Theoretical approach
My primary work is as a psychiatrist practicing psychotherapy. I make use of contemporary psychoanalytic and attachment theory. My work is also rooted in formal training in Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and mindfulness meditation. As my education suggests, I focus on developing use of your own bodily experience as the primary source of safety when things are confusing or frustrating. In time, your narrative and everyday imagery will build upon embodied awareness and support deeper meaning in your life.
The content of psychotherapy is essential for effective treatment. Sessions are mutually designed and rest upon your associations to your current life and developmental experiences. We make use of your reflections, daydreams, and dreams based on your preferences. Especially in the beginning stages, effective psychotherapy simply considers what comes to mind for you and most often involves you openly sharing your frustrations. In time, we can facilitate rekindling joyfulness and purpose in your relationships and life.
the framework of effective treatment
I most commonly see patients 2-5 times per week. Meeting during frenetic and routine times is essential to understand shifts in your states of mind. The terms of our service agreement help create clear and reliable commitments for yourself and our work. More frequent sessions most commonly shift work from considerations of external actions to deeper awareness of internal experiences and dynamics. Shifting to less frequent sessions is often a way to continue therapy on one’s own terms. Satisfaction with any effective therapy is rooted in iterative progress. For some, focused therapy on a specific issue is sufficient and complete over several weeks. Lasting change for most takes several months.
I see patients in offices in Louisville, KY and Portland, OR, integrating telesessions for more than a decade. As the pandemic moves into its fifth year, we are considering effectivness research and policy decisions on telemedicine. Therapeutic work via a private, secure, and reliable teleplatform reduces schedule challenges, facilitates integrating deeper work into your weekly routine, and avails psychoanalytic work to people previously excluded due to geographic and cultural barriers. Virtual work is not the same as in person session; and this format may not be the best choice for you. Many of my colleagues have strong negative views of virtual work; and I think it worthy to consider these. The forum of meeting is usually clear at the end of a consultation.
common sense work in and across sessions
Most people want to know how it feels to work together prior to starting. My work respectfully holds the suffering and isolation my patients experience. Some patients experience me as a quiet, respectful keeper of their secrets. Others experience me as an active and curious partner in addressing frustrations, grief, or deep personal change. I authentically share in and attend to playfulness when alive and real. I aim to attend to the tenderness of vulnerability and deeply respect the wisdom each patient or supervisee brings to any moment and to our work. Most meaning and suffering is rooted in developmental dynamics; and how others experience me is heavily shaped by their wants, needs, and ways of relating.
In any effective psychotherapy, you should feel consistently respected by someone seeking to better understand you and care for your suffering. You should experience hope within a few sessions. You should feel oriented and the beginnings of tangible relief within a few weeks. Defining treatment goals is a meaningful collaborative process that usually is iterative. We will work to understand an area of your life, then support you making improvements, then decide if additional work is wanted and needed. At times in an effective treatment, you may experience periods of feeling worse as you experience your own driving and dysregulating forces. You will endure my imperfect efforts to understand you in a longer treatment; and you should experience effective repair of mistrust during a full treatment if and when it arises.
Psychotherapy, with or without medicine support, is a big investment; and this work can uniquely relieve suffering and support greater capacity for satisfaction, purpose, and fulfillment in your life.