What is therapy?

Therapy, often called psychotherapy or talk therapy, is a way to help people having difficulty managing emotions, behavior, and thinking to the extent that they are experiencing problems in social or occupational functioning. Over 500 different psychotherapies have been developed since Sigmund Freud published his works on psychoanalysis, and for someone seeking therapy, the process of identifying a well-trained, licensed practitioner may seem especially bewildering when distressed enough to seek professional help from a therapist!

Broadly speaking, most psychotherapies fall more-or-less into one of two camps.

  • Interpersonal therapy, where patients learn to:
    • identify their characteristic way of relating to significant others (and how come they developed these patterns that manifest when emotionally disconnected from those they care about most);
    • Block expression of aspects of these patterns that pull aversive responses from others that the patient cannot account for;
    • Mobilize their personal agency and heartfelt desire to change these patterns;
    • Develop new patterns to relate to others in more rewarding and satisfying ways.
  • Cognitive-behavioral therapy, where heighten awareness of patterns that stimulate or maintain anxiety, depression, or relational difficulties, such as:
    • Catastrophizing (e.g., worst case scenario thinking, when the situation does not warrant it);
    • Over-generalization (e.g., making overly broad, usually negative, conclusions about immediate experience);
    • Over-personalization (e.g., taking things too personally);
    • Black and white thinking (e.g., all-or-none, categorical assessments of immediate experience);
    • Selective attention (e.g., to a single negative aspect of immediate experience);
    • Misreading experience in ways that are inaccurate (e.g., “mindreading”) or situationally irrelevant;
    • Striving for outcomes in any given interpersonal interaction that are unrealistic and unobtainable (e.g., wanting to change how another feels, behaves, or thinks).

For relationship difficulties, therapists using interpersonal therapy can help people:

  • Understand their learned interpersonal behavior and perceptions that trigger, intensify, and maintain anxious or depressed states;
  • Identify and better adapt to significant speed bumps along the highway of life, such as major illness, death in the family, job loss, divorce), etc.
  • Understand why one consistently experience unexpected, unaccountable, or puzzling reactions from others that contribute to their anxiety or depression;
  • Regain a sense of control, agency, self-efficacy, and pleasure in life;
  • Identify what they need in relationships to be at their best, and how to maximize the probability of having those needs met;
  • Realize their characteristic vulnerabilities, and develop ways to effectively cope and problem solve, when they’re not getting what they need to live life on their own terms.

For anxiety and mood difficulties, cognitive-behavioral therapy, where patients learn to heighten awareness of can help people who experience some combination of:

  • Feeling persistent (and sometimes inexplicable) sadness, demoralization, helplessness, that just does not seem to go away;
  • Losing interest in activities that usually bring pleasure;
  • Indecisiveness, poor concentration and focus;
  • Persistent and uncharacteristic irritability;
  • Feeling worthlessness, excessive guilt, unusually persistent fatigue;
  • Sleep onset insomnia or excessive sleepiness;
  • Anxious apprehension, excessive caution, rumination that interferes with satisfactory living;
  • Episodes of panic, characterized by some combination of excessive heart rate, sweating, shortness of breath, chest pain, choking sensations, chills/hot flashes, numbness or tingling in limbs, or gastrointestinal distress;
  • Frantic attempts to avoid perceived abandonment by significant others;
  • Intense and unstable relationships, characterized by impulsivity, feelings of emptiness, episodic moments of inappropriately expressed anger, and possibly a fragmented self-image.

And, both approaches, with a therapist who is a good fit for you, can help people maintain satisfying relationships with significant others, by learning how to address problematic interpersonal situations with a balanced perspective.

My New York based therapy practice

I have been a licensed psychologist practicing therapy and psychological assessment for over 35 years. I specialize in working with two groups of patients:

  • People who are struggling to address issues that have emerged as they transition to adulthood;
  • People who may seem successful to others at mid-life, but know that they want to change course in their careers and relationships, perhaps because things just do not seem right or feel on track.

While not excessively eclectic, I would characterize my therapy practice as drawing upon the two traditions mentioned above.

I use empirically supported cognitive-behavioral therapies (CBT) (e.g., Cognitive Behavioral Analysis Systems Therapy; CBASP) as a starting point for treating patients who present with depression, or other CBT protocols for addressing anxiety and mood dysregulation.

When a patient’s primary apparent problem in living is relational, I draw heavily on Interpersonal Therapy and Personal Construct Psychology. Together, these approaches can help people de-pathologize themselves, accept that even though their current patterns of construing and relating to the world once made sense, they no longer work, and learn new ways of interacting with those most important to them – to live life on their own terms.

My approach is:

  • Collaborative and relational. I think of my job as a co-journeyer exploring and navigating through the past, present, and anticipated future of the patient’s life.
  • Characterized by an inquiring spirit. My aim is to listen carefully to your story, your experience, your inner narrative about your life. Then, my intention is to help you hear yourself with greater acuity and clarity, so you can define and construct a path toward the life you want to live.
  • Focused on what you want to change about how you live. I see myself assisting you in identifying the ways to know that you have reached your objectives, your personal criteria for therapeutic success.
  • Evidence-based. My work is based on state-of-the-art theoretical models that have been organized and validated by empirical psychological research.

In general, regardless of the approach I take, I seek to help you answer what I call The Prime Directive:

Why does it make sense that I am having these sets of problems with these people in these situations in my life, and what can I do to be more effective and satisfied in these relationships.

How does therapy start with me?

I respect and honor that to reach out to talk with a stranger – duly trained and licensed as I may be – is often a stretch. You may end up talking with me about topics, situations, relationships, or events that you just would not broach with your spouse or closest friend! I get it. That is why I begin with new patients in an organized and systematic manner.

We start with a 90-minute appointment. My goal is to get a sense of whether or not I believe I have the skill set to help you help yourself. (Not incidentally, I hope that during this session you get clear about whether or not you can see yourself working with me). Much of our time will be spent with us having a conversation about what brings you to my physical or virtual office, and gathering some relevant background information.

Assuming we both agree to continue, the next step will be for you to complete a variety of objective, scientifically developed, empirically validated measures to quantify the relative severity of your problems in living (the issues bringing you to my office in the first place), as well as your strengths needs, and vulnerabilities. Results from these measures allow me to draw upon the research literature to reliably predict the best approach to help you with your problems, as well as begin to get a more thorough window into your subjective experience of being you.

Next we meet to discuss the findings together and develop a working plan to organize our therapeutic efforts together.

HOW MUCH DOES THERAPY COST?

$250/ 45-minute hour. I take a limited number of reduced fee patients, generally, and am willing to slide my hourly rate down should you wish to come in multiple times per week, which often accelerates effectiveness of the psychotherapeutic process.

Please note, I do not see the following patients:

  • Children;
  • Autistic people or those on the spectrum;
  • Dementia/Alzheimer’s/neuropsychological cases;
  • Homicidal people;