Therapy with James Nole, LMHCA

James Nole is a Licensed Mental Health Counselor Associate (LMHCA) in Seattle, WA specializing in trauma, relationship issues, disability/chronic medical conditions, grief & loss, depression, and anxiety. In sessions, James draws upon his training in existential therapy and relational psychodynamics, as well as his own personal experience of living with a disability, to help guide his work with clients. He welcomes individuals, families, and couples across the lifespan to his practice and is passionate about creating an individualized treatment plan for every client that seeks out his support.

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

James’s background and personal life

How did you decide to become a therapist?

My path to becoming a therapist was not traditional. After graduating from university in my early twenties with a degree in philosophy, I meandered through various jobs with little direction. Around that same time, the degenerative retinal condition I had lived with from birth started rapidly progressing, and my eyesight deteriorated rather quickly. This sent me down a deep spiral into depression and despair, as I desperately looked for treatments to either slow the progression of the condition or restore some of my vision. None of those treatments worked, and they only seemed to make things worse. After a few years, I had found myself in a place of complete hopelessness, and after a failed suicide attempt, I made my way into therapy.

Through my own therapy, I learned that I did have something to offer the world, that I wasn't completely broken forever, and that I had a gift for listening on a deeper level to myself and others. Out of my own therapy process, I found new hope and set my sights on a new horizon of becoming a therapist. I wanted to let others know that they did not have to go through the dark night of the soul on their own and that they too can find and facilitate a new attachment to life.

What was your previous work before going into private practice?

I worked on a suicide hotline for a few years before and during my graduate studies to become a therapist.

What do you enjoy doing in your free time?

I enjoy playing guitar, writing, composing songs, hanging out with friends, working out, and reading.

James’s specialties and therapy philosophies

What guiding principles inform your work?

The foundation of my work is built on existential and phenomenological psychology, especially the work of Martin Buber. Buber was a Jewish philosopher and theologian who discusses the nature of a true I-Thou relationship between two individuals—which is characterized by a nonjudgemental, confirming, and respectful attitude towards the Other. I also draw from feminist approaches in terms of making the relationship between therapist and patient less asymmetrical and more balanced and even in terms of power dynamics.

Beyond this, my approach is grounded in relational psychodynamic principles, and I strive to create a nurturing and safe environment that possesses compassion and understanding for the suffering patient. I truly want to understand the experience of the Other, even while knowing that I will never fully understand their experience. In this, I hope to help the patient find their authentic self and heal the wounds that they have incurred emotionally throughout their life.

What clientele do you work with most frequently?

I love working with individuals of all ages, from teens to older adults. In terms of what kinds of issues I love working with—I would have to say I enjoy helping clients navigate complex relational trauma, sexual trauma, mood disorders, and personality disorders. I also work with a lot of grief and loss, combined with relational issues that are grounded in childhood traumas and family/relationship issues.

Can you tell us more about your specialty in trauma?

Trauma is quite pervasive in today's world, and it is highly personalized and unique in its expression. It also comes in many forms, shapes, and colors: physical trauma, sexual abuse, or more complex cases of relational and childhood traumas.

Common aspects of trauma show up in three dimensions—hyper-arousal, intrusion, and constriction. Trauma lives in the body, and while it may originate from emotional or mental abuse, it carries with it psychosomatic symptoms. This is why it is important to take a holistic approach in therapy, and understand that when working with trauma, you have to look at the whole person—body and mind. Although trauma often feels as though it will last forever, it can be healed.

Can you tell us more about your specialties in grief and loss?

Grief and loss are natural parts of life, and we are all mourning a loss of some kind. We rarely make room for grieving in today's world, and when mourning or grief are silenced—the loss will emerge later, unless we actually process the emotions. Grief often brings with it depression and anger—both strong emotions we don't typically allow for the expression of in everyday life. Processing these emotions—and learning to sit with them—allows us to mourn the loss while moving to a place of letting go, moving forward, and reconnecting with life.

Relationship challenges are just as varied as trauma in how they show up, though some common issues find their root in power dynamics, intimacy issues, issues with boundaries, and communication difficulties. Regardless of the challenge, holding space for emotions and strong communication is necessary. The challenge often shows up in learning to listen to the Other, accepting things for what they are, and sharing one's own feelings. Developing healthy boundaries, and being able to stay both connected and retain one's individuality, are key in maintaining a strong relationship. Apology, acceptance, and forgiveness are also cornerstones for a loving relationship and are a part of relationship work.

What do you find most rewarding about your work?

I love seeing people develop and find new ways of Being-in-the-World, finding their true selves, and finding a new connection and reason to live. The greatest gift, I believe, that we can give someone is letting them know that they are worthy of love and life. So, perhaps the most rewarding aspect of this work, is seeing patients discover that for themselves through our work together. The transformation can be quite drastic, and their lives can change for the better in ways that no one could ever predict.

Therapy sessions with James

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

First sessions with me are focused on the presenting issue and immediate concerns. After an introduction and greeting, I focus on getting to know you and listen to what brings you in. I'm focused primarily on creating a safe space for you to feel as though you can speak freely and openly without fear of judgment. I'm also trying to understand your experience, empathize with what you have been struggling with, and recognize the emotions you carry. I also want you to get a sense of not only the therapy process, but what I am like and whether or not I will be a good fit for you. My questions are usually focused on getting a clearer picture of your current situation.

Beyond the first session, we then can start to move into your history and relationships. We explore these issues in greater detail and scope to move towards greater understanding and healing.

How long do clients typically see you for?

It truly depends on the issue and what clients are looking for. Some individuals just want symptom relief, while others want to change aspects about themselves that may take far longer as they might be entrenched in one's personality or relational dynamics.

Are there any books you often recommend to clients?

They aren't necessarily therapy books, but I always recommend either Viktor Frankl's Man's Search for Meaning or Martin Buber's I and Thou. There are tons of others that I could recommend, but a new amazing book I highly recommend anyone to read is Galit Atlas's Emotional Inheritance. It's a book about the transmission of intergenerational trauma and the impact of secrets within families, societies, cultures, and within ourselves.

Do you assign “homework” between sessions?

Not typically, unless the patient asks for it. I have found in my experience that unless the patient truly wants to work on things between sessions, it does not improve engagement. I just encourage people to sit with their feelings outside of session.

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

I check-in with the patient on a regular basis. We continually assess goals, and I make observations based on the minor and major improvements that the patient themselves often may not recognize. I take a collaborative approach that is meant to engage both myself and the patient.

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

When problematic patterns emerge, life becomes too difficult to disentangle on your own, or when you keep trying the same things to no avail, it may be time to seek therapy. It's also a good time to start seeking help when you wish to address something before it becomes a larger issue.

How can I prepare for our first session?

Just bring your authentic self.

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

When you feel you have achieved everything you wanted to achieve in therapy (which might change in the midst of the therapy process), it may be time to end or reduce session frequency. Greater capacity for feeling and expressing emotions, new ways of relating, and a creative and fulfilling life are indicators of this as well.

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

Partners, family, and friends can be a source for help, yet they are close to you in a way that prevents a level of neutrality. They can also start to feel overburdened, resentful, or drained if attempting to hold space for others' emotions and issues. And they will not always have the proper skills or training needed to handle more severe issues, such as suicidal ideation or trauma.

What advice would you share with therapy seekers?

Find a therapist who is a good fit for you. Give therapy a real shot, as it might take awhile, or a few therapists, to find a strong connection and the help you desire. When you've found your therapeutic home, let go, relax, and be your real self.

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