Depression does not have to be extremely strong or debilitating for it to be distressing or to interfere in your life. Even mild depression can have an impact on your life, and it can be helped.

Depression occurs in many forms and may also be an aspect of other psychological and emotional conditions or states of mind. In addition, it may appear like some medical conditions and/or drug (prescription and/or non-prescription) reactions.

• IMPORTANT QUESTIONS

  • To what extent and in what ways is the depression resulting from psychological and emotional factors?

  • Is there any medical condition that may be creating the symptoms of depression?

  • Is there an overlap between biology and psychology in the presence and symptoms of depression in this situation

• FREQUENT SYMPTOMS (Not Complete – May Include Other Symptoms Not Noted)

  • Depressed Mood

  • Sad Or Empty Feelings

  • Low Self-Esteem

  • Feelings Of Guilt, Self-Blame, Or Worthlessness

  • Decreased Energy, Fatigue, Feeling  “Slowed Down”

  • Reduced Initiative Or Motivation

  • Sleep Disruption

    • Insomnia

    • Early Morning Awakening

    • Oversleeping

    • Nightmares

  • Change In Eating (Without Intention)

    • Lowered Appetite

      • May Include Weight Loss

    • Overeating

      • May Include Weight Gain

  • Difficulty Concentrating, Remembering, Or Making Decisions

  • Poor Judgment

  • Hopelessness, Helplessness, Or Pessimism

  • Restlessness, Irritability

  • Loss Of Interest Or Pleasure In Activities Or Hobbies That Were Once Enjoyed, Including Sex

  • Persistent Physical Symptoms That Do Not Respond To Treatment, Such As Headaches, Digestive Disorders And Chronic Pain

  • Muscle Tensions

  • Self-Harm (May Involve Cutting, Self-Burning, Or Other Self-Injury)

  • Thoughts Of Death Or Suicide

    • Suicide Attempts

  • May Accompany Some Kind Of Substance Abuse Or Addictive Behavior

  • May Involve Disruption In Relationships With Family, Friends, Or Co-Workers

  • May Also Be Present With Anxiety

Anxiety does not have to be extremely strong or debilitating for it to be distressing or to interfere in your life. Even mild anxiety can have an impact on your life, and it can be helped.

Anxiety is part of the spectrum of fear, may take many forms, and may also be an aspect of other psychological and emotional conditions or states of mind. In addition, it may appear like some medical conditions and/or drug (prescription and/or non-prescription) reactions.

• IMPORTANT QUESTIONS

  • To what extent and in what ways is the anxiety resulting from psychological and emotional factors?

  • Is there any medical condition that may be creating the symptoms of anxiety?

  • Is there an overlap between biology and psychology in the presence and symptoms of anxiety in this situation?

• FREQUENT SYMPTOMS (Not Complete – May Include Other Symptoms Not Noted)

  • Anxious/Nervous Mood

  • Restlessness, Feeling Keyed Up, On Edge, Or “Hyper”

  • Worry, Intrusive Thoughts

  • Physical Reactions Of Fear

    • Palpitations, Pounding Heart, Or Accelerated Heart Rate

    • Sweating

    • Trembling Or Shaking

    • Sensations Of Shortness Of Breath Or Smothering

    • Feeling Of Choking

    • Chest Pain Or Discomfort

    • Nausea Or Abdominal Distress

    • Feeling Dizzy, Unsteady, Lightheaded, Or Faint

    • Numbness Or Tingling Sensations

    • Chills Or Hot Flushes

    • Muscle Tensions

  • Feelings Of Unreality Or Of Being Detached From Yourself

  • Fear Of Losing Control Or “Going Crazy”

  • Fear Of Dying

  • Heightening Of Emotions And Reactivity

  • Flattening Or Numbing Of Emotions

  • Obsessive And/Or Compulsive Behaviors

  • Sleep Disruption

    • Insomnia

      • Difficulty Falling Asleep

      • Early Morning Awakening

      • Waking In The Middle Of The Night

    • Nightmares

  • Change In Eating (Without Intention)

    • Lowered Appetite

    • Emotional Eating

    • May Include Weight Loss Or Gain (Without Intending To)

  • Panic Attacks

  • Phobias

    • Fears That Are Excessive And Unreasonable

  • Difficulty Concentrating, Remembering, Or Making Decisions

  • Poor Judgment

  • Restlessness, Irritability, Overly Or Easily Critical

  • Loss Of Interest Or Pleasure In Activities Or Hobbies That Were Once Enjoyed, Including Sex

  • Presence Of Physical Symptoms That Do Not Respond To Treatment, Such As Headaches Or Digestive Disorders

  • May Accompany Some Kind Of Substance Abuse Or Addictive Behavior

  • May Involve Disruption In Relationships With Family, Friends, Or Co-Workers

  • May Also Be Present Along With Depression

Trauma refers to a serious injury or shock to the mind as may occur from physical, psychological, or emotional violence. In my view, it may be differentiated into two kinds: Incident Trauma and Developmental Trauma.

• INCIDENT TRAUMA

  • Person To Person Trauma

    • Victims Of Violent Crime

      • Rape

      • Assault

      • Battery

      • Mugging

      • Shooting

      • Stabbing

      • Kidnapping

      • Carjacking

      • Murder (Traumatic Experience Of Family Or Friends Of Victim)

      • Childhood Sexual Incidents

        • Molestation

        • Incest

      • NOTE: If you or a family member have been a victim of violent crime, I give you a place where you can feel safe and where you can honestly and openly talk about what happened to you or your family member and how it still effects you, even when your friends and family don’t want to or can’t stand to hear about it any longer. I will help you to understand why you are reacting as you do, even when you may feel out of control and maybe even a little “crazy.” I will also give you ways to work through the psychological and emotional impact of what happened and to help you get your life back. People often discover new skills, strengths, and internal resources that either they never knew they had or that they have only now developed.

      • I also want you to know that if you or your family member is a victim of violent crime, you may be eligible for therapy at no cost to you.

    • Acts Of War

  • Accident

    • Car Accident

    • Other

  • Natural Disaster

    • Earthquake

    • Fire

    • Flood

    • Other

• DEVELOPMENTAL TRAUMA

  • Traumatic Experience Resulting From Normal Development

    • Not An Incident Trauma That Occurs In Childhood

      • We typically fail to recognize how truly traumatic the experiences of normal development are, for all of us. None of us grow up unscathed. In our work together, I am very aware of this aspect and can help you to appreciate how deeply some of your experiences may have affected you in the past and continue to affect you in the present. This can then help you to deal with them more easily, and it is an important aspect of being able to “move on.”

• TREATMENT NEEDS

  • Left untreated, traumatic experiences can result in emotional wounds that may create substantial, lasting damage to a person’s psychological and emotional development, relationships, and maybe even their ability to function in daily living.

  • However, with treatment, you may be able to integrate your traumatic experience so that it does not significantly interfere with your daily living.

PTSD (Post-Traumatic Stress Disorder) refers to the lasting damage to psychological and emotional functioning that may occur following a traumatic experience. While this may occur, especially with more severe and more frequent traumatic experiences, it does not happen in all cases.

If it does occur, it can be helped and may even be fully resolved with treatment.

For more on trauma, see my book Traumatic Experiences of Normal Development.

When Substances or Behaviors Stop You From Having The Life You Want

Addiction refers to those kinds of behaviors (what are sometimes or loosely called “habits”) that involve the interplay between several factors. These may involve substances, behaviors, or the links between them.

Do you think you might have an addiction. Try this assessment.

• OBSESSIVE THOUGHTS

  • Recurrent, Persistent Thoughts That Seem To Invade Your Consciousness

  • You Can’t Stop Thinking About Them

• COMPULSIVE BEHAVIORS

  • Impulses That Seem To Drive You

  • Things That You Feel You Have To Do

  • You Do Them Even Though You “Know” You Shouldn’t

  • You Do Them Even Though They Have Negative Consequences In Your Life

• TOLERANCE

  • The Need For More Of The Substance Or Behavior In Order To Reach The Desired And Previously Obtained Effect

  • You Need To Do It More In Order To Have It “Work” For You

• DEPENDENCE

  • You Depend On It In Order To Feel Good

  • You Feel Like You Can’t Do Without It

  • You Need It, Not Just Want It

• WITHDRAWAL

  • You Feel Bad When You Don’t Use The Substance Or Do The Behavior

    • Symptoms May Include:

      • Change In Mood

      • Anxiety/Panic

      • Restlessness

      • Agitation

      • Irritability

      • Apathy

      • Attention/Concentration Difficulties

      • Sleep Disturbances

      • Change In Appetite

      • Depression

      • Physical Discomforts/Distress

      • Tremors/Convulsions

      • Change In Sexual Appetite/Functioning

    • You Return (Or Are Strongly Drawn To Return) To The Substance Or Behavior In Order To Relieve The Discomfort Or Distress Of The Withdrawal Symptoms

more…

While I work with heterosexuals, as most psychologists do, I also work with many people who are gay, lesbian, or bisexual. I see them either individually or as couples.

Some people come in because they are questioning their sexual orientation. You may be in a process of self-examination and self-discovery, and you will be the one to decide what your sexual orientation and identity is rather than have me or anyone else tell you what it is.

You may be in a process of coming out, and together we can consider if, when, how, and with whom you decide to do that. I will be your sounding board, your dis-information advocate, your guide, and your ally.

Sometimes, though, people come in being very clear and comfortable with their sexual orientation, whatever that may be. They are coming in to deal with other issues, and they want to do that with someone with whom they can just be themselves.

If you are looking for a safe place where you can be open about who you are, use honest words like “he” when referring to your male partner or “she” when talking about your female partner, talk candidly about your sexual practices, and maybe also frankly discuss how HIV has impacted your life or your relationships, then I’m happy to be able to give that to you.

My education and my own therapy have taught me that the mind and body are functionally identical.  What you think can and does affect how you feel, and what you feel affects how think.

I work at both levels, with people who are interested in doing that.  In addition to traditional talk therapy, I am also able to work somatically (with the body) to help you understand your body’s “language,” resolve your emotional problems, discover deeper levels of understanding and resolution, and realize more of your potential for pleasure and joy in living. In my own life, my focus on the somatic aspects has enabled me to feel more alive, connected, and integrated, and I am glad to provide you with an opportunity to find that for yourself too.

The somatic perspective that I primarily draw from is the one from Bioenergetic Analysis, which is a way of understanding psychological growth and development and of working with it in ways that are 

1) rooted in psychoanalytic theory and practice,

2) focused on the body,

3) derived from and integrating understandings about psychological development, and

4) centered in the practice of psychotherapy. 

For more information, see Bioenergetic Analysis.

The perspective on the mind that I primarily draw from is a contemporary view of psychoanalysis, which draws from all of the lessons learned from psychoanalytic study, not just those of Freud.  My approach takes what I consider to be the best of those various outlooks, especially many of the more modern ones among them, and adds some from my own experience, particularly about the role of trauma in our lives.  It integrates understandings about the unconscious, how your mind organizes your sense of self and experience, how present day living and interacting is influenced by events that have happened in your past, and how all of that affects your current relationships and interactions.  While it pays attention to your past, it is focused on the here and now of your life.

For more on this perspective, see my book Traumatic Experiences of Normal Development.

For people who aren’t interested in the somatic work, I am happy to stay strictly in a talk-therapy mode.

We all may have difficulty with some aspect of relationships at times in our lives. Getting help can make those periods move smoother, change faster, occur less frequently, and be less disruptive or traumatic.

Following are some of the FREQUENT AREAS WHERE PEOPLE STRUGGLE IN RELATIONSHIPS (not complete – may include other areas not noted).

• INTIMACY (Personal, Not Just Sexual)

• GETTING INTO RELATIONSHIPS

• GETTING OUT OF RELATIONSHIPS

• MOURNING LOSS OF RELATIONSHIPS

  • Separation

  • Divorce

  • Death

  • Co-Dependency

• INCREASED COMMUNICATION & PLEASURE

• PARENT/CHILD RELATIONSHIPS

• ADULTS

• SENIORS

• TEENS

• CHILDREN (Approximately 5 Years And Older)

• INDIVIDUALS

• COUPLES

• FAMILIES

People use this term in many different ways, and that may be confusing for people who are new therapy. Some people refer to “brief psychotherapy” as indicating a length of time, and holding it in contrast to the in-depth therapy that takes much longer. In those cases, the “brief” therapy may still take several months. Other people use the term to indicate a particular focus of the therapy, and yet even then that usage may be different from one person to the next.

What I mean by brief therapy is a crisis orientation. It particularly addresses the question, “Why Now?” concerning what the issue is that you are seeking help with. Sometimes, being able to discover the answer to that question may be all the resolution that you need, and that’s why it’s called “brief.” It may provide a refocusing of your attention, thinking, and understanding in a way that helps you to get back to your life as it was before that thing happened. Alternatively, it may provide a focus on that event that may reveal deeper meanings or traumatic underpinnings that may need a deeper examination and working through, and that may lead you into an in-depth therapy in order address and resolve those issues in your life.

People sometimes refer to this as “long term psychotherapy,” though I think that’s not an accurate description. The time required in therapy has more to do with what you want to get out of it. (See FAQ for more about this.)

What I mean by in-depth psychotherapy (sometimes called just “depth psychotherapy”) is developing a deeper understanding of who you are and why you do and don’t do the things in you life. Whatever it is that you are struggling with, there is some reason that you are struggling with it instead of just being able to manage it easily and smoothly. It is these obstacles that are our focus, so you can deal with them and move on in your life.

While this approach does place a high value on looking at the What in your life – what you do, think, feel – it also places an equally high value on the Why. It is the Why that gives the What meaning, and therefore we have a greater possibility of changing the What if we can understand the Why of it. Otherwise, the Why acts like a ghost in the room influencing what you do and don’t do, though it stays unseen. People sometimes refer to these Whys as the unconscious motivators and actors in our life. It is this inner world of meaning, the intersection between conscious and unconscious that is the focus of in-depth psychotherapy.

In a similar way, we look at both your present and past experience, because how you deal with things today is strongly influenced what happened before. If we can discover how those earlier experiences affect your thinking and feeling (and therefore your behaving) today, it is easier for you to make changes in what you do and how you do it from here on.