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he focus of psychotherapy involves the use of psychological information, both conscious and unconscious, based on the client's recollection of past events, relationships, perception of self and metaphorical representations such as dreams, journaling and art work. The therapeutic process occurs between the individual client and the therapist. There may be blending of the several approaches, according to the expressed preferences of the client and determined effectiveness over time. The following is an overview of the subspecialties I treat within the domain of psychotherapy.

Psychotherapy

 

Abuse/Childhood - Emotional, Physical, Sexual:
Recovery from childhood abuse involves a grieving process around the loss of childhood and a recognition of the extent of the trauma that was incurred. Clients often experience symptoms that are components of posttraumatic stress disorder or mimic anxiety and depression. The objective is to move beyond the shame, guilt and anger surrounding the past and develop mature adult coping strategies, and healthy boundaries within relationships that allow for greater intimacy as an adult.

Addictions - Chemical, Sexual:
Tackling addictions requires developing an astute awareness of the signs, symptoms and environmental/psychological triggers that precipitate engaging in addictive behavior. Finding new, alternative solutions for coping with stressful events or emotions is essential to the process of recovery along with taking full responsibility for your behavior. A sound recovery plan may include use of a twelve step or sixteen step model (see below) combined with cognitive therapy and family origin work.

  • Charlotte Kasl's sixteen step approach to recovery blends cognitive, holistic, spiritual, and empowerment techniques to recover form addictions including co-dependency.

Co-Dependency:
Recovery from co-dependency envelopes gaining a clear sense of self and becoming less focused on the actions/motivations of others and/or taking cues from the world at large as to how to conduct yourself. This entails an in depth exploration of family history, values, and expectations that have shaped your personality along with establishing healthy boundaries and moderate responses to people and situations. The recovery process dovetails with that describe for addictions.

Depression/Anxiety:
Living a full, satisfying life while managing depression and anxiety requires developing a healthy lifestyle including dietary, exercise and social components. Employing cognitive techniques to refute negative self talk, and establishing realistic expectations is essential in establishing a sense of well-being. In certain circumstances medication is warranted to alleviate symptoms and promote effective use of therapy.

Intimacy:
Attaining and sustaining intimacy in relationships entails balancing your needs and wants along with those of the other person's. The goal is to feel a deep sense of connection with others while maintaining boundaries and a sense of individuality. Sometimes this requires exploration and resolution your past relationship history along with the development of communication skills so that you can express your vulnerability and at the same time feel respected within a relationship.

Life Transitions/Life phase:
Achieving a successful transition whether it be environmental i.e. work or relocation; or personal i.e. mid-life or postpartum, involves adjustment and acceptance of your new role. Establishment of new goals and a positive outlook is essential to moving from one phase to the next. Education regarding what you can expect in the your near future along with therapeutic support can help provide some solid ground while you are undergoing rapid growth and life altering change.

New Moms/Postpartum Adjustment:
Becoming a new mom can be both exciting and overwhelming. Care for the new born requires singular, continuous focus on the baby’s needs around the clock. Even with adequate support systems, a new mom can experience a let down of mood often referred to as “baby blues.” These periods of depressed mood or irritability can be accompanied by tearfulness, negative thoughts towards the baby and mothering, self doubt about the ability to be a “good” mother, and guilt over not being able fulfill previous roles and responsibilities in the outside world and within the family. The adjustment to this new life role can be complicated further by post natal recovery, chronic levels of fatigue due to loss of sleep, hormonal imbalances, past life history, and the demands of a family (other children), or work. The objectives for therapy within a supportive, encouraging environment include: establishing realistic expectations, arriving at a meaningful personal definition of mothering, becoming more confident in your ability to bond with your baby and be a mom, implementing self-care, and connecting with new support systems. Communication and collaboration with your health care providers may be required given the complex interaction between physical recovery from child birth and emotional well being.

Personal Growth/Spirituality:
Expanding your world, options, and life views are the hallmarks of personal and spiritual growth. Self-actualization involves confronting fears, old perceptions and messages surrounding yourself and the world. A willingness to try new endeavors, and explore different belief systems within an encouraging, supportive therapeutic environment helps foster a spirit of receptivity to creative thought and expression thus enriching your life experience and those of others around you.

Self-Esteem/Assertiveness:
Establishing a positive sense of self and asserting yourself in the world go hand and hand. Healthy self esteem encompasses taking a realistic inventory of the attributes and weak points of your character. It requires self acceptance, setting realistic objectives, addressing perfectionist tendencies and refuting messages given to you by others. Self-assertion stems from a sense of value to both yourself and others and is a natural outcome of achieving self worth. Offering help and opinions, as well as, expressing your needs becomes the inherent motivation for a fulfilling, satisfying life.

Life Threatening Illness/Oncology:
Coping with a life threatening illness poses its own special challenges. The initial diagnosis is often met with shock and bewilderment with questions ranging from how do I determine the best course of treatment, to how will this effect my family, to what will the future bring? The treatment phase requires endurance, setting realistic objectives, and dealing with ongoing fears. Post treatment (survivorship) entails re-entering the “well” world with a realignment of priorities, a shift in family/intimate relationships, and in some case an adjustment to a new body image. Family members/caretakers have their own set of adjustments spanning across providing direct care, determining how and what kind of support to give, and dealing with their own fears about the future. It is the therapist’s role with both the patient and family to provide support, encourage choices compatible with values systems and life circumstances, facilitate clarity and understanding of what a diagnosis means and its specific relevance to the individual and family, assist with setting realistic goals, and being present focused. In all cases open communication is essential as diagnoses such as cancer still harbor social anxiety leading to secrecy and confusion.

Performance Anxiety/Burnout:
Performance anxiety and burnout can be experienced by anyone involved in the performing arts, professions that are service oriented, or with high visibility to the public sector. The demands of such careers can lead to high expectations both real and imagined. The tendency towards constant scrutiny either imposed upon by the professional or the public can result in bouts of depression, fatigue, or addictive behavior. In therapy, the client learns to pace her or himself, establish healthy boundaries, employ stress reduction techniques, and schedule in breaks and vacations. At times, the client may feel it’s necessary to explore other career options. In determining whether a change in profession is required the therapist helps the client gain clarity by reviewing values and life style choices before a decision is finalized. The client is encouraged to take time in making such assessments whether it be to modify what they are currently doing, try a new approach, or pursue another alternative.