I list below clients’ most frequent presenting concerns. Feel free to discuss with me your particular concerns.
Panic, Anxiety and Stress Management
Panic attacks often respond rapidly to treatment. Treatment involves teaching clients the physiology and psychology of panic (not having an explanation for the panic experience contributes to the vicious cycle of a panic attack), and then teaching mastery skills.
Anxiety (or chronic worry) is characterized by “what-if-thinking”. The anxious person is asking her- or himself, “What if (something bad) happens?” Effective treatment typically uses cognitive-behavioral therapy to examine anxious thoughts for distortions and to make necessary corrections.
Many of the skills that contribute to mastery of panic and anxiety are sufficient to help clients master stress. Goal reassessment and lifestyle changes can be helpful.
Trauma and Abuse
Clients with a trauma history require careful assessment and treatment. Trauma survivors can experience symptoms of Post Traumatic Stress Disorder (PTSD), Disorders of Extreme Stress, or Dissociative Identity Disorder (DID). Treatment of these disorders requires special training and experience. Clients’ symptoms and difficulties in living vary with the type of trauma (e.g., abuse, accident, rape), the age at which the trauma occurred, whether it was a single incident or recurring, and whether a perpetrator was a stranger or a trusted person in the survivor’s life. The goals of therapy are first, to help the client increase functioning in everyday life (stabilize sleep, eating, self-care, relationships, ability to work); and second, to address the disruptive memories of past trauma. A variety of treatment modalities may be used to provide safe, effective care.
Depression, Grief and Loss
Depression is not a single entity. Depressions can range from mild to severe. Depressions can be cyclical (periods of depression followed by periods of normal mood) or chronic (extended periods with depressive symptoms). Clients’ histories vary greatly. Some come from families with many relatives who suffer from depression. Some develop depressive symptoms due to a recent setback or loss. Some depressions are symptoms of trauma. Cognitive-behavioral therapy is the most frequently prescribed psychological treatment for depression. I have found psychodynamic approaches helpful also. Anti-depressant medication can reduce symptoms in many cases. I collaborate with prescribing physicians to insure coordination of care.
Psychotherapy and “Personal Growth”
To paraphrase Stephen Mitchell, “the heart of psychotherapy is its commitment to the compassionate, collaborative study of the fine-grained texture of individual lives, in all their complexity and intensity.” I subscribe to Mitchell’s view of therapy as a collaborative, open engagement in which the patient is empowered through thought provoking questions rather than declarative interpretations that presume to reveal “what is really going on” in the patient’s mind.
For over ten (10) years I have co-led a group with a focus on relationship concerns. Group therapy provides the opportunity to practice many of the skills for healthy living in an atmosphere of support and safety. Groups are limited to a maximum of eight members. There is a minimum commitment to remain in the group for six months.
Throughout my career I have worked with clients whose presenting concerns consisted of work related problems. Clients have come both from small companies and large corporations such as General Electric and Proctor & Gamble. Effective coaching includes helping clients develop clearly specified goals and the strategies to achieve those goals. Coaching typically focuses on “soft” (interpersonal) skills which are increasingly recognized as vital for successful collaboration in a diverse business world.