For the past few months, we’ve been interviewing members of our team as part of an employee spotlight series here on our blog.
Today, we’re introducing you to the woman who started it all: Kimberly Keiser, MA, NCC, LPC-MH, CST.
In this intimate, in-depth Q&A, Kimberly shares her story — from childhood to career to the accomplishments she’s most proud of today. We hope it inspires you in some small way.
Meet Kimberly Keiser!
What was your background before starting Kimberly Keiser and Associates?
I was born in Hawarden, Iowa, but I grew up outside of Alcester, South Dakota, on a dairy farm, which my family owned. I'm the fourth generation, so we have long history and roots in the area.
I think that's an important component of my development because I grew up in nature, I grew up around animals, and I grew up around a family business. All of those things developed my work ethic and how I work, which plays a direct role into this business.
I went to high school [in Alcester], and then I went to University of South Dakota, where I got my undergraduate degree in psychology. During my last year of my undergraduate studies, I went to Europe for six months, where I studied philosophy before coming back and graduating from USD. During that time, I was applying to graduate school, and I got accepted to a university in New York called the New School for Social Research, where I graduated with a M.A. in General Psychology. This program is one of the few psychodynamic-oriented psychotherapy programs in the United States, so, I feel very fortunate to have had that experience.
Can you describe briefly what “psychodynamic” means?
Freud was the originator, but there have been generations of psychologists who have continued to develop his original theories. Freud was a medical doctor, a psychiatrist, and was practicing at a time before neuroscience existed in the way it does today. Freud saw the limitations of science to study the brain during his lifetime, so he sought an alternative route to understanding human psychology, which is known as psychoanalysis.
Given the development of modern neuroscience and more advanced ways of studying the brain, it is fascinating to see how some of Freud’s theories about how the mind stores information and how trauma impacts human psychology do map on to modern neuroscientific findings.
A lot could be written about what psychodynamic means. From a more personal standpoint, psychodynamic psychotherapy, for me as a practicing therapist, is the only section in the field of psychology that describes what human experience is. For me, it's like the poetry of psychology. It goes in-depth into trying to understand, explain, label inner psychic processes and the human experience. It addresses meaning in human experience and existential struggles inherent in the human condition. In addition, it looks at the developmental nature of human psychology to understand how childhood experiences impact adult functioning intrapsychically.
So, the school you attended in New York was modeled after this approach?
Yes. The program was started during World War II when some German psychologists came to the United States and continued their work utilizing psychoanalytic concepts and research. I feel very fortunate to have studied at the New School for Social Research because it's shaped how I work.
After I completed my M.A. in General Psychology, I decided I wanted to become a psychiatrist. I did three years of premedical studies at New York University and Columbia University. I figured out toward the end of those studies that I actually had more of an intellectual interest in medicine and medical science, but it wasn't where my talents lie. I was better at working in the experiential, philosophical, and existential aspects of psychotherapy and psychological counseling. But everything I learned was very helpful when I became a sex therapist, which interfaces with a lot of medicine.
At that time, I had been in New York for over 10 years, and I wanted to move back home and be closer to family. I was working on some projects here, so I decided to go back to the University of South Dakota and got a second master’s in counseling psychology to obtain a license to practice. I felt like when I graduated at age 25 with my first master's, I didn't have enough life experience to be an effective practitioner, and I wanted more experience living and growing as a person, so I could really work with people.
When I was working on my second master's, I worked for a psychologist who works with sex offenders. I was co-leading sex offender treatment groups and being mentored to conduct psychosexual evaluations. During this time, I was trying to figure out, "What do I want to do as my specialty?"
I started interviewing different therapists in the area, asking, "Where do you see a need?" You know — just asking for mentoring and advice on what I should do. And a psychologist told me, “There's nobody doing sex therapy.”
I just felt a natural comfort with this. When I was doing my internship, my supervisors told me I seemed to be very comfortable working with sex offenders. And I never minded hearing about things. I don't know that all therapists are comfortable working in sex therapy. So, I really felt like it was a natural fit.
I think a lot of that comes from the fact that I did grow up on the farm, and sex was just part of life — my dad regularly did artificial insemination with his cattle herd; I saw animals being born; I saw female cows in heat “humping” other female cows. You see everything in nature, and everything is normalized and healthy. It's not charged with positive or negative human interpretations or experiences.
I think that, combined with the fact that I didn't grow up with a lot of religion (because religion sometimes can have the effect of making people have more sex-negative views), meant I grew up with a very open mind and a very natural view of sexuality. And it was talked about in the context of family. From a very young age, I was asking, "Hey, Dad. What are those animals doing? What is that? Why do male cows have nipples?" My dad always answered me with the facts in an open way. Looking back, I can see that I was provided with very good sex education.
You know, this is all interwoven into good family relations and conversations. One thing I've learned as a sex therapist that is most people who come in who have sexual concerns or challenges didn't grow up ever talking about sex or talking about it in a healthy way in the context of healthy family attachments. So, I feel like I got educated in a very natural way, as a part of life without any negative connotations. I was always very comfortable, even with my own sexuality.
So, would you say you didn't necessarily always want to work in sex therapy, but once the need was identified, you realized you were perfectly equipped for it and you enjoyed it?
I wouldn't use the word perfect, but I would say once I knew the field existed, I felt like I had found a field of study that I could go into. I think the most important advice I can give to people (and something I tell my patients) is, "Just keep putting yourself out there. Keep working toward something, and eventually, the pieces will fit together."
When I was transitioning out of studying premed, one of my professors told me something I'll never forget: “Kim, don’t worry. Some of the most interesting people I know are the ones who have had many different paths to get to where they're going."
I think that's true. I feel I have had an incredibly fascinating career, and the work we do is always exciting. I never would have picked this. But I just kept following the path, and then things cleared.
During the time I was training in my internship working with sexual offenders, I started transitioning more into the non-criminal population and working to promote sexual health. In 2010, I started my own business; I was working with sexual dysfunctions, LGBTQ, sexual abuse recovery, and sexual addiction — things that people weren't also having legal problems for. There was nobody in our area doing that, so it was a wide-open field.
So, when you were practicing on your own, what did that look like exactly?
It was a long period of time of working very hard. I would say the next eight years after that were spent getting consultation and training from more experienced AASECT certified sex therapists all over the country who specialized in different aspects of sex therapy.
Every time I would get any new patient issue, I would study: "What is this? What's going on here? How can I solve this problem? How can I help this person?" And just training myself how to do the work one client at a time.
About four years ago, I discovered that I was really at capacity and that there was way more need than one person could do. I wanted to start hiring and training people to develop a sexual health specialty practice.
So, that's what we've done. Over the last four years, we now have four full-time therapists (besides myself) working here, and we're in the process of hiring a fifth. So, it continues to develop.
The environment of your office must make a difference for your clients and even your team. Do you want to speak to that?
Yes, I do. I think it's very important.
I think many psychotherapists also have the spirit of an artist because a lot of what we do is artful. That can get expressed in all kinds of different ways for each person. For me, one of the ways I express my creativity is through design. I think as a psychotherapist, as well, who you are as a person is the instrument of healing in the space. So, you have to always strive to be healthy, to manage your own state of mind, to stay centered.
One of the ways I've found that I do that is through creating peaceful environments. Over the years, I’ve cultivated an understanding of what that means to me and then have received feedback on how other people experience that.
So while I've never formally studied design or architecture, when I was planning the design of this office, I went to Paris for my 40th birthday, and I just walked around and went to all kinds of museums and beautiful places, and I took pictures of everything that made me feel transcendent. By transcendent, I mean when you walk into a space, you just feel uplifted. Like, when you walk into like a beautiful church, or you walk into a museum, there's an openness, a stillness, and you just feel like there's a shift in your state of being.
I wanted to create that [for Kimberly Keiser and Associates] because I think a lot of medical settings have different standards for how they have to be set up. But sometimes what's compromised is how the person feels.
It can be something as little as fluorescent lighting versus the lighting we’ve chosen, which is meant to create a certain mood. All our ceilings are also very high, so it feels open versus being in a small space. Then, there’s the flow of the office: If you have patients coming in one door and then leaving in another, they feel more privacy.
There are a lot of things you can do with design: the colors chosen, having living plants, the texture of being in nature — feeling the grittiness of the dirt, the hardness of the rock, the softness of the grass — having wood floors and rugs versus just a carpet. There's a lot you can do to create a space that makes you feel grounded.
When people are in a healing space, their system is going to relax — their physical system, their state of mind, their emotions — and they're going to start to get centered. My goal is to create a space where people can enter, start to create that connection, and center themselves before they enter into the therapy session.
Each office [at Kimberly Keiser and Associates] is designed with the same feeling. When you're in here, the experience is not only coming from the quality of care and the relationship with the therapist, but also the physical space that you're in. It’s no different than if you go to a spa or a nature reserve — you know, spaces that are designed very consciously to alter human experience. I wanted to bring that into the healthcare setting so that people could have that to facilitate some velocity to the healing process.
That is fascinating — how intentional you have been about the design and culture at your office. You must be that intentional with your staff, too. What do you look for when hiring a new team member?
This has evolved over time, because as a business owner, you have to always stay humble. There's a lot you don't know. There's a lot I still don't know.
I think unless you're formally trained in business, you have to really seek that education out. It's one thing to be a therapist, to be successful with patients and know how to deliver good psychotherapy and counseling care, but it's quite another to be a good manager of employees and a helpful and supportive clinical supervisor.
So, that's been an ongoing learning curve of hopefully getting better — but I think that creating a quality team is critical to having a quality environment. So, just like the design of the environment, the design and care of the team is just as important, because if any one person feels unhappy, or unsettled, or unsafe, then the energy in the space will shift.
When we go to hire people for our current business model, based on all the things that I've learned, I'm really trying to look for someone who wants to be a team player. Some people want to be totally independent; some people want to work in a company but want to keep a distance. We try to create an environment where people want to contribute to the team. In addition, I’ve found that one of the biggest hindrances to a long-term employment relationship is a therapist who maybe isn't ready to do that deeper work to look at themselves and figure out, "How am I contributing to dynamics?"
Sometimes, there's more of a projection of, "I don't like this and it's your fault." And I think that also hinders your ability to be an effective therapist. So, everything that a person brings into the environment is a direct reflection of how effective they can be as a therapist. Their ability to resolve conflicts, their ability to take a look at their own stuff and to own it, their ability to communicate, their ability to express needs. This is nothing negative, because it's all about human development — most of us don't grow up in families where this level of emotional maturity and insight is fostered.
It's something we have to develop after we get out on our own. You're lucky if you grow up in a family where you learn all that, but most people don't. Part of the work of being a therapist is practicing all the principles that were taught and incorporating them into yourself and making them your own, and to have the flexibility to do that.
Sometimes people say, "Oh, yeah, therapists. Those are usually the craziest people." I can't tell you how many times I've heard that. And the difference is everybody has issues — every person on the planet. The human condition is fraught with imperfections. The difference with a lot of therapists is that we also have the capacity for healing and the curiosity about what those issues are and where they come from and an inherent passion for improving human experience.
Ultimately, we're looking for somebody who can be a good fit for this practice. Overall, to be a good therapist is to be somebody who can really look at themselves and engage in this kind of dual conversation where “I'm having an intense experience, but I'm also aware it's mine, and I want to explore it with you and be open to looking at that.” That requires a very secure sense of self, and not everybody's ready to do that. That happens in relationships of all kinds, and that also happens in employment relationships as well.
What are your goal(s) for your practice? Are you looking to grow it? Are you happy where you are?
This year, our 2019 goals and initiatives are all around trying to really tighten up the operations — to improve and standardize all of our processes, become more HIPAA compliant, do some cost reduction with overhead, tighten up our financial policies, and just get this business functioning as solidly as possible. We already have the business built, and now I'm looking at just making it operate more tightly and effectively on all levels.
One of the reasons we're doing that is because we're looking at scaling the business. This coming year, we'll be opening a second practice location in Sioux Falls. There's a lot of potential for sex therapy because there are only about 800 certified sex therapists in the world. So the potential to grow from a business standpoint is really quite unlimited — it's very exciting for me. I love business. if I could go and get my MBA, I would, but there are too many irons in the fire to do that right now!
It's very exciting to think about scaling the business and what that will look like. Our administration manager, Jessica [Harm], is currently living and working remotely in Arizona. We’ve talked about, when she's ready, starting a practice there for the company. So, the kinds of things we're going to be looking at are: "What markets do we want go into? And how do we want to scale the business over time?"
Another area we're looking at growing in 2020 besides opening our second practice location is starting to have some products available. A lot of sex therapy overlaps with sexual medicine. We work with endocrinologists, with transgender patients or infertility clients. We work with pelvic floor physical therapists with disorders like sexual pain disorders, pelvic floor dysfunction, vaginismus. We work with urogynecologists, with vulvodynia, with pain disorders, vaginismus. We work with urologists on erectile dysfunction, premature ejaculation. We work with oncologists, with cancer patients. We work with so many different medical providers.
One thing I see that's missing is that we have to send all of our clients who need something in the realm of sexual healthcare online to purchase it. Products like vaginal dilators or educational materials, or any type of sexual device or even sex toys, or if someone has back problems and they need something for a different position . . . there are a lot of sexual medicines and sexual health products that aren't available at a typical adult entertainment store. In addition, adult entertainment stores usually don’t employ sex therapy professionals. They might have people who are knowledgeable of the product but not about sexual therapy or sexual medicine.
So one thing we're going to pilot this coming year is having more products available in our current and new location, where we can be a bridge between clients going online and getting things they don't necessarily know about and physicians having to tell their clients to do that. There are a lot of possibilities to explore there for how we can grow the business.
All of these future plans seem to revolve around sex therapy, but you do provide other therapy services as well. Would you say you want to continue focusing primarily on sex therapy, or is there anything you wanted to say about some of your other services?
It's a really good question because we're always questioning, "What are the needs in the community, and what are we learning that maybe we didn't see before that would be useful now?"
One of the things I discovered as a sex therapist is that most of the people coming in have some history of trauma. That’s why, over the years, we've really taken on this other training route of becoming trauma therapists. The symptom a lot of times is sexual in nature, but we utilize trauma therapies in overcoming that in addition to sex therapy techniques.
The two really go hand in hand. We do a whole handful of different trauma therapy approaches that we could easily transfer into working with non-sex therapy patients; that might be something that we can develop in the future. But we already have patients who come in just for trauma therapies, and we can do that quite easily because sex therapy is really kind of like another level of training.
We also work with a lot of couples, so we're all trained in couples therapy.
It seems as though most therapists don't have that sex therapy background. So, what do you do specifically to train or supervise your staff?
I would say this overlaps with the question about who we would we hire: somebody who has a genuine interest in personal development and intellectual development or who is fulfilled through intellectual stimulation.
One of my passions is the study of the mind. It's not just a hobby or work for me; it's part of who I am as a person to be intellectually curious. For me, that has meant this sort of existential reflection on life and solving these human dilemmas with my patients. Some people ask why — you know, "How can you sit and listen to people's problems all day?"
But that's never what it's been about for me. It's like each person who comes in is a puzzle: "Intellectually, emotionally, how am I going to solve this puzzle?" It's highly stimulating.
I believe in ongoing intellectual growth, and our clinic fosters intellectual development. Part of the way we do that now [at Kimberly Keiser and Associates] is that we have multiple group trainings a week. We're always undergoing clinical training through involvement in professional development programs or hiring an expert to provide training to us. We're always reading things; we're always discussing as a group. So, I try to create a very rich learning environment, where people are always very stimulated.
I believe that it's in the asking of questions that we get to better questions. So we're always asking questions; we're analyzing; we're finding information; we're finding new questions; then, that intellectual inquiry you're always on brings a very rich component to the environment.
What accomplishment are you most proud of, either in your personal life or in your professional life?
I would say my biggest accomplishments professionally are my graduate degrees and starting and growing this business. In some ways, I feel like we're still beginning, but in other ways — like when I go into the lobby and see six people in the waiting room — I know that this dream I had is now having a ripple effect into people's lives. I think about the potential for that, and it makes me incredibly proud — almost emotional — because I want to add value that's bigger than me.
To see [the growth of this practice] is very powerful — to be a source of healing. This world is full of a lot of pain, and to be able to create some healing and potential, and to be able to do that on a larger scale . . . it's very meaningful for me. That's something I'm very proud of.
Personally, I'm most proud of the work I've done with my children.
My son has Down syndrome; he's nine. When he was born, I told myself that he was going to function as a neurotypical child, and I worked very hard to learn about his condition and research the best ways to treat the symptoms associated with it.
You come up against a lot of stereotypes and obstacles. People telling you, "He'll be sterile and never have a family. He'll die at a young age; he'll never be able to do things.”
I’ve researched a lot of my own, always having this "I'm never taking no for an answer" attitude. And right now he is extremely healthy. He has average to low-average IQ. He does not have a cognitive disability. He has tons of friends. He's involved in three sports. He is a master with LEGOs. He has the kindest, most beautiful spirit.
Growing up with certain privileges as a white person, as a person of middle class . . . [my son] taught me what it means to experience prejudice. That has opened my eyes and made me more compassionate to people with all kinds of differences or who are at a disadvantage because of discrimination and prejudice. I think that's very significant.
I was 35 when I had [my son], and things didn't work out to continue a partnership with his father. I wanted to have more children, but I didn't feel I had a lot of time biologically to have more children.
So, when I was 37, I started researching Single Mothers by Choice, which is an organization that supports single women who, for whatever reason they have, decide to pursue motherhood without a partner. And I went on a motherhood journey by myself. I spent two years in my own therapy with Jane Mattes, a psychotherapist who started Single Mothers by Choice in New York City. It was a group she started 40 years ago, when she was a single mother by choice. And it wasn't known at all at the time. I went through a process of deciding how I wanted to have children on my own. And then I had my twin girls in 2016 on my own after two IVFs; the first one failed, and the second one was obviously successful.
I'm very, very proud of that because those girls are unbelievable. They're so vibrant and beautiful. People ask me, "What are you going to tell your girls about the fact that they don't have a father?" And I'm going to tell them, "Whatever you want, you can do it if you put your mind to it. Just keep your eye on the prize."
That's what they are to me. I was alone, you know, and I had a child with a disability. This isn't a sob story, but to me, it's a testament to a belief in your goals and going for it. I did all the injections by myself, and I spent a significant amount of my time and resources to make this happen. I traveled to Denver for my second doctor and IVF, and then I got these beautiful babies . . . and it's not easy.
But, you know, I made it work. I requires a lot of discipline and tolerance for discomfort, not knowing what's going to happen. And then having to go through that journey, you know, and explain it to people. So I'm just extremely proud of that because, to me, what I try to work with my clients is: "You can't always choose what happens to you in life, what it presents, but you can choose how you're going to deal with it."
And you can make those positive choices, solutions to really get what you want. Like, go for your dreams. Like, what do you really want?
So, I try to live my life that way. Because if you're not walking the talk, then you're not going to be effective as a therapist.
Maybe there are times in each person's life when it really comes down to, "Are you going to do it or not?" And you have to give your all; you have to say, "I'm going to do this no matter what."
I feel like with my children, and with my company, that openness to possibility and the perseverance when things are challenging is what has made me be successful in the areas most important to me.
So, those are the things I'm most proud of.
And they’re pretty great things to be proud of, aren’t they?
On behalf of the Kimberly Keiser and Associates team, we are grateful for Kimberly’s leadership in our practice. After all, without her, none of us would be here!
You can learn more about each of our Sioux Falls therapists by reading the other interviews in this employee spotlight series:
. . . And by visiting our individual bio pages, which feature each therapist’s education, credentials, experience, and affiliations, from our team page.
If you would like to meet with Kimberly Keiser or one of our other counselors in Sioux Falls, please give us a call at 605-274-0095, or fill out our contact form.