Psychotherapy is an effective tool to help people lead happier and more satisfying lives. Sometimes called “talk therapy,” psychotherapy works by helping people identify and change the factors that are contributing to their distress and unhappiness. The first step in psychotherapy is to complete a comprehensive evaluation. During the initial evaluation, which is usually conducted over the first few sessions, I ask questions to get a full understanding of your current symptoms and life circumstances. I also ask questions designed to understand any background factors that might be playing a role in your current issues. Additionally, I will want to make sure I have a good understanding of your therapy goals. With this information in hand, I can make recommendations about what approach I feel will most helpful in helping you to resolve your issues and meet your goals. The type of approach I use then depends on your individual circumstances and therapy goals. Most often, I use a combination of cognitive behavioral and psychodynamic approaches.

Cognitive behavioral psychotherapy focuses on how one’s unrealistic thoughts and maladaptive behaviors contribute to one’s symptoms. For example, if a person constantly thinks about the worst case outcomes of even minor problems (e.g., “catastrophizes”) he or she will likely experience considerable anxiety. If a person continually isolates from friends and family and stops all previously pleasurable activities, he or she is likely to become more depressed. In cognitive behavioral therapy, we would closely examine your thoughts to help improve your mood through developing more realistic ways of thinking. We would also focus on setting behavioral goals (e.g., starting an exercise program, reaching out to friends, changing a negative life situation) to enhance mood through increasing motivation, energy, and life satisfaction. Cognitive behavioral treatment can be very helpful in alleviating both anxiety and depression.

Psychodynamic psychotherapy focuses on how past unresolved and often unconscious conflicts contribute to current problems and symptoms. For example, a relationship break-up might trigger a depressive episode by bringing back unresolved feelings about a past ending, such the divorce of one’s parents. Unresolved issues around being raised in an alcoholic or otherwise chaotic home might leave one prone to experience chronic anxiety. A difficult relationship with a parent might keep replaying itself in having difficulty maintaining healthy relationships in the present day. A psychodynamic psychotherapist focuses not just on alleviating current symptoms but on understanding how past hurts and conflicts are causing the distress. By understanding the potential causes, people are able to generalize the gains made in therapy not just to current symptoms but future challenges as well. When current problems seem deeply rooted in past events, or when symptoms or problems keep coming back despite previous attempts at self help or psychotherapy, psychodynamic psychotherapy may be the treatment of choice.

It is important to note that these treatments are not exclusive of one another, in that I frequently draw on both treatment methods to fit your unique needs and circumstances. If after talking, it seems that medications would be beneficial, I work closely with several psychiatrists in the area and can give your referrals and collaborate with them throughout the course of your treatment.