Treatment Options
Mental and physical health are entwined.
My practice is grounded in collaborative relationships. Together we build trust and an understanding of what is most important to you.
I emphasize the web-like interaction between the mind, the body, and the social world. I carefully and conservatively recommend psychiatric medications, when applicable, as one of many other valuable tools for treatment. When medically appropriate, I help patients reduce or eliminate overcomplicated psychiatric medication regimens, including addressing antidepressant withdrawal syndrome.
I welcome referrals from trusted psychotherapists for psychopharmacology and functional medicine, when indicated.
I accept referrals from primary care physicians and specialists interested in the interface between psychiatric distress and complex medical illness.
Learn more about my specific treatment approaches below.
PSYCHODYNAMIC PSYCHOTHERAPY
Psychodynamic (psychoanalytic) psychotherapy is at the core of my practice because of its demonstrated ability to promote lasting change in many instances. Psychodynamic therapy encourages exploring and discussing the full range of a patient’s emotions and experiences. In my practice, I work with you to put words to unthought feelings and symbols, examining what lies beneath surface experiences. We emphasize interpersonal experiences and relationships, including the patient-physician relationship, and pay attention to recurring themes. I will encourage you to speak freely, understanding that dreams and fantasies provide an extraordinary lens for self-reflection, self-exploration, and self-discovery.
One widely cited study* found an “effect size” — a measure of treatment benefit — of .97 for overall psychiatric improvement in patients suffering from depression and anxiety and treated with psychodynamic therapy. A typical effect size for treating the same conditions with cognitive-behavior therapy is .68. The typical effect size for antidepressant treatment alone is .31.
*The Efficacy of Psychodynamic Psychotherapy. J. Shedler in American Psychologist, Vol. 65, No. 2, pages 98–109; February/March 2010.
Personalized treatment builds on psychodynamic therapy with the following approaches, as necessary:
PSYCHOPHARMACOLOGY
Psychopharmacology employs the full breadth of psychiatric medications to help mitigate needless distress. I work with patients to develop a medication regimen that is as simple, elegant, and effective as possible while avoiding unnecessary side effects. I typically prescribe with a thoughtful and conservative approach. Sometimes, I work with compounding pharmacies to find personalized prescription solutions.
FUNCTIONAL MEDICINE
Functional medicine takes a web-like systems biology approach to ask why and how disease occurs. It focuses on identifying underlying causes, looking to the gut-brain axis, and the neuro-endocrine-immune system as nodes to modulate function. Measured recommendations utilize interventions such as activity and movement, food plans, laboratory studies, and nutritional supplements. Recommendations may also include mind-body interventions including meditation, guided imagery, self-hypnosis, breathwork, and relaxation exercises.
MEDICAL HYPNOSIS
Medical hypnosis is a collection of methods that enable mind and body to share information more effectively. All hypnosis is self-hypnosis; patients are always able to make choices in accordance with their best wishes, ethics, morals, and values. One common method is the utilization of trance: the process of creating an inner experience of focused consciousness that allows body and mind to share information. Hypnotic trance is a familiar state, much like a daydream, during which you remain aware of who you are and what you are doing while cultivating a vivid inner experience. Hypnosis can be a useful alternative to medication for rapidly reducing psychiatric and physical symptoms, especially in cases of anxiety, insomnia, and chronic pain.
MINDFULNESS-BASED COGINTIVE THERAPY
Mindfulness-based cognitive therapy applies mindfulness-based meditation to a clinical context. Mindfulness is the combination of focused attention — directing and sustaining your attention, noticing when your mind wanders, and gently redirecting it back to focus — and moment-to-moment awareness — acknowledging but not reacting to every aspect of your current experience. These practices inform helpful insights and strategies.
MENTALIZATION-BASED TREATMENT (MBT)
Mentalization-based treatment is a manualized psychodynamic therapy approach that operates from an inquisitive space; you learn to be more curious about yourself and curious about other people. Mentalizing imaginatively explores the mental states in oneself and in others to more fully explain behavior, beliefs, thoughts, and feelings.