Therapy with Brian Henderson, AMFT

Brian Henderson is an Associate Marriage and Family Therapist located in San Francisco, CA specializing in LGBTQ-related topics, chronic pain, couples counseling, and anxiety. Brian approaches therapy sessions from a social justice lens, understanding clients’ struggles in the context of a challenging world. He also believes in the power of the mind-body connection in the healing process, often drawing upon grounding mindfulness, sensorimotor, and ecotherapy techniques to assist clients in making progress toward their therapeutic goals.

We asked Brian more about his work with clients and his guiding philosophies on therapy.

Brian’s background and personal life

How did you decide to become a therapist?

For almost fifteen years, I struggled with severe chronic back pain. I tried everything. I spent years getting bodywork, physical therapy, chiropractic work, acupuncture, yoga. I went to the Mayo Clinic to get my body thoroughly analyzed by western medicine. I got steroid injections in my spine and I considered spinal fusion surgery. During this time I became more and more isolated, as I worked harder and harder in my job as a copywriter in tech, to be able to afford all of the treatment for my worsening pain.

I was suffering from the way that society burdens the individual with the responsibility to heal on their own. Because of my upbringing and male socialization, I was taught that if there's something wrong with me, I have to figure it out on my own.

It was ultimately my sensitivity that saved me, that continues to save me. My ability to feel, to share what I feel, to explain what's happening in my body — abilities that I feel my queerness have gifted me — helped me begin to tell other people how much I was suffering. I started therapy. I deepened my relationships. My pain started to lessen. I went on a 3 week whitewater rafting trip down the Grand Canyon, and it went away completely for a time. I learned how powerful community and nature can be as accompanying forces for us, when we are struggling to make sense of our lives.

It was during that trip that I decided to become a therapist. My pain is not gone. It will always be with me. It has seasons, it has tides, like nature does. It is no longer something I try to excise, like a tumor, or chastise, like an unruly child. I treat it instead like a wise elder, reminding me to come back into balance in some way.

What was your previous work before going into private practice?

I was a journalist working in climate justice, and then for 5+ years I was a copywriter in brand marketing in the SF tech industry (some content marketing as well, so this blog piece will be right up my alley!). Between my time as a copywriter and starting therapy school, I spent a year studying California ecology and became certified as a state Naturalist.

What do you enjoy doing in your free time?

I am a partner, a friend, a writer, a swimmer, and a lover of queer dancefloors and music. I'm a gardener and a passionate ecologist. I tend to my relationships like plants in a garden — I love my community in San Francisco.

Brian’s specialties and therapy philosophies

What guiding principles inform your work?

I have a lot of techniques and ideas in my quiver. What I pull out changes a lot from client to client.

We often feel like small islands, alone with our pain. And we feel like if we’re not “moving forward” toward certain milestones, we’re broken. But I take the view that life is a series of cycles in which we are offered opportunities to grapple with the same difficulties a little differently. After all, we live nested within big systems: families, communities, societies, and ecosystems.

Each of those systems go through cycles of creation, evolution, and destruction — and so do we. We look at these systems to help us understand which messages or patterns we want to release, which transformations we want to undertake, and feel the grief that is an integral part of loving something and letting it go. And these systems do not treat us all equally. Social justice work is a key part of my practice. I believe we cannot heal without compassion for what we have survived, and folks that live in the margins of society have a lot to survive each day. In my work with my clients, I hope to contextualize their suffering as wise and intelligent responses to a challenging world.

Broadly, I seek to reconnect my clients to others, and to the larger ecosystem of which we are a part. We can't do this alone. We are meant to heal in community. I make use of my relationship with my clients to shed light on the way they see themselves in relation to others. The therapy room is a testing ground for learning to set boundaries, state needs, and nourish yourself. We also talk about what it is that community means to us. What is their racial and spiritual heritage? What rituals and ways of being from that tradition offers peace and connection? What have we lost and what might we reclaim?

What clientele do you work with most frequently?

As a queer man, I am drawn to work with transgender and queer folks across the spectrum. I work with a lot of folks struggling with chronic pain, chronic illness, and the painful, looping mental states that come with them. I work mostly with adults.

I work with couples as well; I find that I end up working with couples who are trying to reckon with remaining in a vibrant relationship while also exploring and growing as individuals. I am kink, gender, and poly-affirming.

I do ecotherapy with individuals — my experience of my pain being held by nature was foundational for me, and I find that doing therapy in a safe, private place outdoors can be a powerful accompaniment to the work.

Can you tell us more about your specialty in working with members of the LGBTQ community?

So much of how I work with queer folks is to listen for the grief they have not been able to access. Perhaps they didn't have models for grief, for most of their lives, and they need to earn how. Perhaps they have been too focused on survival in a harsh world to slow down enough to feel what they feel. Or perhaps they have had to stay fierce and angry as a way to build safety for themselves, and they are an engine running overtime, burning itself out.

I understand grieving to be an integral part of the healing process. If we can't mourn what hurt us, if we can't offer ourselves a new experience of being held and witnessed in a painful moment, then we call in circumstances, relationships, physical conditions that express that pain for us.

And once we queers grieve, my goodness. We are something to behold. All the life force that goes into holding that tide at bay gets to explode outward in joyous, creative, liberatory celebration!

Can you tell us more about your specialty in chronic pain/illness?

I see chronic pain and illness as a signal flare from a deeper, more intact part of ourselves, trying to light the way to a more relationally balanced, spiritually rich way of being. A lot of my work with pain and illness is to help the client stop pathologizing themselves.

What would it mean to, rather than shame my body for getting sick, accept the invitation to slow down, rest, turn inward, stop producing? What would it mean to, rather than forcing myself to work through pain or endure physically uncomfortable social settings until my pain is screaming at me, chose a pace of life that works for my body, or cultivate relationships and activities that are kind to my body? What would it take for me to love my body, and recognize that the voices that shame it are not mine? How do I cultivate compassion?

Can you tell us about your work with couples?

I love working with couples. I believe there are two basic impulses in relationship — the urge to merge, to become one, to lose oneself in the other; and the desire to pull away, to individuate, to specialize, to curl into oneself and celebrate what makes us unique and different. In relationship work, I watch how these impulses ping back and forth between the members of the unit, triggering old defenses and setting off painful stories. I work with them to normalize these impulses and recognize how the urge to merge can feel like smothering or the urge to individuate can feel like abandonment when we are personally out of balance.

What do you find most rewarding about your work?

This work is constantly humbling. Just as I had to learn how to listen to the wisdom I contain, my clients and I are in an ever evolving practice of trying to learn how to listen to theirs. It is my life's work. I love it.

Therapy sessions with Brian

What will our first session together be like? What happens in ongoing sessions?

In our first session, we start a collaboration that will continue until our work feels complete. By that I mean, we figure out what brings you alive. And by alive, I don't necessarily mean "what makes you feel good." I mean the broad spectrum of being human. Not just joy, creativity, laughter, and desire, but aggression, fear, grief, and physical pain, too.

We start to pay attention to what it is in your life, and in our conversations, that moves the life force in you. That takes time to figure out. But through our conversations together, we start to notice patterns. It might be that you like to do therapy out in nature, where the trees help you feel calm and part of something greater; it might be that you prefer to bring pen and paper to a session and doodle while we chat; it might be that you are interested in mindfulness and want me to lead you in a meditation before we talk about challenging things.

I do not pretend to know how to heal anyone. Together, we find where the life is. And we trust that if we get that life force moving, healing will come on in its own mysterious and powerful way.

How long do clients typically see you for?

I have clients that I've seen for 4 years or more. I love developing long relationships with my clients and watching them move through the world over time. And I also meet folks who work with me for less than a year before we decide together that we achieved what we set out to do.

Are there any books you often recommend to clients?

Do you assign “homework” between sessions?

I don't often assign homework. I might offer a reflection to mull over, or an image that came to mind as I listened to you speak. But I'm not going to send you home with workbooks to fill out. There's enough focus on productivity and achievement in the world to make the therapy room yet another place to judge your worth based on your output.

How do you help ensure I'm making progress in therapy?

We'll set some goals in the early phase of therapy — it could be more peace with or within your body. It might be resolution with your families or deeper relationship with your partner(s). Or you could be trying to figure out how to be less alone with your grief and pain, or something else altogether. But we'll have regular check-ins about how our work is helping you make sense of your life.

I am part of a vibrant consultation community of other therapists and I am lucky to be surrounded by mentors who I can turn to when I'm not sure what a treatment needs. Your details are always confidentially held, but it's not just me guiding our work. It's held in community.

How do I know that it’s time to start seeking therapy?

You might notice that you're starting to pull away from relationships in your life, or that those relationships are starting to involve more and more conflict. A soothing habit like recreational drugs or exercise suddenly takes a hold of you in a way that starts to take a toll on your body. You might be pouring yourself into work in a way that is smothering other parts of yourself. It's that unsettling feeling of losing balance, of not remembering the last time you had it. That's when you start reaching out for help, if you can.

How can I prepare for our first session?

Don't overthink it. Bring as much of yourself as you feel comfortable, but don't force yourself to dive into your most challenging material just yet. There is often so much pressure on us to heal and "figure it out." The therapy room should push us in ways that feel uncomfortable at times, but it shouldn't feel like the classroom, where you're graded on your "progress." Bring a willingness to be curious and your inner wisdom will do the rest.

How will I know it’s time to end my time in therapy with you or reduce session frequency?

If you start to feel like you dread coming into therapy, that's a sign that there's something not moving in the work. In that case I welcome you to bring it up with me (though if I'm doing my job right, I should notice it first!) so that we can discuss what needs to change. In general, if the work feels stuck, then we need to go back to the drawing board. We might change up our format, or our frequency. I might consult with colleagues to ask their advice and see if I'm unaware of a blindspot that's keeping me from understanding you.

Why should I seek therapy, rather than turning to my partner, friends, or other loved ones?

Ideally, you would do it all! You would turn to your partner, to your friends, to your spiritual leaders, to your god, to nature, to a sense of meaning and purpose. But our wounds often make it hard to do that. We carry the sense that what makes us different, makes us a burden to the people around us, and we learn to shut down our feelings and our needs. The therapy room is a practice ground for relearning how to turn outward to the world for the help that we all deserve as humans.

What advice would you share with therapy seekers?

We therapists have degrees and we spend a lot of time doing this work. It gives us an aura of authority. But ultimately, you are the expert on you. If something doesn't feel right in therapy, it's because you're doing something wrong or that you have to try harder. It's that some wise part of you isn't getting seen by your therapist. If they're a good fit, they'll listen to you and try their best to meet you where you are.

Visit Brian’s profile to read more about him and book an initial call!