Carlsbad, Vista or Online
Dr. Lillian Mecum
Postdoctoral Fellow | Family Estrangement, Trauma & Relationships | she/her
I gravitate toward depth-oriented work that is caring and honest, with room for humor.
A short introduction
About Dr. Mecum
Dr. Lillian Mecum (she/her) is a postdoctoral fellow at Coastal Therapy Group. She works with teens and adults and has special interests in therapy for family estrangement, complex trauma, anxiety, relationship concerns, and multiracial and queer clients. She works relationally and psychodynamically and also draws from Internal Family Systems (IFS), also known as parts work. She holds a PhD in Clinical Psychology from Alliant University, where her doctoral research at the Trauma Research Institute examined mechanisms of intergenerational trauma transmission among mothers and daughters. She cares deeply about providing affirming care to people across diverse cultural and ethnic backgrounds, sexual orientations, and gender identities.
In her own words
What to expect
When clients first begin therapy, my priority is to help them settle in and feel safe being themselves in session. Building a relationship that feels trusting and collaborative is an essential part of meaningful therapy, and I approach this process with care.
Two approaches that particularly inform my work are relational psychodynamic therapy and Internal Family Systems (IFS), also known as parts work. What this means for clients is that I’m mindful of how the relationships and experiences we grow up with can stay with us and shape the ways we see ourselves and connect with the people in our lives. I also believe there is value in getting to know the parts of ourselves that we dislike, judge, or want to keep hidden, so that we can better understand them and why they are there.
I appreciate the effort and courage it takes to come to therapy, as informed by my own experiences in therapy and ongoing commitment to learning. Meeting my clients with curiosity, compassion, and attunement is important to me, as is providing a space where they feel supported as they explore what matters to them.
A special interest
Therapy for family estrangement
I enjoy supporting clients as they navigate complicated, painful, or estranged family relationships. For many people, especially in cultures and communities where family comes first, maintaining distance from family or even acknowledging conflict can feel deeply taboo. It can be difficult to find someone who is willing to take the time to understand the complexity of your family’s dynamics without judging or shaming you, offering advice that doesn’t fit your situation, or trying to steer you toward a particular outcome. The emotional pain of estrangement can feel overwhelming and difficult to put into words, especially when we feel alone in it.
Part of what can make estrangement so disorienting is the emotional turbulence that often comes with it: anger, grief, relief, guilt, loyalty, hurt, longing. Estrangement can also take many forms and involve varying degrees of distance: little to no contact, increased conflict, a loss of trust, walking on eggshells, avoiding deeper conversations because the relationship doesn’t feel emotionally safe. These dynamics can all be at play.
As a therapist in North County San Diego with experience supporting people navigating distant or strained relationships, my goal is to offer a space where we can slow things down and attend to whatever you’re feeling and thinking about, without pressure or judgment. Together, we can make sense of what’s been happening, get clearer about what you want and need, and help you find your own way forward, however that may look for you.
Ways to work together
Three ways to start
Most people begin with a free consultation and move into weekly sessions. As a postdoctoral fellow, Dr. Mecum sees clients at $230 per 45-minute session.
The foundation. Weekly individual sessions for teens, young adults, and adults, in person in Carlsbad or Vista. Some clients come with a specific knot to work through; others want a steady place to think out loud.
The same work by video, for weeks when getting to an office is not realistic, or for clients elsewhere in the state.
About online therapy →A short, no-pressure conversation about what you are navigating and whether working together makes sense. Most people start here.
Book a consultation →Credentials as a Psychological Associate
Registered Psychological Associate #94029707. Dr. Mecum practices under the supervision of Clare Edwards, PhD, a licensed psychologist.
- Post-doctoral Fellowship, Coastal Therapy Group
- Pre-doctoral Internship, California State University San Marcos, Student Health & Counseling Services (APA Accredited)
- Doctorate in Clinical Psychology (PhD), California School of Professional Psychology, Alliant University (APA Accredited)
- Master of Arts in Clinical Psychology (MA), California School of Professional Psychology, Alliant University (APA Accredited)
- Bachelor of Arts in Human Biology (BA), Stanford University
Areas of Specialized Experience
- Family Estrangement
- Complex Trauma
- Inherited Family Patterns
- Relationship Concerns
- Anxiety
- Multiracial & Multicultural Identity
- LGBTQIA+ & Queer Clients
- Teen Therapy
- Young Adults & College Students
- Internal Family Systems (Parts Work)
- Psychodynamic Psychotherapy
Before you reach out
Questions clients tend to ask first
What does “family estrangement” actually mean? I am still in contact with my family.
It covers far more than cutting someone off. Estrangement can look like little or no contact, but it can just as easily look like increased conflict, a loss of trust, walking on eggshells, or avoiding deeper conversations because the relationship does not feel emotionally safe. Plenty of the people I see talk to their families every week. If the relationship is painful or complicated, it belongs here, whatever you call it.
Will you tell me to cut my family off?
No. I am not steering you toward any particular outcome, including that one. My job is to help you make sense of what has been happening, get clearer about what you want and need, and find your own way forward, however that looks. Some people end up closer to their families, some further away, and many somewhere more complicated than either.
In my culture, distance from family is taboo. Will you understand that?
Yes, and you should not have to justify it first. In many cultures and communities family comes first, and simply naming that there is conflict can feel like a betrayal. That context is part of the work rather than an obstacle to it, and I hold it alongside whatever you are feeling about the relationship itself.
What is Internal Family Systems, or “parts work”?
It is a way of understanding that we are not one uniform self. There is often a part of you that wants to reach out and another that wants distance, or a part that criticizes you before anyone else can. I think there is value in getting to know the parts of ourselves that we dislike, judge, or want to keep hidden, so we can better understand them and why they are there. In practice it makes the contradictory feelings easier to hold without having to pick a side.
What does relational psychodynamic therapy mean in a session?
It means I am mindful of how the relationships and experiences we grow up with can stay with us and shape the ways we see ourselves and connect with the people in our lives. Rather than only managing a symptom, we pay attention to the pattern underneath it, including how it shows up between us in the room.
What are the first few sessions like?
When clients first begin therapy, my priority is to help them settle in and feel safe being themselves in session. Building a relationship that feels trusting and collaborative is an essential part of meaningful therapy, and I approach that process with care. There is no requirement to arrive with your history organized, and no rush to get to the hard thing before you are ready.
Do you work with queer and multiracial clients?
Yes, and both are among my special interests. I care deeply about providing affirming care to people across diverse cultural and ethnic backgrounds, sexual orientations, and gender identities. You can also read about our practice’s LGBTQ+ therapy.
What does “postdoctoral fellow” mean?
It means I have finished my doctorate in clinical psychology and my APA-accredited internship, and I am now accruing supervised hours toward licensure as a psychologist in California, with ongoing supervision from a licensed psychologist here. Practically, it means two doctoral-level clinicians are thinking about your work rather than one, at a lower fee than our licensed psychologists charge.
Where do you see clients, and what does it cost?
In person at our Carlsbad and Vista offices, and online throughout California. Sessions with me are $230 for 45 minutes; across the practice individual sessions run $230 to $300 depending on the clinician. Our cost and insurance page has the full breakdown, including how out-of-network reimbursement works.
What is the first step?
Schedule a free 15-minute consultation. We talk through what you are navigating and whether we are a good fit, and from there we can usually book a first full session within a week.