Pre-screening Questions to be Considered for Services with Sara Ouimette, LMFT

Please read through these pre-screening questions. This will help us rule out any potential barriers to working together. Thanks so much for taking the time!

1.       Do you have a flexible schedule and are therefore able to come to in-person sessions during the week in the daytime? My current openings are mid-day (12:15 pm) and mid-afternoon (2:15 pm) on Mondays; 1 pm on Wednesdays; or Thursdays at 12:30 pm or 1:30 pm. I am restricted to working with CA residents only, and in-person sessions are preferable over online sessions. I will consider working online with CA residents in some circumstances.

2.       Are you able to commit to a regular weekly time slot? Sessions are 50 minutes long. I do not see people less than once weekly because I believe the therapy is much less effective that way. I will hold a weekly time slot especially for you.

3.       Are you able to attend therapy for a few months or longer? Therapy is most beneficial when a relationship is established. Therefore, I do not recommend just one or two sessions. However, I do offer consults about psychedelic use and psychedelic harm reduction. Please let me know if this is what you’re looking for. I am also willing to work over a period of a few months if you are seeking psychedelic integration therapy (please click on link for clarification of what integration services entail). Length of treatment varies and often cannot be predicted. Generally, the more severe the symptoms, the longer and more intensive the treatment.

4.       Are you able to pay my fee of $180 per 50-minute session? I do not take insurance. You may be eligible for reimbursement if you have out-of-network benefits (I will provide you with the form you will need to submit to your insurance in that case). You can read more about what to ask when calling your insurance company at the bottom of my contact page here.

5.       Are you experiencing severe depression, extreme dissociation, debilitating anxiety or frequent suicidal ideation with a plan to follow through? If your symptoms are extreme, you may need more intensive treatment than I can offer. I will only take you on as a client if I feel that I can fully hold you through what you are going through. With more severe symptoms, I encourage or insist upon more than one session a week. Please do email or call if you’re not sure if your symptoms would be too severe for us to work together. We can assess that together and I might have some other recommendations for you.

If you have read through these questions and want to speak further, please email me at, or call me at 510 859-7724 to set up a brief phone consultation.


If your answers to any of the questions above prohibit us from being able to work together, I have listed some referrals and resources below. Please don’t wait to seek help if you are suffering too much!

Some local therapists I often refer to:

Heather Galvano

Amy O’Brien

Rae Walker Mountz

Sliding scale therapy in Berkeley:

The Psychotherapy Institute

Women’s Therapy Center

Psychedelic Integration Providers:

M.A.P.S. list

Psychedelic Support Network

Crisis Support and hotlines:

Alameda Crisis Support Services

National Suicide Prevention Lifeline

Local Stabilization Clinic (Sausal Creek)

The HSP and C-PTSD; The Highly Sensitive Person and Complex Trauma

If you’re reading this, you probably identify as a highly sensitive person (or an HSP). However, you may not know what C-PTSD is or if you’re suffering from it. Complex trauma forms in childhood, possibly even in infancy. For those who were born with the trait of high sensitivity, there’s an even greater susceptibility to being traumatized when there’s a lack of sufficient emotional nurturing early in life. In my work as a therapist, I have come to understand the connection between high sensitivity, emotional abuse and neglect, and the large number of people I see in my office who have both the trait and the trauma without knowing it.

As infants and small children, we rely on our caregivers to survive. There’s an instinctual drive to do whatever it takes to keep our caregivers around. Yet what if our caregivers were depressed, anxious, stressed, insecure or preoccupied? The child or infant naturally adapts by rejecting its own needs and carefully tuning into the caregiver’s needs. This happens unconsciously, and it happens very early.

Babies, especially highly sensitive ones, are very tuned into the facial expressions and emotional feedback they get from their caregivers. This is how they make sense of the world and their place in it. Babies learn who they are in the mirror of the caregiver’s face. If the baby senses aggravation, annoyance, disgust, anger, anxiety or apathy often enough, they believe they are the source of these emotions and may stop attempting to communicate their own needs.

You’ve probably heard of “failure to thrive.” When babies don’t get enough emotional and physical contact to make them feel safe and loved, they stop growing. If nobody comes to tend to the crying baby in the crib, the baby eventually gives up. Or perhaps the caregiver only comes sometimes. When the care is too inconsistent, the infant may never develop a sense of true safety and trust with another human.

A less than ideal early emotional environment is especially damaging for the HS infant or child. Not only is there not the love, care, and safety the caregiver ideally provides, but the baby can shut down their own needs completely. An infant may stop crying when it’s hungry and wet or never “mold” to the caregiver when being held because they don’t feel safe. Imagine seeking comfort from someone extremely anxious or frustrated. It’s nearly impossible to be soothed by someone who isn’t soothed themselves. By the time we’re toddlers, we may even unconsciously develop ways to try to take care of our emotionally unavailable caregivers to somehow make them available:

Perhaps if I’m perfect I won’t upset Mommy. Maybe if I don’t have any needs I won’t suffer anymore. If I make Mommy happy or better will she love me? If I never make another mistake maybe everything will be okay.

The physical and emotional home environment is of the utmost importance for the healthy development of an HSP. Over-stimulating the infant with bright lights, loud noises, yelling, harsh materials or handling… even anger can create overwhelm and shut down. It is commonly believed that infants are somehow less affected by exposure to pain, violence, harshness, yelling, etc., or that they won't remember the experience. Yet infants are likely more affected and remember in their cells, in their nervous systems, and in their unconscious preverbal memories.

All children need to feel safe to thrive; when you’re highly sensitive, feeling safe can be even harder to achieve. When safety and comfort don’t happen at home, when there is nobody to show you just how special and treasured and protected you are, this carries into the adult experience of life as well… this is complex trauma.

Complex trauma happens over time. It can develop as a result of physical or sexual abuse in childhood; but it can also stem from emotional neglect, which is more insidious and harder to understand and acknowledge. Emotional neglect can be not getting much, or any, physical affection, emotional support, positive attention or a sense that one is loved. As a child, it’s difficult to know what you’re feeling at all, let alone where the roots of fear, loneliness or emptiness lie.

Many people, especially HSPs, go a long time not knowing how neglect contributed to their symptoms of anxiety, depression, perfectionism, addictions, eating disorders, and ADD to name a few possibilities. As a HS adult, just as you thought as a child, perhaps you believe something is inherently wrong with you. Yet I’ve seen many times over that these symptoms can develop as a normal response to and way to cope with a childhood that was actually traumatic. When we don’t get what we need emotionally, aren’t hugged, don’t see our caregiver’s love for us in their eyes, spend the majority of time by ourselves, feel consistently alone and scared, then we come to believe that we’re unlovable and that the world is unsafe.

Another thing that can happen with complex trauma is that the child holds the negative projections of the parents or caregivers. For example, a new mother gives birth to a highly sensitive infant. The new mother is overwhelmed by the duties of motherhood, isn’t finding much joy in her new baby, and feels extremely insecure in her abilities to mother. Yet these feelings are largely unconscious and then get projected onto this new “difficult” child who is particularly overstimulated and therefore more likely to fuss. Instead of the mother being able to own her limitations and insecurities, the baby becomes the problem, the challenge, and the difficulty.

The negative projections held by the highly sensitive child are internalized. This means that the child takes them on and believes themselves to be bad, too sensitive, difficult, problematic, or intrinsically flawed. The child may develop ways of trying to remedy this by developing perfectionistic tendencies in an effort to attain the love that isn’t and never was there to be given by the caregiver. The child may also develop codependent tendencies, care-taking the caregiver, hoping to hold everything and everyone together at the cost of their own needs.

The highly sensitive child who experiences this form of emotional neglect and/or abuse no doubt develops depression and anxiety. Perhaps you’ve sought mental health care, only to be misdiagnosed and potentially labeled and medicated, therefore deepening the belief that something is indeed intrinsically wrong with you.

Here’s the good news: if you’re reading this blog, are an HSP, and now believe you have complex trauma, this is a huge realization! Now the real healing can commence. You’ve found someone (me) who really understands how your suffering came about, and what you may need to recover. Healing requires that you get in touch with your highly sensitive trait as well as your childhood trauma. Having never been given the experience of safety or love or the opportunity to really get to know yourself and have compassion for what you’ve been through is quite a loss, but it can be achieved and developed, especially via therapy, books, groups, pets, or some combination of these.

A significant amount of grief may be in store, but you will be grieving for the child in you… feeling anger and sadness and outrage that this precious being you are was robbed of a carefree, happy childhood. This is one of the first steps in having compassion for yourself. You can also learn to cherish and manage your sensitivities as opposed to pushing yourself to adapt to a world that feels assaultive at times. You can come to embrace your depth of feeling, your imagination, your appreciation of the arts, and all the unique gifts you alone have to offer yourself and this world. That highly sensitive infant and child still live inside of you, and you can come to care for them in the ways they’ve always needed and deserved. You are no longer in the situation and predicament you were back then; as your adult self, you can save your younger selves. You may not be able to travel back in time, but you can heal the past.



The Complexities of Cannabis Use

As psychotherapists, how do we think about clients who use cannabis? I suspect our opinions vary, based on factors such as race, culture, upbringing, value systems, personal experience, age, education, and so on. According to the National Survey on Drug Use and Health, “cannabis is the most commonly used illicit drug in the country,” and the Bay Area has the highest rate of use in the nation (Hughes, Lipari, & Williams, 2016). I believe that many of our perceptions of cannabis have been shaped by the prohibition and criminalization of this substance in the United States since the beginning of the 20th century. I also believe we have an ethical duty to educate ourselves on this history, as it informs both the collective and the personal unconscious and is largely unknown.

Why Psychotherapy?

I truly believe that there is nothing more important than our mental and emotional health. We can often lose track of what we're actually striving for in life. Society leads us to believe we will get love and acceptance with things such as beauty, status and financial success. We get what we think we want and then there's something else missing... another void. The void is an emotional one - a lack of connection to self and other - a false belief that our worth is attached to what we do as opposed to who we are. Then we may not even know who we are because we've been trying to be something else. We may even believe that we are somehow intrinsically bad.

Your Brain on the 2016 Election and What to Do About It

There is a great deal of anger and fear in our country right now. There is a huge divide. People are scared. With the news and social media full of fear-inducing and anger-inducing messages, we are in a state of heightened alarm. 

What does this do to our health? For many, this election is stressful on a traumatic level. With chronic stress, the nervous system is in a perpetual flight-or-fight mode which wreaks havoc on our emotional and physical bodies. We may be having more depression, anxiety, headaches, stomach issues, and illness. Even if we feel removed and disconnected from the election, we are still impacted by the environment we're exposed to.