DR RACHAEL VAUGHAN LMFT

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    • Menopause and peri-menopause
    • Workplace bullying and abuse
    • Adult ADHD
    • Chronic fatigue and burnout
    • Trans-affirming therapy for the San Francisco Bay Area and Northern California
  • Articles etc
  • supervision
  • Contact
  • En français
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  • Home
  • Specialities
    • Menopause and peri-menopause
    • Workplace bullying and abuse
    • Adult ADHD
    • Chronic fatigue and burnout
    • Trans-affirming therapy for the San Francisco Bay Area and Northern California
  • Articles etc
  • supervision
  • Contact
  • En français
  • Testimonials
specialities

menopause and peri-menopause

You can get through menopause happy, healthy and strong. I know this from experience. But what I also know is that women don't talk about menopause enough with each other. So all our questions ("Should I do hormone replacement?" "Is my sex life over?" "How do I deal with being angry all the time?" "How do I age with strength and without losing who I am?")
go unanswered. Too many women struggle alone, in silence.
And if you're trans-masc or GNB, it can be even trickier to think and talk about.
So if you're finding this stage of life challenging, reach out. You don't have to do it alone.

workplace issues

work life balance

I spent 20 years in international business, working at small start-ups and Fortune 500 companies, so I have insider knowledge of the corporate world and the pressures it can exert. I help professional clients with a variety of career goals, including better work-life balance, identifying limiting beliefs and other blocks to success, and working toward career change.

WORKPLACE BULLYING AND ABUSE

 Workplace bullying is rife. I can't help with the legal side, but I can help you cope with the pervasive negative influence such things can have on your self esteem and your sense of agency. I can help you map out how you want to respond to the situation, and work out how you can best take back your life.
The dangers of not taking enough vacation are described in this Business Week article.
Some of the effects of stress are listed in this article from the Mayo Clinic. The Workplace Bullying Institute is here.

CHRONIC FATIGUE AND BURNOUT

As a chronic fatigue survivor myself, I understand what it's like to be so indescribably tired that you cannot remember what it felt like to be you. I can help you navigate the process of stabilizing, managing, and then, hopefully, healing. 

ADULT ADHD

Adults with ADHD have a mix of superpowers and strange areas of incompetence that confuse us, because we ought to be able to do it, but we just can't. When we're interested, we're all in with total focus. When we're not, we space out or get twitchy. As an ADHDer myself, I work with you to understand limitations, build strategies to help with concentration and focus, reframe past experiences, and work toward building a life that's less exhausting. 

relationships and separations

finding a partner

I work with singles who want to stop dating unavailable others, and improve their chances of finding and keeping a satisfying partnership. Relationship involves finding a suitable partner, but it also involves locating an authentic self from which to relate. For most of us, that can take some excavation. We'll look at your family history, the beliefs you've built up over time about yourself and relationships, and talk about how you can more authentically be who you are and interact from there.  

surviving DIVORCE AND separation

Recovering from divorce or separation usually follows several stages. First of all, you need to survive the shock of finding yourself alone among the wreckage of your former life. Even if you wanted it, divorce can be devastating.
Next comes picking up the pieces and creating a new life: finding a place to live, managing the feelings that come up, coping with grief and anger, dealing with legal and custody issues. Then you'll be working out who you are now you are no longer partnered. Certainly not the you that you were before you got married. Finding your new self takes a while, as you establish your new life and enrich it over time. Re-entering the dating world can sometimes be daunting.

adult children of alcoholics

ADULT CHILDREN OF ALCOHOLICS: I work with ACOA clients to identify and understand the ways their childhood with an alcoholic parent continues to affect them today. Fear of abandonment, and long-learned communications patterns often afflict relationships. Extreme sensitivity to criticism and difficulties with authority figures, as well as feelings of not fitting in, are ACOA traits that can affect your career.
ACOAs often have a hard time inhabiting their own experience, so we'll work on knowing what you know, and feeling what you feel, as well as on authentic, appropriate self expression and boundaries--so you can be more truly yourself both in solitude and in relationship. We'll look back into the past, and work on issues in real-time in the present, in order to unlock the structures that limit you. There's grief work involved here, but there is also joy, and growing self confidence.
Here is a screening quiz for ACOA people. It's not the last word, but it might be helpful.

international people

IMMIGRATION, third culture kids AND CULTURAL IDENTITY

The stress of migration is a factor in the lives of many people. The grief of leaving home, the stress of immigration into a new country, fear of deportation--these are at the sharp end of the scale. But many of us also struggle with more subtle issues of how to feel at home in a foreign language, or in a culture that is different from our own, sometimes confusingly so. I understand what it's like to come from another place, span several cultures, and/or operate in two or more languages. Born in Asia, I hold a UK passport, lived for most of my adult life in France, and became a naturalised US citizen. Issues of cultural identity and displacement are very close to 'home' for me, as a third culture kid, as they are for many of my clients. 

EXPATS AND AMERICANS MOVING TO FRANCE

Sometimes the reality of ex-pat life doesn't live up to your dream. But don't give up on your new country yet; there are ways of negotiating strange customs, stressors you weren't expecting, and simply missing home. I've been through it, and I get it. 

LINEAGE trauma and resilience

We are affected not only by things that happen to us personally, but also by things that have happened in our lineage, to our parents, grandparents and ancestors. These traumas have often been forgotten, or hidden away in secret, relegated to the unconscious realm. They can cause physical symptoms, phobias, depression, nightmares and other unexplained things. But remember, wherever there's a trauma story, there's also a resilience story.
We use family trees, photos, maps, family myths and stories, and other material, to piece together the story of what happened and undo some of the lingering pain of traumatic memories and haunting images. Creative expression or ritual can help to release the ghosts and grieve the losses, as well as call in other narratives, helpful legacies and new possibilities.
By making the trauma in our lineage and in our culture more conscious, we can loosen its hold on--helping to restore a sense of our own self and our own freedom of choice, and allowing what is not ours to rest in peace.

climate psychology 

Climate-related emotions are real. If you're feeling fear, despair, rage, grief, or other feelings based on the unfolding climate catastrophe and its impact on the world, you are not alone. I'm a member of the Climate Psychology Alliance for this reason.

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 Dr Rachael Vaughan LMFT Integrative depth psychotherapy for women and AFAB people. Trans-affirming and queer-friendly, specialising in menopause, burnout, workplace bullying and abuse, and ADHD. Online in Silicon valley, San Francisco Bay Area, Los Angeles, Northern California and international for expats. Copyright 2026