My primary goal as a clinical psychologist is to provide patients with a safe, supportive and growth-oriented environment so they can face into life’s challenges from a stronger emotional base, improve their relationships, and reach their full potential.
There is an emphasis on emotional attunement in my work with patients. Many of the people I treat find it difficult to sit still with their feelings, either ignoring them or attempting to push them away through “reasoning” or with devaluing thoughts. (“That happened a long time ago—I shouldn’t be feeling upset!” or “How stupid that I’m crying about something so silly-- what’s wrong with me?”) Although these individuals are not always aware of this thought process, they often feel the unconscious need to squelch their emotions in order to avoid feeling vulnerable or in order to regain a sense of “control”. What they don’t realize is that avoiding their feelings has actually made them more anxious and more depressed—and that in order to regain actual control, they need to be able to experience these feelings on a conscious level.
I assist these patients in finding a loving response to their own pain, enabling them to provide a kinder and more compassionate way of responding to the parts of themselves that are in pain and feeling isolated. Although many patients insist that they “can’t be nice to themselves”, even the most resistant patient can learn how to respond with kindness. When you stop pushing your feelings down and you stop battering yourself with harsh thoughts, a significant portion of your depression and anxiety will be diminished.
My style is more interactive, as opposed to neutral. I am an engaged participant in the therapy process, helping my patients to feel connected to themselves, and assisting them as they progress towards their goals. I believe that healing and growth takes place in the context of a strong therapeutic relationship, and I pay close attention to this aspect of the work.
I employ a variety of tools and techniques to help my patients attain their therapeutic goals, and actively tailor the treatment approach to suit the needs of my patients. I draw from & theories, (including the latest neurobiologic findings on the benefits of psychotherapy), and techniques in my work with patients. My research background in also gives me a unique understanding of how the mind impacts the body, enabling me to assist patients in creating balance between the physical and the psychological realms. In addition to my doctorate, I also have a master’s degree in theology, maintaining a real sensitivity to the and issues that patients may bring into their treatment. I maintain a great respect for individual differences, and welcome the opportunity to work with clients of diverse races, religious and ethnic backgrounds, and sexual orientations.
OBJECT RELATIONS & CONTEMPORARY PSYCHOANALYSIS: The feelings, thoughts, and behaviors of my patients are explored within an object relations & contemporary psychoanalytic context, looking at childhood experiences and how they helped to shape the individual’s mind. Object relations is a relational model of psychoanalytic therapy with a focus on the impact your childhood has had on the way you view and respond to yourself and the world, as well as on your experience within the therapy relationship. (Please note that contemporary psychoanalytic therapy is not the same as the traditional “Freudian” approach to treatment; they differ greatly, both in their theoretical underpinnings, as well as in the nature of the relationship that is established between patient and therapist.)
The goal of treatment is not to learn how to blame your parents, but rather, to develop an appreciation for how these early experiences impacted the way you think, feel and behave today. Although we may naturally possess some awareness of how early experiences have shaped our minds, all too often these forces continue to operate on an automatic and unconscious level. When left unexamined and "in the dark," these early influences can act as obstacles in life, preventing us from truly getting what we want and need.
The object relations approach focuses on the kind of relationship you maintain with yourself, based on the belief that "we learn to treat ourselves the way we are treated." If you learned that your needs and vulnerabilities were not well accepted by others early in life, to what degree can you genuinely accept these aspects of yourself as an adult? In therapy, I help patients learn how to respond towards their hurt and upset feelings with kindness and understanding, rather than neglect or hostility. Even though many patients say-- “But I can’t be nice to myself; it’s impossible!”-- patients can and do learn how to find genuinely kind feelings towards the parts of themselves that are hurting in treatment. This shift in response style towards your self will mark the end of being in the grasp of chronic depression.
The object relations approach also focuses on the kind of relationship you maintain with others, based upon your early relationships, especially with your primary caretakers. (Primary caretaking relationships include your Mom & Dad; sometimes older siblings, grandparents, and nannies are also included.) In the therapy we explore to what degree your childhood experiences may have taught you to guard against trusting or relying upon others, or taught you that it was unsafe to allow yourself to become vulnerable with them. Did your childhood experiences teach you to believe that you must only show certain parts of yourself to others in order to maintain harmony and receive acceptance? How do these beliefs affect the way you relate to others, and limit the degree to which you can feel truly fulfilled in your life?
The object relations approach to treatment also means maintaining an active interest in the ways that a patient responds to the therapist. Sometimes, patients bring their painful and guarded expectations into the relationship with their psychologist, and it is important to look at the ways in which these “stacked” beliefs impact the patient’s ability to feel comfortable and safe within the therapy relationship. It’s important to be aware of what’s happening in the present, and that includes, making sure that our relationship is intact, and that disappointments and injuries are properly understood and addressed, in order to maintain a strong, therapeutic bond.
NEUROSCIENCE & PSYCHOTHERAPY: The latest findings in the neuroscience literature have great relevance to the practice of psychotherapy. Past and current neurobiologic research is shedding new light on how childhood experiences impact the development of the brain, and how psychotherapy has the power to heal a vast array of psychological conditions on a neurobiologic level.
For example, trauma during infancy (including abuse) can alter the structural development of the brain’s right hemisphere, leading to inefficient mechanisms for coping with stress and attachment disorders during childhood and adulthood. Also, adults who have suffered profound childhood losses, such as the death of a parent or abandonment by a parent, have increased cortisol responses in tests, compared to the neuroendocrine functioning in adults who have not suffered severe losses.
On a very hopeful front, the newest studies in neuroscience demonstrate a myriad of ways in which the experience of psychotherapy can alter and improve the structure of a patient’s brain, changing neurochemistry, modifying dysfunctional neural circuitry, establishing new neuronal pathways, and functionally, “rewiring” the brain. These important discoveries provide a fascinating glimpse into how conditions such as anxiety, depression, phobias, obsessive compulsive disorders, coping and attachment disorders can all be effectively treated and significantly reduced as the experience of psychotherapy transforms the landscape of the mind.
The following links will connect you to some of the latest studies found in the medical literature that demonstrate the healing effects of psychotherapy that take place on a neurobiologic level in patients undergoing treatment. Also listed are studies demonstrating the impact that childhood trauma and abuse have on the development and functioning of the human brain.
Neuroimaging and the functional neuroanatomy of psychotherapy:
Neuroimaging studies of psychological interventions for mood and anxiety disorders: Empirical and methodological review:
Change the mind and you change the brain": Effects of cognitive-behavioral therapy on the neural correlates of spider phobia:
How psychotherapy changes the brain--the contribution of functional neuroimaging:
Brain imaging and psychotherapy: Methodological considerations and practical implications:
Effect of mind on brain activity: Evidence from neuroimaging studies of psychotherapy and placebo effect:
Modulation of cortical-limbic pathways in major depression: Treatment-specific effects of cognitive behavior therapy:
Relational trauma and the developing right brain: An interface of psychoanalytic self psychology and neuroscience:
Childhood parental loss and adult hypothalamic-pituitary-adrenal function:
Dysregulation of the right brain: A fundamental mechanism of traumatic attachment and the psychopathogenesis of posttraumatic stress disorder:
Traumatic childhood background, impulsiveness and hypothalamus-pituitary-adrenal axis dysfunction in eating disorders. A pilot study:
Hyperresponsiveness of hypothalamic-pituitary-adrenal axis to combined dexamethasone/corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse:
COGNITIVE BEHAVIORAL APPROACH: A cognitive behavioral perspective is also incorporated into the treatment, after a patient has developed an emotional connection with his or her feelings. The theory underlying the cognitive perspective suggests that it’s not just the events or circumstances that occur in our lives that strongly determine how we think, feel and behave—it is also the meaning that we assign to those events and circumstances that shapes our emotions and actions. In other words, it is the way we interpret what happens to us that determines how we will behave and how we feel about ourselves, our future and the world around us.
I work with patients to help them discover the “spin” they put on their circumstances, looking for patterns in the way that they interpret the events that are occurring and helping them to discover the distorted or exaggerated meanings that are assigned to these events. It is the story you tell yourself in your own head about these circumstances and what they mean that ultimately leads to unpleasant feelings and potentially destructive behaviors.
For example, depressed, anxious and suspicious individuals often tend to use distorted or unbalanced thinking in some very predictable ways. Depressed individuals commonly focus on the most negative aspects of themselves, their experience and their future, based upon a belief that they are bad, inadequate or unworthy. They tend to interpret their experience primarily with an eye to their past failures and disappointments, and usually overlook evidence of accomplishments and attainments. Anxious individuals, on the other hand, tend to focus their attention upon signs of warning, threat or danger. Their belief that they are weak, fragile and vulnerable dominates their thinking, and there is little attention paid to their strengths, abilities, and coping skills. Finally, suspicious individuals are usually most focused on "evidence" that they are being disrespected, controlled or otherwise violated, without entertaining alternative explanations or factors. Their belief that they are going to be disappointed, rejected, or mistreated dominates the way they view themselves and their experiences. So, for depressed, anxious and suspicious individuals, their ensuing reactions in terms of mood and behavior are consistent with the types of beliefs they possess and the “organizing principles” they employ to interpret the data being focused upon.
So how exactly is it that we develop these potentially distorted organizing principles—the ones that so powerfully drive our emotional and behavioral functioning? It's pretty clear that nobody wakes up one day and decides, "Hmm, given all the options, I think I will be excessively alert to danger around me, and will therefore distrust anyone who tries to get close to me" or "Perhaps I'll decide to base my value as a person upon exceeding high, perfectionistic standards, setting myself up to emerge from most situations feeling like a failure. In reality, our tendency to interpret the world around us is shaped by two variables—our childhood environment (nurture) and our genetics (nature). In therapy, we focus on the environmental contributors that went into shaping a patient’s beliefs and thinking habits-- how did your childhood experiences set you up to interpret the world through this particular grid or organizing principle? (This is where the object relations focus on childhood history becomes very important.) Then we work to establish a new and therapeutic environment for the patient—one that will provide new and reality-based options for interpreting the events that take place in your life.
In utilizing cognitive therapy to address your symptoms, we will evaluate the way you are seeing yourself, thinking about yourself and talking to yourself, and examine the degree to which you are using a fair and balanced method of self-evaluation. The truth is that, with training and practice, we can learn to modify the way we interpret ourselves and our experience. Of course, these changes cannot occur overnight. Consider, for example, your ability to interpret yourself and your world in a negative manner. How long have you been “practicing” this technique? A long time? How good have you gotten at it? If you are like most people who have struggled with depression or anxiety, you are probably an expert at seeing the downside of life. If this ability to negatively interpret were a muscle in your body, we would imagine it to be quite strong and well-developed. After all, it gets “worked out” often, automatically. Now imagine the other muscle, the one that is able to view yourself and your life in a more balanced and accurate manner. This muscle exists, but it has probably atrophied from lack of use. It most certainly needs strengthening, which is precisely the task of cognitive therapy.
Although most commonly applied to the treatment of depression and anxiety, cognitive therapy has also been extremely effective in addressing substance abuse, bipolar disorder and personality disorders. Many psychological symptoms are based on faulty or distorted belief systems, thus cognitive techniques can be extremely helpful in improving them. PLEASE NOTE: Cognitive therapy is not simply “positive thinking” and the goal of treatment is not to get you to see every aspect of your life in a rosy, optimistic and hopeful manner. This would be unrealistic, especially since life typically contains a mixture of successes and disappointments. The goal is to help you view your experience in an appropriately balanced and accurate manner.
SPIRITUAL & EXISTENTIAL ISSUES: In some cases, patients present with psychological issues that are impacted by spiritual and existential longings. As mentioned above, my additional degree in theology has provided me with a real sensitivity to the spiritual issues that individuals of any belief system (non-religious or religious) may bring into their therapy. This interest includes working with clients who are looking for more meaning in life through a spiritual and/or religious path, as well as clients who have been injured through their experiences within organized religion, who are attempting to separate from their religious tradition.
There is a clear overlap between psychological and spiritual well-being, and I believe it is important to honor the spiritual dimension, if and when a patient presents with this specific need. For example, as the economic crisis has swept our nation, feelings of despair and hopelessness have arisen inside many people. While these feelings are psychological in nature, they can also represent bigger and broader issues of a spiritual and existential nature: Some patients may ask, “How do you have hope when everything around you is falling apart? Your world view (which includes your belief about the “goodness” or “badness” of the universe) and your identity as a person (who am I and how do I define myself as my career or retirement account are slipping away?) are two concepts that are impacted by both the spiritual and psychological dimensions.
For some patients, a spiritual direction is the next step, after many years of having a more psychological focus in their lives. These individuals may still struggle with “being” or “staying present”, but they have reached a level of awareness that leaves them longing for more connection within themselves and within the “universe”. Psychotherapy can assist these patients in this growth process, as they reach for the next stage in their development as human beings.
For other patients, the “spiritual” side is not the primary focus, but rather, they present with a need to separate from their religious tradition. Some individuals have experienced considerable pain and suffering within the context of their religious heritage. They may also experience severe and sometimes, crippling guilt and confusion, secondary to the religious beliefs from their childhood tradition. Some of these beliefs may have left patients feeling afraid to separate from their religion, for fear that bad things will happen to them (or that they will be considered bad people), if they choose to strike a more independent path. A patient in this position may ask, “Will I be ‘damned’ if I question the tenets of my family’s religion?”; “Am I a good person if I don’t believe in God or if I do believe in God, but no longer believe the way others tell me I should believe?” With support and a clearer understanding of the psychological nature of this dilemma, these individuals can find a way to face into their fears and comfortably separate from the damaging traditions and beliefs, without feeling condemned, guilty or anxious.
MIND-BODY & PSYCHONEUROIMMUNOLOGY: The mind-body literature, also known as psychoneuroimmunology (PNI), also informs me in my work with patients-- especially those who are suffering with depression, chronic stress, and illness. PNI is an interdisciplinary field that studies the interaction between psychological processes and the nervous and immune systems of the human body. PNI has bearing on the way that I conceptualize the psychological needs of my patients that are suffering with chronic illnesses, as well as infertility.
Chronic Illnesses: In the past thirty five years, PNI research has clearly demonstrated that stress, depression, and repressed negative emotions, can impair a person’s immune system, making them more vulnerable to a multitude of illnesses and diseases.
Chronic stress can be brought on by multiple external factors ( job demands, job loss, divorce, protracted illness, being a caretaker, infertility, death of a loved one, military combat, homelessness). There are also “internal” factors, such as chronic depression and denial of negative emotions that can create chronic stress. Over the long-term, prolonged stress brought on by external and internal factors can lead to an impaired immune system.
Many of the patients I treat have a tendency to unknowingly transfer negative emotions into their bodies, rather than experiencing their feelings on a conscious level. This tendency, also called repression, is often employed by patients who believe that it will be too painful or overwhelming to experience their hurt, anger, guilt, fear and anxiety consciously. Chronically depressed patients are especially prone to repression of angry feelings, which exacerbates their depression and can lead to a multitude of physical ailments, eventually creating immune suppression and dysfunction.
When treating these individuals, the focus of psychotherapy is to help them to feel safe enough to allow for a conscious exploration of these feelings. Through this process, patients discover that their emotions will not overwhelm me or scare me away, and ultimately, they learn that they will not be overwhelmed by their own emotions either. There is a great sense of psychological relief as the negative emotions are incorporated into the patient’s conscious awareness. There is also a great physical relief as the burden that had been placed on the individual’s body and immune system is lifted.
Here is a short list of some of the diseases and conditions that have been linked in PNI studies to chronic stress and repressed emotions: Colds, flu, slower wound healing, herpes, skin conditions such as atopic dermatitis, irritable bowel syndrome, recurrence of cancer tumors, incidence of many cancerous tumors, including malignant melanoma, breast cancer, rheumatoid arthritis, multiple sclerosis and other autoimmune diseases.
Studies demonstrating link between illness & repressed emotions:
Infertility: Research also shows that stress can have a significant impact on one’s fertility. The most recent studies have found that up to 30% of infertility cases are the result of stress. Recent studies also show that stress plays a role in the success of fertility treatments such as IVF. Researchers have also found that when couples reported that they were feeling “relaxed”, the rate of pregnancy went up. The good news is that studies have found that psychotherapy can play an important role in reducing stress for women struggling with infertility.
Studies demonstrating link between infertility & stress:
