What to Expect:
In therapy, I perform a comprehensive evaluation of symptoms and behavioral targets, which we then discuss and set goals around. Depending on the nature of treatment, I utilize Cognitive Behavioral Therapy (CBT,) Dialectical Behavior Therapy (DBT,) Exposure with Response Prevention (ERP) and Habit Reversal Therapy (HRT.)
I work with patients to understand how their symptoms are negatively affecting their life, and collaborate to make a treatment plan customized to meet their specific goals. I am sensitive to the fact that finding a therapist and beginning therapy can be both overwhelming and intimidating. I take my work very seriously, though I try not to take myself too seriously, finding moments of humor and levity where possible. I am encouraged frequently by the bravery and resilience of my patients in their willingness to face and overcome their fears and anxieties.
I treat therapy as a collaborative, active experience. Please bring a notebook with you and plan to work on the concepts discussed between sessions.
Approach to Therapy
To treat depression and low mood, I utilize CBT and DBT, as well as behavior activation strategies. Goals can include decreasing unhelpful thought patterns and behaviors, increase helpful behaviors, thought patterns and increase activity. I work collaboratively with my patients to enact strategies, thought and behavioral changes to target improved mood. DBT includes a set of behavioral skills to help that cope with painful thoughts and emotions.
To treat of anxiety, phobias, and OCD, I utilize ERP. The nature of these disorders is "a misfire" of fear in our brain in response to a trigger. This can be considered a "misfire" in that the fear is either incongruent to the stressor or the intensity of the fear is incongruent to the trigger. Another consideration would be that there is a real danger, but the extent of the anxiety or obsession is negatively affecting quality of life or ability to function. The goal of ERP is to expose to the emotion of fear (though it can be guilt as well) and teach the individual how to tolerate to the intensity of the emotion without blocking it. Over time, this helps reduce the frequency of "misfire" and helps the individual better tolerate difficult or uncomfortable emotions and anxiety.
Anxiety grows over time and creates behavioral patterns of avoidance, rituals and compulsions which function as "fixers" to remove anxiety. For example, if I have a thought that I "messed up," which spikes anxiety, I learn that I can reduce my anxiety immediately by seeking reassurance. Reassurance in this example functions as a ritual or compulsion, a "fixer" because it gives relief from anxiety. This increases anxiety over time as reassurance becomes a reinforced behavioral pattern. Over time, the frequency of anxiety grows and is less satisfied by the reassurance requiring more frequent reassurance. This teaches our brain that we cannot handle our anxiety and must find something to "fix" it. ERP functions to remove the "fixer" and expose ourselves to anxiety, learning over time that we can tolerate anxiety without finding a ritual or compulsion to "fix" it.