My Expertise

I offer counseling therapy in sessions of 60 or 90 minutes. I have experience and expertise working with a wide variety of people and their symptoms. This includes people with severe mental health issues as well as those with more general life challenges.

The initial counseling session or two involves an assessment of your medical, psychological and social history. I do a complete assessment of your symptoms and how you are experiencing life. I evaluate your strengths. We discuss your goals and intentions for seeking therapy. If helpful, I will often educate you about how these symptoms can develop. At the end of the assessment, I will propose to you a direction and approach with the intention that you reach your counseling goals. I am committed to working from theories and orientations that are substantiated with strong research evidence of their effectiveness. I do much of my work in the cognitive-behavioral tradition. With trauma, I rely on EMDR, a technique that taps into the healing power of the brain to create healthy and adaptive information networks to replace problematic experience processing and integration. Finally, when we are further along and when the client so chooses, I employ theories and techniques from existential psychotherapy, an approach that focuses on choice, responsibility, and meaning-making in one’s own life.

Karin Sable LMFT

I am a licensed marriage and family therapist providing mental health therapy and counseling services in the North Lake Tahoe and Truckee areas.

Please call me for a free in-person or phone consultation. Let’s talk about how counseling therapy can work for you.

Individual Therapy


  • Stress and anxiety
  • Life transitions & adjustment
  • Low self-esteem and confidence
  • Post-trauma stress (e.g., PTSD)
  • Depression
  • Bipolar disorder
  • Emotional volatility
  • Impulse control
  • Sleep Issues
  • Relationship and family
  • Domestic violence
  • Adult survivors of child abuse

Couples Therapy

  • Relationship Disappointment
  • Decision making
  • Communication problems
  • Developing healthy intimacy
  • Improving the ability to genuinely support one another
  • Improve problem-solving skills
  • Infidelity issues

Trauma-Focused Therapy

  • EMDR (Eye Movement Desensitization and Reprocessing)
  • Prolonged Exposure Therapy
  • Cognitive Processing Therapy
  • Internal Family Systems Therapy

I have a particular interest and specialized training in treating symptoms that can develop after acute or chronic trauma. I have worked with people who have had recent trauma as well as those with the trauma that occurred in the past. Examples of types of trauma include physical and sexual violence, combat experiences, car accidents, death of loved ones, child abuse, being bullied, divorce, abandonment, and many other experiences.

Why does the trauma experience find its way into therapy? Trauma is an event or event that causes a sudden or significant negative change in our concept of self, the world, and/or our future. When this sudden or intense shift occurs, we experience it as loss, confusion, disorientation, or even threat and danger. To move through the trauma experience in healthy ways requires an adaptive neurological and psychological response that integrates the trauma experience into a new sense of identity, worldview, and sense of future. The problem is that for some people, this adaptive integration does not occur. There are many possible reasons for this, but the end result is that the person continues to experience parts of the trauma as if it were alive and in the present. It is as if they cannot get away, close the door, or just get back to “normal” life. They are haunted by the event every day, if not every hour. And the haunting can lead to changes that complicate life.

Below are some of the more common symptoms of traumatic stress:

  • Intrusive re-experiencing: nightmares, flashbacks, or thoughts
  • Avoiding anything that triggers the memory: people, places, things
  • Elevated arousal, always feeling primed to react to threat, never relaxed, anxious
  • Mood extremes: depression, irritability, aggression
  • Feeling numb, detached, or spacing out and dazed
  • Memory lapses, concentration problems, learning difficulties
  • Reactivity and intensity– acting immediately and with intensity before thinking about consequences
  • Physical problems – GI problems, pain, migraines as examples
  • Distorted body perception
  • Relationship/trust issues
  • Self-loathing, shame

Counseling techniques have been developed to specifically integrate trauma and relieve symptoms. The best evidence out there indicates that therapies that combine desensitization with cognitive (thoughts and thought patterns) restructuring are most effective. I use these therapies. I am a certified EMDR practitioner. I have also trained in Prolonged Exposure Therapy, Cognitive Behavioral Therapy, and Internal Family Systems Therapy.