All therapy begins with an initial consultation. Together we will assess the problem that brings you for help, your hopes for change, and your expectations of treatment. This will give us some time to get to know each other, and together decide what kind of help you require. This also gives you a sense of what I am like, my manner of working, and how I conduct my practice. Sometimes a consultation will involve a few sessions.
It is important that we agree there is a good enough “fit” between us if we agree to work together. Some people will interview a number of therapists before deciding to work with a therapist. Trust your intuition. I can help with referral to another therapist in the community.
When I feel I have some sense of your difficulties, I will share my impressions with you, and together we will formulate a plan to address them. Often, I will recommend psychotherapy, group therapy, couple’s or family therapy, or some combination of therapy. Occasionally, the work we do in consultation may be sufficient to address the problem that is troubling you. At times, I will recommend psychoanalysis. Frequently, I will suggest additional consultations or treatment with other professionals: psychiatrists, psychologists, physicians, or addictions specialists.
Therapy is an honest, confidential conversation about what troubles you, what matters most to you, and what gets in the way of creating the changes in your life that you want. Therapy can be very helpful for negotiating life’s transitions, losses, and major decisions. Two minds are better than one.
Some people come to therapy with a bigger agenda; they feel their life is not working and they do not understand why. Often psychological symptoms of depression and anxiety signal deeper distress and pain. People seek therapy not only to get relief from pain, but also to gain a better understanding of their thoughts, feelings, behaviors, and relationships.
Because people have different goals and needs, therapy can be a matter of meeting once a week for a couple of months, or twice a week for several years or more. After our work is completed, I will continue to be available to you, if more work is needed or new difficulties arise.
Psychoanalysis is the most demanding and thorough, life-changing therapy, not only because it requires a commitment to working three-to-five times a week for several years, but also because it evokes a deeper, trusting, emotional engagement with the therapist, and a more profound level of self-exploration and self-disclosure. Analysis is not for the faint of heart; indeed it is recommended only for people who have basic emotional strength and stability. Analysis can be enormously helpful at getting to the roots of chronic emotional distress and resolving self-defeating relationship patterns.
Committed relationships require work once the magic has worn off. All of us are conflicted in relationship, simultaneously desiring and fearing intimacy. Every couple develops their own unique relationship dance, patterns of relationship that express a compromise between desire and fear, patterns that too often devolve into cycles of anger, hurt, misunderstanding, resentment, or deadness. Often couples come for help in crisis. Often a major event that throws the relationship off kilter and opens the fault lines: financial reversals, a loss of a job, or a death or illness in the family. The pain of infidelity brings many couple’s to therapy.
Sometimes, a couple with a basically sound relationship will work with me for a month or two on a weekly basis, especially when there is a specific crisis to negotiate, or a particular disagreement or miscommunication. Often, problems are more complex and chronic and demand deeper exploration and emotional growth from both parties.
I work with married couples, and couples in all kinds and degrees of committed relationship, both straight and gay. The basic requirement for couple’s therapy is that both partners are willing to honestly collaborate in the work.
Family therapy, like couple’s therapy, focuses on relationships that are not working well. Families, like individuals, go through stages of development that create a crisis, and demand new solutions and new perspectives. This is often true with families with young adolescents, and with older teens that are gearing up to begin separating from the family. Very often I use family therapy along with individual therapy in my work with adolescents to facilitate change, communication, and growth.
I see a number of psychotherapists with an interest in the psychoanalytic approach, either for short consultations of problematic patients, or for ongoing weekly consultation. At times I have available supervision groups and study courses in psychoanalytic theory and treatment.
I see a few folks who are explicitly seeking help with their spiritual life and are seeking a confidential, non-authoritarian relationship to explore their experiences and relationship to the sacred. Spiritual companionship involves an open mutual exploration towards greater understanding. Most often this involves meeting once a month for an hour.