: Because you’re not the girlfriend.

[39:16] Mildred: I’m not the girlfriend or the boyfriend or the partner or whatever, you know? And then, yes, there have been times where I have had to end those therapeutic relationships. And let me explain that a little bit because it’s not like it’s like, oh, I don’t like you. That’s not the way that it works. That’s very unethical.

It’s more about, oh, you’re making me feel unsafe.

[39:39] Paulette: Oh, yeah, yeah.

[39:40] Mildred: Now you’re threatening my life. Or you’re saying things that are very insulting and I’m not going to stand for that, so we’re going to end here.

[39:53] Paulette: Yeah, the space has to be safe for you as well.

[39:56] Mildred: Absolutely.

[39:57] Paulette: I never even thought of that.

This was a lot of fun. I definitely want to have you back. I think we can drill down on boundaries, which all adults need some assistance with.

[40:06] Mildred: That is actually my niche: boundaries, and how do you set boundaries within the family system in traditional, culturally dense, family systems. And maintain them without the idea of like estrangement, because I think oftentimes we go to like the extreme, the polar opposite. And that’s not the case for like 99. 9 percent of my clients.

[40:30] Paulette: Yeah. That fear of being shunned or being estranged keeps us in, in toxic relationships. And not just romantic relationships, but attached to family members that maybe we need a boundary with.

[40:44] Mildred: Yeah.

[40:44] Paulette: So that’s what we’ll be talking about next time here on La Vida Más Chévere.

[40:47] Mildred: Yes. Yes. Yes. I’m excited about that. Yes.

[40:51] Paulette: So, Doctora Ortiz, muchísimas gracias for your time today for, if you have never had a therapist and you don’t know what’s involved, you really gave us like the one, two, three, like this is how you do it. This is what you should expect. Maybe these are the questions you should ask.

So thank you for that. And will you please wrap the episode up for us?

[41:10] Mildred: Absolutely. I will, but I want to say thank you for having me on board and having this great conversation. I look forward to coming on again and talking a little bit more. But for today, that’s a burrito!

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