Aviva Psychology Services is built on the idea that we are both harmed and healed in relationships. We believe that relationships are core to our wellbeing as humans, and this includes your relationship with your psychologist. 

It might sound strange to think of yourself as having a relationship with your psychologist. While they are an expert you’ve hired to help you, they’re also a human being who will co-create the therapy experience with you over the course of months to years. Given the investment of time, energy, trust, and money that therapy involves, being thoughtful about who you want to work with just makes sense! 

The team of psychologists at Aviva Psychology Services represents a diverse array of psychological training, therapeutic styles, specialty skills, and personalities. To help you learn more about which psychologist at Aviva is the right fit for you, we offer this Clinician Spotlight series. 

Clinician Spotlight: Liya Akoury, Ph.D.

Dr. Akoury has been a staff psychologist at Aviva Psychology services since October 2020 and has been providing therapy as a licensed psychologist since September 2020.

Dr. Akoury provides individual therapy for adults with a wide range of concerns, including anxiety, depression, trauma, and acculturation difficulties. She has experience working with indigenous, immigrant, and marginalized individuals to build empowerment from a cultural humility lens. Dr. Akoury also has specialized training in evidence-based treatments related to body image and eating.

Her psychology training includes earning her Ph.D. in clinical psychology from the University of Nevada. Following completion of her academic training, Dr. Akoury completed her predoctoral internship at the Norton Sound Health Corporation/Alaska Psychology Internship Consortium and her postdoctoral training at The Community Services Institute and Walden Behavioral Care. 

To learn more about working with Dr. Akoury, you can read her Aviva team page, read her Psychology Today profile, and read the interview written below. 

What Does a Typical Session Look Like With You?

I approach sessions with a sense of structure on a meta level by paying attention to our overarching goals and tracking the areas of concern for the client. In the session, it may feel like we’re having a casual conversation and checking in about how the week was. I often ask the client what they’d like to talk about today. We might meander across sessions, spending one week talking about work stress and another about a conflict with their mom. Sometimes clients who are hypercritical of themselves will worry that they’re rambling or apologize for not having a plan for the session. In those moments, I reassure people that we are always gathering information. We are building a data set and working to observe and understand patterns. To quote Irvin Yalom, “Everything - especially episodes containing heightened emotion - is grist for the mill.” 

What Types of Clients Do You Work With?

I work with many different kinds of clients, but I especially enjoy working with clients who are anxious achievers. These are people who use anxiety to propel themselves through life, and they often have the idea that love is conditional and based on the idea of achieving. They’re often extremely good at enduring. They’ve learned from caretakers that if they endure harder and longer, there will be a big payoff for them in the end. 

By the time they begin therapy with me, they’ve probably already been enduring a long time. They’re often at or approaching the point of burnout. Maybe they’re in medical school, law school, or a first job, and they’ve been working so hard for so long, but the promised payoff doesn’t happen. And for these anxious achievers, this creates a new type of struggle: not just anxiety but burnout and depression. 

Do You Specialize in Treating Certain Conditions? 

I think less about specific diagnoses and more about the way clients present. In addition to the anxiety-driven achievement I mentioned before, I work with many clients who exhibit perfectionism. Usually they are pursuing perfection to be beyond reproach and beyond doubt. The idea with perfectionism is that no one could possibly have a reason to reject us if we are perfect. We never have to ask uncomfortable questions like if we’re in the right career. We never have to tolerate uncertainty. 

What Makes You Passionate About Working With "Anxious Achievers" and Perfectionists?

They are exceptionally capable people who are working hard at everything except their own well-being. When we work together in therapy to reframe their own needs as worthwhile, they get to use those amazing skillsets to their advantage. They can become exceptional at the things they struggle with initially. They’re so skillful that their early efforts can be hugely impactful.. Even when they’re operating at 10% self-care, they’re often doing life-changing work. 

How Do You Measure Progress in Therapy? 

I think of three stages in therapy. First I work to recognize the patterns in the client’s life. Then, we recognize those patterns together in session. When a client is really making progress and turning a corner, they’ve started to catch it on their own. They can say “I did it again” and from there we can start to work on changing the behavior. This third stage takes time to achieve as we build skills of mindfulness, pattern recognition, self-compassion, and acceptance of both how hard it is to change and how important change is for living in a more valued way in the future. 

Another marker of progress is figuring out what our patterns are about. For example, this could look like asking, “What is perfectionism distracting you from? What is it helping you avoid?” Perhaps focusing on being perfect is a distraction from the discomfort a relationship isn’t meeting their needs. Maybe perfectionism means you never have to wonder if your career is unsatisfactory. 

How Do You Know When It’s Time To End Therapy? 

When we run out of things to talk about. There’s no set timeline for reaching that point. Sometimes it takes years to reach that point in therapy. Sometimes it’s much quicker than that. When we feel that there is nothing left for us to address, we might end therapy entirely, but we might also decrease the frequency of sessions.

What Do You Most Enjoy About Therapy? 

Providing therapy means my job involves having genuine, deep, quality relationships, and I’m so glad I’m doing that for work and not talking about share-holder value or something like that.. I don’t have to engage in any pretending or people-pleasing. I get to be authentic about the things we’re often asked to hide. My work involves talking about what’s really going wrong in a person’s life or in the world. I get to name it, not ignore it. There’s a sense of sanity in that. 

What’s Something You Wish More People Knew About Therapy? 

That ultimately therapy is about increasing tolerance for your entire emotional range and increasing compassion for your entire emotional range. It’s about that rather than something like “not feeling anxiety.” People often come to therapy saying “the anxiety is the problem,” but it’s often more that we have shame about the anxiety, and that’s the problem. I think of the Rumi quote, “This being human is a guest house.” In therapy, we’re asking “What would it look like to invite emotions in as guests?”

 Ultimately, we are working to make peace with uncertainty. What therapy offers is space to trust in our own resilience. We don’t know what life will throw at us with respect to circumstances or even our own emotions, but we can trust that we can respond to it in a way that reflects our values. We may hear from our guilt and shame parts, and we can learn to trust our own capabilities to survive things anyway. 

What’s A Misconception About Therapy You’d Like to Change?

That therapy is about you changing other people. For example, I’m probably not going to help you “fix” your mom. What we can do in therapy is help you learn to accept your mom and that she may have no capability or desire to behave in the ways you want. This is a process. First, we have to grieve the reality we wished for. Then we have to work on accepting the reality we do have. Once we are in the stage of acceptance, we can plan for what doesn’t work, accept what happens, and appreciate what does work. 

How Do You Like To Spend Your Free Time? 

I do a lot of yoga and thrifting. I enjoy walking around my neighborhood while listening to an audiobook. I enjoy reading and especially like speculative fiction genres, like sci-fi and fantasy. I like that these genres explore what humans (or human-like characters) do in unusual circumstances, and it’s also nice to have a way to escape a little.