​HOW I WORK

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​​My theoretical orientation is primarily psychodynamic, but because every client is unique, I use an integrative approach to psychotherapy that draws on aspects of psychodynamic, cognitive-behavioral, systems, humanistic, and existential thought.  I work collaboratively with my clients, listening, asking questions, and making observations.  I strive to be compassionate and empathic and, at the same time, to challenge clients with fresh perspectives.

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Much of the pain we struggle with – whether it manifests as depression, anxiety, relationship problems, addictions, eating disorders, creative blocks, sexual problems, identity issues, or other troubles – stems from early childhood experiences.  Some disorders have a biological component to them, of course, and I am happy to collaborate with your psychiatrist if you have one, but a lot of the difficulties we encounter as adults are the result of patterns of thinking, feeling, and behaving that we developed when we were very young.  Childhood trauma may consist of one or two devastating experiences, but it can also be the result of a series of smaller blows to the psyche, experienced day in and day out over a long period of time.  Because human beings are so adaptable and resilient, we develop defense mechanisms to protect ourselves from experiencing psychic pain as children.  This is natural, and it allows us to survive situations that might otherwise be literally unbearable.  Problems arise, however, when we hold onto defensive patterns as adults in situations where they are no longer needed, and where they may actually be damaging to ourselves and to our interactions with others.

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In working with a client, I use the relationship that develops between us over time as a way to gain insight into the client's defensive, often unconscious, patterns of thinking, feeling, and behaving in the larger world.  Temporary relief from psychological symptoms is often achievable relatively quickly using cognitive-behavioral techniques.  Profound, lasting change, however, is usually attainable only through deeper, more insight-oriented work that may take some time, or through the use of EMDR.

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EVIDENCE-BASED PRACTICE



Many people have heard the term "evidence-based practice," which refers to forms of medical or psychological treatment that have been scientifically tested and found to be effective.  Many people are also aware that cognitive-behavioral psychotherapy is an evidence-based practice.  Fewer are aware that psychodynamic therapy is also evidence-based, and that meta-analyses of rigorously controlled studies indicate that "effect sizes for psychodynamic therapies are as large as those reported for other treatments that have been actively promoted as 'empirically supported' and 'evidence based,'" and that "the (often unacknowledged) 'active ingredients' of other therapies include techniques and processes that have long been core, centrally defining features of psychodynamic treatment" (​Shedler, 2009​​).​​ The efficacy of EMDR has also been well-established in the scientific literature.





 







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