Therapy with Erik Karff, LMFT

Erik Karff is a Licensed Marriage and Family Therapist in California specializing in anxiety, LGBTQIA, gender, & sexuality topics, perfectionism, and social anxiety. We asked Erik more about his work with clients and his guiding philosophies on therapy.

Erik’s background and personal life

How did you decide to become a therapist?

Growing up I became increasingly intrigued with the ways in which people are different. Throughout my years I have encountered individuals with a variety of mental health challenges - all manifesting in such contrasting ways. I longed to understand the reasons why people behaved, and thought in the ways that they do - rather than stand in judgement.

Further, I have found joy in storytelling, and in these endeavors, I was most interested in people, and the stories of their lives. Within these stories, even when deeply buried, I find that at the core there is an aliveness.

What was your previous work before going into private practice?

I worked in education and business. Out of college I was a National Park Ranger and to this day find the natural world intriguing, enlivening, and healing.

What do you enjoy doing in your free time?

I love music and most things in the great outdoors. I play and write music and have been for years. Also, spending time with close friends and family.

Erik’s specialties and therapy philosophies

What guiding principles inform your work?

I hold the belief that when provided the right conditions the heart, spirit, and psyche will heal itself. In my experience, the most potent way to do this is while in relationship with a non-judgemental, authentic, and curious other. I believe that all of the parts of ourselves - the parts we love, the parts we want to show the world, and the parts we want to obscure and hide - all exist within us for a reason. The work of psychotherapy is creating a space and relationship where one can uncover, understand, and have dialog with these parts in the service of wholeness.

What clientele do you work with most frequently?

I work with adults and children. Many of my clients often feel keyed up or nervous but are unsure why. Many people I see struggle with social anxiety, procrastination, perfectionism, and a loud and controlling self-critic. I widely find myself working with sexual and gender minorities.

Can you tell us more about your specialty in social anxiety?

I find that social anxiety can be crippling to many people, getting in the way of nurturing relationships and a sense of joy and well-being. In my experience, those who live with social anxiety fear how others may respond or react to them or are very concerned with the ways in which they are perceived.

In my work, I have found the correlation between social anxiety, the inner-critic, and body image. The work here is to provide enough safety and support so that some of these seemingly engrained ways of being can be looked at, met, and understood - together. I have found that when this occurs, over time the symptoms that hold people back begin to abate - making more room for meaningful relationships.

LGBTQAI2S+ people face a unique set of challenges in the world. Navigating the different complicated social spheres - the community, work, family, school, expectations, etc can be daunting and stress-inducing. Further, the process of coming out (both to one's self and to others) is an experience unique to LGBTQAI2S+ people.

Societal attitudes around sex, love, gender, and relationships can be projected and carried on the shoulders of LGBTQAI2S+ individuals - oftentimes without their awareness. This can be a heavy burden to bear - alone. Having a safe space to be understood on a deep level, where conversations about relationships, sex, anxieties, gender, and traumas can occur without judgment - is crucial to the healing process.

Can you tell us more about your specialty in perfectionism?

I find that anxiety and even shame exist in the space between the thought of our idealized "perfect" selves and our concrete realities. Many of the people I work with who have increasingly high demands or expectations for themselves and others find that these feelings have carried themselves from early childhood experiences to adulthood.

Often, people who struggle with perfectionism are longing to be flawless and can be petrified of the thought of failure. Yet, under this exists very human needs that were likely unmet or unseen in the past. Further, these tendencies, although they can be quite painful, are encouraged by the culture thus creating an added layer of confusion or dysphoria. Gaining deeper insight into these experiences and their functions can provide people with relief and freedom.

What do you find most rewarding about your work?

I feel honored that my clients allow me into their inner worlds. Bearing witness to my client's processing of complex feelings and traumas while seeing what emerges as the storm clouds begin to part. This is hugely rewarding.

Therapy sessions with Erik

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

Every first session is different! Making that first, in-person (or virtual) contact can feel vulnerable or scary. But, in that first meeting having the experience of being supported through those fears can in and of itself be powerful. I find that these anxieties are often related to the reason why people seek therapy.

Over time, rapport and trust are built. I find that the therapy changes and morphs and new parts of the person reveal themselves - as needed - within the context of the relationship. Many of my clients have reported a greater ease in relationships and with themselves. This is often accompanied by deeper insight and self-compassion.

How long do clients typically see you for?

Some clients are content with seeing me for a few months but, more so than anything, I am a depth therapist and typically see clients for at least a year - and often more.

Are there any books you often recommend to clients?

Do you assign “homework” between sessions?

I rarely do. At times I may invite clients to do self-inquiry or think about something that is particularly relevant to their unique situations. I hold the belief that formally assigning homework is rarely necessary and that if the therapy is working what comes up in the session is carried through, contemplated, and processed through the course of the week.

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

This is an ongoing conversation between therapist and client. There can be moments when the therapy feels alive and moving while other times it feels stuck. Exploring the nature of the process, together, creates a platform for learning, growth, and awareness of change.

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

Some folks feel a sense of worry or darkness that they can't put their finger on. Some are noticing patterns over time that they are having difficulty making sense of.

How can I prepare for our first session?

I think taking pause and turning one's attention inward with curiosity helps to set up one's internal world for therapy. I encourage clients to leave space between whatever activity they are coming from and therapy. Some clients like to take notes - so a notepad can be helpful but that is up to each person. That being said, part of what I do is help my clients "arrive" in the room. Therapy with me can be a place of comfort where one can 'be'.

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

You'll notice a reduction of symptoms, improved relationships with others and yourself.

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

Therapy is a unique type of healing relationship that allows one to show up in ways that no other relationship allows for, fully. The support of one's partner, loved ones, and friends are crucial but a trained therapist will act as a sherpa through terrain that may feel rough or unmanageable.

What advice would you share with therapy seekers?

Trust your gut.

Visit Erik’s profile to watch his introductory video, read more about him, and book an initial call!