Dr. Hoekstra provides Individual Therapy to Adolescents and Adults and Parenting Consultation to parents of very young children through teenagers and young adults. Philosophically, her approach to psychotherapy revolves around a deep commitment to the tenets of Attachment theory. Attachment Theory (founded by British Psychoanalyst, John Bowlby) is a model for understanding how humans develop and grow. Attachment theory suggests that the security of a child’s relationship with their caregiver(s) from birth on is CENTRAL to the nuances of how a child develops, learns, grows and experiences themselves and others in relationships.
Dr. Hoekstra feels passionately that healing and transformation take place most powerfully within the individual and that one’s own healing and self-care can have a powerful impact on those around that individual. Surely, none of us escapes suffering in this world. Dr. Hoekstra believes that a safe, secure psychotherapy relationship can be a powerful vehicle of transformation and healing on many levels—emotionally, physically and spiritually. She believes that healing one’s own pain can be transformative and can emanate outward, contributing to the healing of loved ones, children, partners, families, coworkers and communities. Whether emotional suffering is the result of growing up in imperfect families doing the best they can or is the result of trauma suffered as a child or adult—healing and growth are possible for those who seek it.
Above all, Dr. Hoekstra approaches all patients with compassion and the belief that our wounds—no matter how old or how profound—can be healed. She strives to offer hope and a new beginning to each client.
Mood Disorders are conditions where there is a serious change in mood. These conditions include: major depressive disorder, bipolar disorder, persistent depressive disorder, cyclothymia or Bipolar II (a mild form of bipolar disorder), and SAD (seasonal affective disorder). People who suffer with depression are withdrawn, unreasonably self-critical, irritable, impulsive, or hypersensitive to loss or upset. What is often most difficult about depressive conditions is that the symptoms can interfere with people getting the treatment they need (e.g. low self worth, helplessness and hopelessness.)
An anxiety disorder develops when a person starts to become frightened and alarmed by his or her fear response. We are all born with a wide range of emotional experiences, which includes the feeling of fear. Fear is an automatic and fundamentally helpful response, that aids us if our body needed to respond to an immediate and actual threat, or danger.
With anxiety symptoms, the perception of threat becomes an exaggerated and ongoing state, and most importantly one that gets easily get triggered by things that don’t actually relate to immediate and dangerous threats. These threat perceptions feel very real and convincing. Response patterns such as avoidance, safety seeking, freezing up, or even fleeing are quite understandable, but these patterns then increase a perception of dangerousness in the world around us and also results in the fear response being more easily triggered again.
Anxiety disorders sometimes can run in families. It can also be a response to stress, trauma, or life change-which even includes positive life changes. The important thing to know is that anxiety, while it feels very scary and can contribute to functional issues, is actually treatable. In fact, a lot of people don’t pursue treatment and have life limiting effects, when there is actually a lot that can be done to help an anxiety sufferer.
Dr. Hoekstra is passionate about treating women across their lifespan. Women face unique challenges in their identity development, negotiation of life-transitions and often in their own family of origin. As women negotiate Issues around dating relationships, marriage or partnership, and parenthood, we have lost the community supports that used to scaffold and hold women. For Dr. Hoekstra, psychotherapy is necessarily geared toward providing a supportive relationship in which to heal and grow AND on accessing resources in the community we all need to live and thrive. Life transitions such as separation and divorce, "empty nest" phase, and transitioning back to work can be enormously helped by the presence of an attuned therapist.
"Dr. Hoekstra has a special place in her heart for first time mothers and feels strongly that all perinatal mothers and families are under-served by our current healthcare system. Too many new mothers suffer tremendously and often go untreated for serious mood disorders as they transition to parenthood. This transition is often so profound on every level-biological, emotional, spiritual-and impacts women more than our current society and the healthcare system recognize. Dr. Hoekstra has undergone specialized training in the assessment and treatment of Post-Partum and Perinatal Mood Disorders. She has participated in extensive training on Maternal Mental Health with Post Partum Support International (PPSI) and is a professional provider and Member of Post Partum Support International. She is also a professional member of Post Partum Support Virginia and is registered provider for PPSVirginia. She has also taken the Advance Clinical Training at the Post-Partum Stress Center, LLC in Philadephlia with Karen Kleiman, MSW.
Pregnancy and childbirth are periods of dramatic physiological and emotional transition which leave women vulnerable to symptoms of anxiety and depression. Women and couples need support and holding during this time. One in seven new mothers and one in ten new dads suffer from postpartum depression.
Parents need to know: "You are not alone, you are not to blame, and with help, you will be well."--Post Partum Support International
Children don't come with a manual and there is a great deal of information from the "self-help" world that is overwhelming and often contradictory. Dr. Hoekstra believes that our cultures focus on "discipline, rewards and punishment, and appropriate behaviors" misses the central principal that it is the SECURITY of the RELATIONSHIP with caretakers that is most influential in development, growth, and eventually, healthy functioning as adults. In order to thrive and flourish in our lives, we humans need to know we are loved and lovable--and to this end, Dr. Hoekstra works with parents to enhance their relationships with their children. Dr. Hoekstra is a Registered Circle of Security (R) Parenting (TM) Facilitator. This program is designed to provide early intervention to parents to enhance their child's security in the world. This model is applicable to parents of children of all ages.
Most people experience some trauma in their life time. Trauma can be defined as an overwhelming experience where a person perceives their life to be in danger. This can include accidents, natural disasters like hurricanes or floods, or experiences of one time or going assaults. It is striking how often the prevalence of traumatic experiences and interpersonal violence are denied, minimized or distorted in the US (and around the world for that matter).
Neuroscience has made great strides in the last few years in understanding how the human brain processes traumatic experience differently than non-traumatic experience. When life threat is involved, certain structures in the brain responsible for encoding the experience in memory, organizing memory, and planning and reflecting on experience “turn off” and the memory is largely encoded as a sensory experience or flashes of visual memory. These highly charged memories can be “triggered”—including the terror or shut down that occurred as a result — by experiences in the present that are somehow similar to the original trauma. While far more complex than can be detailed here, the take home message is that individuals with a history of trauma can be triggered into “re-experiencing the trauma” in a way where it feels as though it is happening how. For this reason, it is ESSENTIAL that individuals with a history of trauma who want to work in therapy to resolve symptoms of trauma meet with therapists trained in trauma treatment. VERY OFTEN, talking about the trauma makes one feel worse and can be “re-traumatizing”.
Therapy for trauma involves working with resources for calming and soothing a person, so that the memory can be processed with the person “present”. Some of these resources are already available to the person and some are taught. Treatment needs to proceed planfully, with stabilization in life occurring before a person work on healing from the trauma. For every patient (but especially those involved in witnessing or experiencing domestic violence) both safety and stabilization are the essential, primary goals of therapy. No healing can take place unless one feels safe.
The experience of trauma survivors needs to be understood as the body and brain’s response to overwhelming experience —especially because shame and self-blame are so often felt by survivors. This shame and self-criticism are compounded by our society’s propensity to deny, hide, and turn away from the reality that these experiences occur far too often. Trauma survivors need to know—you are not alone.
Healing and growth can't occur unless one feels safe in the world. Dr. Hoekstra specializes in treating individuals with a history of trauma and those impacted by current or past domestic violence. It is striking how often the prevalence of traumatic experiences, one time or ongoing abuse, and interpersonal violence are denied, minimized or distorted in our society (and around the world for that matter). Many people experience some trauma in their life time –trauma can be defined as an overwhelming experience where a person perceives their life to be in danger. Trauma can take the form of accidents, natural disasters like hurricanes or floods, or it can take the form of abuse (physical, verbal or sexual) or inter-personal violence. Domestic Violence is, by definition, traumatizing to the victim.
One in four women will experience domestic violence in their lifetime and one in four children will be witness to domestic violence in their home. When domestic violence is occurring in the present, therapy is necessarily structured differently and present day safety is emphasized. Safety planning and self-care are of the utmost importance, as well as the education about the impact of domestic violence and trauma on individuals. Dr. Hoekstra prioritizes the well-being of both child and adult survivors. She interacts with legal counsel and law enforcement when appropriate and is familiar with the system of services in Fairfax County and Northern Virginia to provide advocacy, legal advice and safety planning to survivors of domestic violence. She receives ongoing consultation from DMV area expert, Susan Folwell, LCSW, BCDV around domestic violence cases. Through the Women's Center in Vienna, VA, she has lead trainings on the Integration of Trauma Treatment and Domestic Violence for Psychotherapists.
Dr. Hoekstra is supportive of including spiritual exploration in psychotherapy for clients who are interested in exploring this level of experience. She does not impose a particular tradition or school of thought, but seeks to help interested clients explore their own questions and concerns regarding spiritual beliefs and practices. Spiritual exploration is only included in psychotherapy at the specific request of the client.