A blog post by Melissa Ruisz Nazario, based on an interview with Mai Breech, conducted by Bonnie Bright, Ph.D.
Mai Breech, a Psy.D. doctoral student in Clinical Psychology at Pacifica Graduate Institute, has a long history of working with orphans and foster children. In 2007, she founded the Children’s Art Village, a grassroots non-profit organization providing art and music to children in Ghana, India, and Nepal so that they can express their creative selves through a means that doesn’t require language, but rather utilizes their creativity. Over the years, the Children’s Art Village has served over 3,000 children annually, and continues to do so. Typically, the programs are summer programs, offering art and music camps for these children in very different orphanages that she partners with.
In her graduate work, Mai’s main area of therapeutic focus is on childhood trauma and attachment. Her experience working with these orphans translated easily to her practicum experience of working with foster children, specifically foster children who are now young adults and have aged out of the care system. The agency that she has worked with for her practicum, called Ready to Succeed, helps former foster youth with attaining higher education, job placement, internships, training, interviews, and full-time placement.
While the young adults that she works with are extremely bright, Mai relays the staggering statistics that out of the 400,000 children in the foster care system, 25,000 age out of the care system, and only 3% of those, so less than 700, go on to get a higher degree, such as an undergraduate or professional degree.
Mai works with the young adults who fall within that 3%, and she’s observed that all of them have mental health issues. Their mental health simply hasn’t been addressed. They can set goals for achievement, but they struggle with getting better from an emotional perspective.
And that’s where Mai’s role as a clinician comes in. She uses the psychoanalytic attachment system in her work, and is interested in how that relates to intrinsic motivation and if there are interventions that can help stimulate intrinsic motivation to further a youth’s success in having a healthier outlook on life, feeling more content, having a secure place to live, and so on.
British psychologist John Bowlby, M.D., who is considered the founder of psychoanalytic attachment theory, described secure attachment as “lasting psychological connectedness between human beings.” From an evolutionary standpoint, attachment likely formed because infants who displayed attachment and proximity to caregivers would get their needs met and survive, especially in the face of danger. 
There are four markers of a secure attachment bond between the child and caregiver. First, the child wants to be in close physical proximity of the caregiver. Second, the child experiences separation distress when the caregiver leaves, what we commonly understand as “separation anxiety.” Third, when the child feels a sense of danger or anxiety, he or she will retreat to the caregiver. And finally, the child explores the surrounding area while regarding the caregiver as a safe haven or “home base,” knowing the caretaker will offer protection in the face of danger. 
What Mai has found in her individual therapy work and support groups with these youth is that none of them had a secure attachment to their primary caregiver, most often their biological mothers. Instead, she sees a lot of ambivalent attachment as well as anxiety attachment, and mostly disorganized attachment. Mai explains that disorganized attachment, conceptualized by Mary Main, “is when the mother is both the place to go for warmth and care but at the same time is a frightful person. And so, what that creates later in life is a sense of disorder, disorganization, and what results ultimately most of the time is disorders such as borderline personality.” Mai also points out that when the youths experienced ambivalent attachments with their mothers early on, they usually experience anxiety, despondency, and depression later in life.
Mai both advocates for and utilizes different interventions to help support these youths as they transition into adulthood, such as having adult role models and mentor-mentee programs, as well as logistically funneling money into the right resources so that they’re used productively. She also supports more education programs and resources to teach foster parents who may struggle with the unique challenges of fostering children.
Mai also finds opportunities to use depth psychological tools in her therapeutic work. For example, she’s hosted a support group for former foster students and will invite them to share an image from their dreams or an image from a recurring dream, in order to bring it forward into community. She explains that she learned that an image always wants to be in relationship with you when she participated in the Dream Tending Program at Pacifica Graduate Institute with Dr. Stephen Aizenstat. Mai has observed that the youth are excited to share their images, and while the images themselves can be scary and/or profoundly insightful, bringing the images into community for them all to share and hold has been quite powerful.
In her individual clinical work, Mai also encourages clients to share their dreams and use active imagination. In one instance, one of her clients had a recurring dream of flying above the ocean. The time of day and settings in the client’s dream would change, but she’d still be flying over the ocean. After some time, the client had a breakthrough, in which she dreamt that she fell into the water, and as she went under, she saw many horrific things, like demons. However, she was able to both see what was underneath and then whirl herself to come up for air.
Mai and the client worked on that dream in therapy. Mai recalls, “the breakthrough of coming up through the air and willing herself to breathe in active imagination in our therapeutic time together enabled her to see that she was the one who was keeping herself from doing what she most wanted, which was to move on with her career.”
Mai also had a client who was suffering somatic bodily pain. The young woman had a very challenging childhood and history with her biological family, and while she was able to talk about and feel her own feelings about that, she suffered from intolerable pain all the time, specifically in the shoulder area. As they continued to work in therapy, there came a realization and awareness that her client was taking on the burden of both her biological mother and her biological father. Mai explains, “The awareness was present already, unconsciously, with the pain that was present in the body, but it was the conscious that was pulling, the pulling of the understanding in order to release from the pain in her shoulder.”
This is an example of the transcendent function theory, which “is about compensation and coming to balance,” Mai says. “It’s about the unconscious speaking and trying to break through that awareness of the conscious realm in order for there to be balance in the person’s psyche.”
“That means that there is the conscious world and there is the unconscious world, and there always seems to be a balance of both,” Mai explains. “When the one-sidedness is too much for the conscious world, then the unconscious pulls us and brings us back to center.”
Mai Breech is currently a Psy.D. doctoral student in clinical psychology from Pacifica Graduate Institute. Her main area of therapeutic focus is on childhood trauma and attachment. Mai's dissertation will explore former foster childrens' attachment systems and the types of interventions that can affect intrinsic motivation to live a more fulfilled life. Mai has had a long history of working with orphans and foster children. In 2007 she founded the Children's Art Village, a non-profit organization providing children in Ghana, India, and Nepal art and music to express their creative selves (www.childrensartvillage.org). Prior to transitioning to becoming a clinician, Mai worked as an executive at a private equity and investment banking firm in Los Angeles. Mai has has her MBA from U.S.C. and had been in finance for over 23 years working in investment banking, real estate finance, and finally private equity.
Websites: Children's Art Village: www.childrensartvillage.org
Melissa Ruisz Nazario is a graphic designer and social media consultant for Pacifica Graduate Institute. She is also the production manager and webmaster for Immanence Journal. In 2006, Melissa earned an M.A. in English and American Literature at The University of Texas at El Paso. Her thesis, “Parting the Shadowy Veil: Trauma, Testimony, and Shadow in Toni Morrison’s Beloved” received UTEP’s 2006 Honors Convocation Award for Outstanding English Thesis. Melissa has served as a content editor and graphic designer for the U.S. Marine Corps Public Affairs Department in Okinawa, Japan, as well as a technical writer and quality assurance specialist for Advanced Computer Learning Company in North Carolina. As an educator, she has taught college-level literature, composition, and drama; she also taught English as a second language to adults and children in Japan.
Bonnie Bright, Ph.D., earned her doctorate in Depth Psychology at Pacifica Graduate Institute. She is the founder of Depth Psychology Alliance, a free online community for everyone interested in depth psychologies, and of DepthList.com, a free-to-search database of Jungian and depth psychology-oriented practitioners. She is also the creator and executive editor of Depth Insights, a semi-annual scholarly journal, and regularly produces audio and video interviews on depth psychological topics. Bright is especially interested in ecopsychology, dream work, and divination, and has completed 2-year certifications in Archetypal Pattern Analysis via the Assisi Institute and in Indigenous African Spiritual Technologies with West African elder Malidoma Somé. She has also trained extensively in Holotropic Breathwork™ and the Enneagram.