My work as a therapist and coach is characterized by intuition, compassion and a deep respect for the mind-body connection. My approach blends psychodynamic theory, elements of cognitive behavioral therapy, interpersonal neurobiology, EMDR therapy, mindfulness and effective approaches for couples and relationships. These techniques are effective in helping clients heal obstacles to health and well-being, address unresolved trauma and enjoy satisfying personal and professional relationships. Please take some time to look through my website to learn more about emotional health and wellness and my psychotherapy and coaching practice in New York City.
Kimberly Seelbrede, LCSW is a licensed Psychotherapist, Coach and Consultant working with international and Manhattan-based clients and has extensive post-graduate training and experience working with individuals, families and couples. As a mind-body practitioner, Kimberly has expertise in lifestyle and stress management and works to create a unique and integrative psychotherapy practice for her clients. She skillfully blends psychodynamic psychotherapy with elements of CBT, DBT, mindfulness, EMDR therapy, mind-body techniques, self-care practices and wellness coaching. She sees therapy clients in her Manhattan office and consultation and coaching clients in-person or online via Skype, FaceTime or a HIPPA-compliant platform
Kimberly understands the unique demands of high-profile and talented individuals and has a special understanding of celebrity mental health concerns. The majority of her clients are high-functioning New Yorker's who struggle with stress, anxiety and mood issues, performance blocks, emotion regulation, addictions, eating disorders, trauma, life transitions and spiritual concerns. In their busy lives, they seek life-balance support, increased resilience, support for unhelpful patterns and habits and improved professional and personal relationships. As an integrative psychotherapist, Kimberly incorporates a holistic approach, offering alternative treatments to medications for anxiety, depression, ADHD and other health concerns including hormonal imbalance, chronic pain, illness and autoimmune disorders. As an EMDR expert, Kimberly is delighted to offer this alone for trauma resolution or integrated into regular psychotherapy sessions. In Addition to EMDR therapy, Kimberly offers mindfulness and focusing techniques for clients open to mind-body and somatic therapies.
In addition to her advanced EMDRIA-certified training, Kimberly has received specialized training with the William Alanson White Institute For Psychoanalysis for eating disorders, addictions and compulsions, couples training with the Gottman Institute and Emotionally Focused Therapy or EFT, mindfulness, nutrition guidance and integrative yoga therapy with The Urban Zen Foundation. Kimberly Seelbrede maintains relationships with talented professionals who offer such services as meditation, mindfulness coaching, nutrition, chiropractic treatments, acupuncture, psychiatry, psychopharmacology and massage therapy. She coaches and counsels private clients, couples, families, entrepreneurs, politicians, celebrities, actors, musicians, artists and Fortune 500, C-Suite executives.
New York University Graduate School of Social Work
EMDRIA-Approved EMDR Therapy I + II Advanced Attachment-Based
New York University Post-Master's Certificates - Advanced Cognitive Behavioral Therapy, Advanced Clinical Practice, Clinical Approaches To The Addictions, Clinical Practice With Adolescents, Spirituality And Social Work, Psychodynamic Psychotherapy
Brainspotting - BSP
Psychotherapy + Counseling
Couples + Relationship Counseling
CBT, DBT, Crisis Counseling
Family Therapy + Support
Distance + Online Counseling
Anxiety, Trauma + Depression
Consultation + Coaching
Executive + Peak Performance
Clinical Consultation + Referrals
Lifestyle + Stress Management Coaching
Integrative Therapy + EMDR
Meditation + Mindfulness
Integrative Therapy Workshops
Stress Reduction Workshops
Integrative Psychotherapy + Coaching For Individuals + Couples
- Gain support through a personal crisis, transition, loss, trauma or challenging situation
- Using EMDR, increase capacity to experience calm and comfort in the body, release trauma, uncover hidden blocking beliefs that may be sabotaging success and happiness or contributing to anxiety and depression, reduce the impact of negative experiences
- Address dissociation, body image, eating disorders, compulsions, addictions, substance use or abuse and obsessions using cutting-edge therapies such as EMDR, Focusing, Somatic Experiencing techniques & Brainspotting
- Break through blocks in intimacy; recognize unhealthy relationships; break patterns of repetition in significant relationships
- Learn to identify triggers that lead to anger, confusion and relationship dysfunction
- Learn more adaptive coping skills and develop nurturing self-care rituals
- Process and heal painful feelings of loneliness, disappointment, sadness, loss, grief, guilt, shame, anger, envy and fear
- Develop enhanced attention and awareness through relaxation techniques, mindfulness and radical acceptance
- Resolve trauma and abuse symptoms, develop healthier boundaries and heal early attachment wounds
- Unearth parts of yourself that are dissociated and explore areas of spirituality and your true nature
- Heal physical symptoms of disease and pain by connecting to habitual thoughts, unexpressed emotions and trauma
Through the lens of relational, attachment-based and psychodynamic-informed approaches to therapy and counseling with her clients, individuals and couples are able to understand themselves and their relationships, as well as any unconscious internal conflicts that interfere with personal development and goal-attainment. Without insight, conflicts and the unconscious drives dynamics and behaviors that lead to anxiety and mood problems, addictions, self-destructive patterns and unhappiness. When clients are able to explore, understand and finally work-through underlying conflicts, symptoms are greatly reduced and individuals and couples are less likely to repeat patterns and experience freedom and enhanced self-esteem. Additionally, avoidance and fear of anger or other strong emotions, self-sabotage or self-defeating patterns, fear of intimacy and closeness, and boundary issues can be addressed. Emotional healing and change occurs in the context of healthier relationships and research reveals that through the relational process of being in a healthy relationship with another, clients develop the freedom to relate to others, to practice new behaviors, to feel safe enough to be "seen" by others and experience freedom from anxiety and fear. In the context of a safe and supportive counseling relationship, attachment theory and neuroscience reveals that new neural pathways can be established, traumatic experiences can be healed, the parts of us that become "stuck" in the past can be understood and worked through.
Kim Seelbrede is a highly-trained psychotherapist and utilizes a mind-body, integrative style of treatment in her private practice with Adults. Integrative psychotherapy means that techniques and strategies from evidence-based therapies are combined with cutting-edge treatments to create an individualized treatment plan, with the goal of addressing patient. Psychoanalytically-informed and relational psychotherapy is the foundation of her therapy approach to which other forms of therapy such as EMDR Therapy, Focusing, Mindfulness and Somatic Experiencing Techniques can be blended as needed.
Generalized Anxiety Disorder, Panic Disorder, Agoraphobia, Social Anxiety Disorder, Separation Anxiety, Phobias, Obsessive-Compulsive Disorder, And Post-Traumatic Stress Disorder (PTSD)
Kim Seelbrede uses a very effective protocol and combination of techniques when working with clients who struggle with anxiety. Her high success rate for helping clients overcome anxiety using combined mindfulness, CBT and EMDR techniques means that clients experience healing at the level of the nervous system, as well as gaining important self-empowerment tools to handle future situations. With fewer anxiety symptoms, her clients report an improvement in both personal and professional aspects of their lives in addition to improved productivity, motivation, focus and a decrease in procrastination. Using the nervous system healing techniques of EMDR combined with the emotion and thought management techniques of CBT, clients are able to effectively control their anxiety symptoms. Because CBT is skill-based, clients feel empowered and are able to manage and control their anxiety symptoms. Because EMDR therapy heals at the level of the nervous system, clients find that they spend less time doing CBT homework, and are more often than not, able to maintain and return to a state of self-regulation.
Major Depression, Dysthymia, Postpartum, Premenstrual, Seasonal Affective, Atypical, Situational, Bipolar
Depression and anxiety symptoms are a common reason teens, adolescents and adults seek treatment. Therapy and the support of talking with a therapist helps resolve depression and anxiety symptoms for many. Psychotherapists and psychologists are trained to provide their clients with helpful tools, coping skills and ways to challenge and change or accept the thoughts, feelings and behaviors that may contribute to depression. Understanding the source of the problem or situations that trigger depressive episodes may not always lead to symptom relief. Kim Seelbrede uses an integrative approach when working with depression symptoms that includes: psychodynamic psychotherapy, interpersonal therapy, cognitive therapy, EMDR therapy, lifestyle changes, mindfulness and acceptance. For some, a combination of psychotherapy and medication offers the safest, most comprehensive healing approach. Milder forms of depression can be effectively treated with supportive lifestyle changes.
ABOUT EMDR THERAPY
EMDR treatment is based on the neuroscience of the brain and uses the technique of alternating bilateral stimulation to process through memory networks and release the emotional charge associated with distressing thoughts, memories and blocks. Compared to traditional forms of cognitive behavioral therapy or CBT, EMDR has proven to be extremely effective in treating even the most problematic issues in fewer sessions. Because EMDR therapy addresses the root cause and heals at the level of the nervous system, clients have a better chance of achieving healing without needing to return to therapy. EMDR therapy identifies and addresses experiences that have overwhelmed the brain’s natural coping capacity and resilience, which has led to traumatic symptoms and harmful coping mechanisms helping clients reprocess traumatic information leading to a peaceful resolution. Negative, painful thoughts and beliefs are replaced with more adaptive and realistic, here and now, self-concepts. EMDR therapy is particularly supportive for clients who need to strengthen inner resources and develop self-soothing techniques. Kim Seelbrede is a level I & II EMDRIA-trained EMDR and Brainspotting clinician with a private psychotherapy and consultation practice in Manhattan. Learn more about EMDR Therapy here.
addiction treatment + EMDR Protocols for Addictions + Compulsions
Kim Seelbrede views addictive behaviors as symptoms of other underlying, unresolved issues and has developed a special interest in recovery support as well as having received specialized training in this area. Addictions such as substance abuse and process addictions are complex problems and can be successfully treated when other co-occurring difficulties are addressed, such as depression, panic disorder, ADD, Aspergers and personality disorders. Many may have more than two conditions that contribute to maladaptive coping responses. Some common addictions include: alcohol, drugs, gambling, food, shopping, video games, the internet, sex, pornography and work. Successful treatment for addictive behaviors is an integrative approach that may include some combination of psychotherapy and behavioral treatments. EMDR therapy using addiction protocols, psychodynamic psychotherapy and dialectical behavior therapy or DBT skills are also very effective forms of treatment. Learn more here.
Couples + Marital Therapy, Relationship Counseling, Pre-Marital Counseling
Couples therapy or relationship counseling is designed to help clients work through relationship and communication problems and create or reconnect to love, mutual respect and intimacy. I work with high-functioning couples and couples in crisis to help them heal, listen for and understand the emotional needs of the other. Effective couples therapy should provide helpful feedback, support and guidance so that communication can feel safe and constructive. Additionally, couples can learn tools to navigate problems, work through conflicts and increase the attachment bond, which results in deepened intimacy and trust. Kim Seelbrede works with heterosexual and gay couples and has received training with The Gottman Institute and integrates principles of EFT or Emotionally Focused Therapy and Non-Violent Communication into sessions with clients. EFT or Emotionally focused therapy is an intervention based on scientific studies about the adult bonding and love in couples. EFT also focuses on helping couples address and resolve distress in intimate relationships. Emotionally Focused Therapy can also be used to support family members during family therapy focusing on attachment and emotional connection. Couples seeking counseling to reconnect to love and improve their relationships may find EFT beneficial as it fosters deeper understanding of their own and the emotional responses of significant others in their lives.
Therapists who provide emotionally focused therapy typically work with couples and families to help facilitate the creation of secure, lasting bonds between intimate partners and family members and reinforce any preexisting positive bonds, with the goal of helping those in treatment increase security, closeness, and connection in intimate relationships.
What Gottman's Research Tells Us About Relationships
- Emotional distance can be as destructive to a relationship as conflict
- The way a couple fights, repairs and resolves problems is more important than what they fight about
- Attachment insecurity leads to conflict and or distance
- In distressed relationships, some partners shut down and withdraw as a way to manage intense emotions
- Couples must nurture fondness and respect for the other in order to thrive together
- Couples need shared meaning in their lives to remain connected
Couples therapy or relationship counseling supports couples experiencing external stressors such as illness, job loss and family conflicts as well as natural shifts in couple dynamics and roles. Some individuals benefit from individual sessions without their partner to help them work on personal challenges and relational needs before working together with a couples therapist. Kim Seelbrede counsels individuals and couples in various types and stages of relationships including: pre-marital counseling, marriage counseling, committed relationships, open relationships, as well as those considering separation, divorce, newly-single and dating again. Sessions are available weekly, bi-monthly or as weekend intensives in her Manhattan-based office or online via FaceTime or Skype. Learn more about relationship and couples counseling here.
Personal + Executive Performance COACHING
Clients seeking coaches are not looking to heal issues rooted in the past, nor are they looking for an expert to help them understand and explore complex family dynamics, neurotic patterns, conflicts or trauma. While the past may interfere with goals and moving forward, it is only addressed in an effort to understand what may be blocking a client from moving forward. The focus is always on clearing the path and any blocks, as needed, to help clients become more available for a new reality and way of life which includes creating goals, strategizing, taking action and gaining accountability. Generally speaking, coaching clients are men and women who are busy, self-directed, goal and performance-oriented and often, high-achievers, who thrive using personal accountability, honesty, feedback, perspective shifting, action steps and focused, challenging questions. Partnering with a life coach can be supportive, encouraging and empowering. Coaching can help clients navigate change and restore balance and enhance life-satisfaction. Whether you're interested in taking control of your health concerns, peak performance, blocks, losing weight, breaking a habit, repairing a relationship or transitioning to a new chapter in life, coaching can provide the needed inspiration, knowledge, accountability and results that you desire. When clients are interested, I combine EMDR with coaching for optimal results. Read more here...
I Enjoy Working With Creatives, Entrepreneurs And Professionals Who Are In Need Of Dynamic Coaching And Support In These Areas:
- Change + Challenges - breakups, separation, divorce and other major life-transitions
- Passion + Purpose - discovering what you really love to do
- Healing + Personal Empowerment - learning to communicate your needs in healthy ways
- Self-Love + Self-Care - discovering your strengths, talents and possibilities
- Happiness + Inner Peace- aligning or re-aligning yourself with your true nature and developing intuition
- Goals + Dreams - identifying goals and taking action
- Weight Loss - undoing bad habits while creating new, healthier possibilities
- Health - support and coaching for chronic health concerns including cancer, chronic pain and autoimmune disorders
- Creating Prosperity + Abundance - removing blocks and opening to potential and possibilities
- Love + Relationships - breaking old patterns and habits and attracting the right relationships
SELF-CARE, MINDFULNESS & INTEGRATIVE THERAPY
As a mind-body psychotherapist specializing in trauma, emotion regulation and stress management using EMDR therapy, Kim Seelbrede, LCSW works with individuals and couples from an experiential, intuitive and present-focused, mindful perspective. She regularly teaches her clients the basics of meditation and gives them the tools to create a mindfulness meditation practice. She works with beginning practitioners as well as individuals who are looking for support with emotional and health challenges. Many clients are interested in creative approaches such as guided imagery and body scans which can also support wellness goals. As a registered yoga therapist (200 + 500 hrs) and a Reiki practitioner, she regularly recommends a variety of helpful practices for her clients including referrals for energy or body work such as: acupuncture, craniosacral therapy (CST) and Phoenix Rising Yoga Therapy, as examples. Integrative therapy may include some combination of the following: meditation support, mindfulness, breathing techniques, stress response training, guided imagery, somatic psychotherapy, Focusing, Brainspotting and EMDR therapy to help clients strengthen inner resources and develop self-soothing techniques with the goal of a healthier life-balance.
Kim Seelbrede trained with Donna Karan's groundbreaking Urban Zen Foundation and the Urban Zen Integrative Therapy Program (UZIT) and mentored students in the UZIT 2010 program. As a registered yoga therapist she received training in five key modalities: yoga therapy, Reiki, essential oils, nutrition and contemplative care, to address the needs of patients in the healthcare system, medical professionals and caregivers. She is comfortable working with patients receiving conventional and alternative treatments for a variety of conditions. Some examples of chronic health conditions that benefit from self-care support and advocacy are the following: Fibromyalgia, Chronic Fatigue Syndrome or CFS, arthritis, MS, Lupus, asthma, obesity, hypertension, diabetes, Lyme disease, autoimmune thyroid disorders (Hashimoto's & Graves), depression, IBS, IBD, hormonal imbalance and diseases of aging as a few examples.
Self-care is not being selfish or indulgent, it is the ability to care for one's own emotional needs and interests and set boundaries. Individuals with low self-esteem, depression, anxiety, dependency issues and codependent individuals fail to care for themselves, often until it's too late and they become sick. Conventional medicine rarely addresses the root causes of many of these chronic conditions, and treats only the symptoms. A whole-body approach gives clients the choice to make radical lifestyle changes that may actually cure these common diseases, or at least greatly reduce symptoms and suffering. Learn more about Urban Zen Integrative Therapy here.
RECOVERY SUPPORT + AFTERCARE
Kim Seelbrede works with individuals just released from addiction or eating disorder inpatient rehab and provides support in the form of individual psychotherapy, EMDR trauma treatment, and when helpful, family therapy.
Consultation For Family Members
Getting a loved-one into treatment and finding the right program requires help, support and resources. It's difficult to do this alone. Additionally, family members experience strong emotions related to the experience of having a family member who is addicted and at-risk.
Recovery support can help clients and family members with the following concerns:
- Maintaining motivation and staying focused on personal goals
- Support for creating healthy and safe boundaries for self and others, identifying needs, communicating effectively, learning to ask for help, and self-empowerment
- Repairing relationships and gaining support for maintaining the energy, passion and desire for healthy relationships
- Help with engaging in activities and relationships that replace the desire to use drugs or engage in harmful behaviors
- Creating a self-care practice that nourishes mind and body, maintaining support and positivity
- Learn to identify cravings and triggers
- Celebrating important gains and achievements and learning to make healthier choices
- Support with structure, activities, exercise, nutrition, socializing and sleep hygiene
- Help with learning to be present, tolerate discomfort and live in the present moment
CONSULTATIONS, REFERRALS, PROFESSIONAL SUPERVISION
Consultations And Referrals
Kim Seelbrede, a New York State licensed psychotherapist, offers psychological consultation and guidance to individuals and families, helping them move through personal and life challenges, a difficult transition or a crisis -- it is supportive, proactive and preventative in nature. Clients benefit from the expertise of working with a highly-trained clinician who provides a focused, solution-based approach using assessment, education, guidance, advice and resources. One example might be a family member who is struggling with an addiction and/or a mental health issue. Consultations tend to be time-limited and problem or goal-oriented in nature. Consultations allow a client, parent or family member to explore concerns and to make decisions or changes in their lives that move them forward in a helpful direction.
The consultation process is an opportunity to speak about a crisis, or problems and concerns in one's current situation or to gain a second opinion. What makes this different from ongoing therapy is that the experience is limited -- usually one or two sessions, and is not meant to replace ongoing therapy or counseling. A consultation can help a client gain advice, insight, perspective, guidance and resources for their particular circumstance. At the end of the consultation process, clients are offered an assessment of the situation, a recommendation for treatment if needed, and possible referrals to allied professionals, complementary/alternative referrals, medical doctors or other psychological services such as psychopharmacologists or psychiatrists. Because of the nature of the consultation process, clients are offered sessions in Manhattan or online using Skype or FaceTime for convenience. Learn more here.
Professional Supervision And Private Practice Building
As an integrative psychotherapist, Kim Seelbrede enjoys helping psychotherapists, psychologists, counselors and marriage and family therapists integrate mind-body techniques into their work with clients. Specifically, her expertise includes helping professionals incorporate complementary modalities such as relaxation techniques, guided imagery, mindfulness, grounding techniques, breathing exercises, self-care and meditation into their work with clients. She is delighted to provide private practice building support and clinical case consultation to new practitioners or to those interested in increasing their awareness of issues impacting therapy in an effort to deepen their work with their clients or patients. Professional case supervision can be counted toward the requirements for clinical social workers in training.
In her private practice, Kim Seelbrede practices psychodynamic and interpersonal psychotherapy, also integrating cognitive therapy, CBT, DBT skills, mindfulness, acceptance, solution-focused therapy, focusing techniques and EMDR therapy. When working with couples, she enjoys using her training with The Gottman Institute as well as EFT and Non-Violent Communication (NVC). Kim Seelbrede provides clinical supervision to new therapists working towards licensure as well as helping psychologists, psychotherapists and counselors integrate mind-body techniques into their practices. Kim Seelbrede has been a student of psychology for decades and has enjoyed learning and gaining new skills from a variety of traditional disciplines as well as cutting-edge techniques. She enjoys the healing results and creativity of weaving various modalities into her work with clients when helpful. She consults, practices psychotherapy and has international coaching clients that she sees in-person and worldwide via telephone, Skype, FaceTime or HIPPA compliant videoconferencing.
Kim's nature is curious, non-judgmental and compassionate; her psychotherapy and consultation practice reflects her core values of respect, integrity and kindness, as well as offering a flexible and eclectic approach to treating psychological and somatic symptoms. Her clients describe her as intuitive and warm, and particularly helpful for clients who are seeking counseling for the first time. Psychological counseling is not only a place to explore personal struggles, but also a place to feel supported as clients celebrate and enjoy personal growth and success. Private consultations tend to be time-limited and offer clients the opportunity to gain professional knowledge and guidance to help and evaluate a particular issue or situation regarding themselves or someone they care about. Psychotherapy sessions tend to be most effective when conducted weekly or twice weekly. Executive, mindfulness, wellness and stress management coaching sessions are client directed and conducted as needed.
HOW CAN THERAPY HELP YOU?
- Life is improved by identifying important thoughts, feelings and motivations
- Change and growth occurs when clients develop a deep understanding of self and others
- Break through blocks in intimacy, detach from unhealthy relationships, develop healthy personal boundaries
- Recognize and break through obstacles, negative patterns and self-defeating behaviors
- Gain support through a personal crisis, transition or challenging situation
- Identify problematic thoughts and triggers that lead to anger, confusion and relationship dysfunction to allow for more satisfying relationships
- Gain the necessary insight and self-awareness for change to occur
- Become more confident, effective and assertive in personal and professional relationships
- Uncover hidden blocking beliefs that may be sabotaging success and happiness with the help of EMDR therapy
- Learn more adaptive coping skills, self-care rituals and habits
- Address body image, eating disorders, compulsions, addictions, substance reliance and obsessions
- Process and heal painful feelings of loneliness, disappointment, sadness, loss, grief, guilt, shame, anger, envy and fear
- Develop enhanced attention and awareness through mindfulness and radical acceptance
- Resolve trauma, abuse and PTSD symptoms as well as heal early attachment wounds
- Develop self-care rituals and work towards enhanced physical health and life-balance
- Celebrity mental health expertise
- Trauma -- Sexual, physical and verbal abuse, repeating family dynamics, violence, witnessing or involvement in crime, catastrophic events, rape, accidents
- Sexual Disorders -- Difficulty during any stage of the sexual act (desire, arousal, orgasm, resolution) that prevents or limits the enjoyment of healthy sexual activity, either alone or in the context of relationships
- Creativity and Success -- Blocks in writing, creating and producing, repetitive patterns of self-sabotage and self-defeating patterns, perfectionism, fear of failure, fear of success, neurotic undoing
- Communication Difficulties and Relationship Problems -- Difficulties identifying and expressing emotions and feelings, feeling victimized, attacked and blamed, defensiveness, problems listening or understanding the other, feeling easily angered and triggered, frustrations due to not feeling heard or seen, violent or destructive communication patterns, problems with intimacy or maintaining relationships, adult children of alcoholics, family of origin problems
- Postpartum, Parenting Issues, Family Problems and Crisis Counseling -- Feeling easily frustrated, alone or isolated, overwhelmed and confused, difficulties communicating feelings and needs, exhaustion, helping a loved-one get sober, mental health issues affecting family members
- Anxiety -- Panic attacks, generalized anxiety, fear, excessive worry, phobias, obsessive-compulsive behaviors
- Depression -- Major Depression, Dysthymia, Bipolar Disorder, sadness, irritability, social withdrawal, hopelessness, sleep disturbances, guilt, lack of desire, poor concentration.
- Eating Disorders -- Compulsion to eat or not eat as well as other disturbances in body image and thoughts, beliefs and behaviors affecting physical and mental health.
- Addictions -- Destructive coping mechanisms and compulsions to engage in specific activities despite negative consequences to one’s health, mental state, career, family and social life as well as co-occurring or underlying mental health problems such as ADD, anxiety, trauma and depression that may have led to the reliance on substances or problem behaviors
- Recovery -- Support for individuals in all stages of recovery from addictions, alcohol, eating disorders, anxiety, depression and trauma (pre-rehab, post-rehab or residential step-down support), wellness planning, practicing new habits, maintenance and self-care
- Life Changes -- Transitions in the life cycle that cause emotional, psychological and physical challenges (new relationships, marriage, birth of a child, aging, perimenopause, menopause, ending relationships, separation, divorce, career or job struggles, death of loved one, becoming sober or challenges to maintaing sobriety