My Approach
I usually do what I describe as “medium-term therapy,” in units of about a year. My clients and I don’t immediately try to fix every single thing in their lives they might want to change. Instead, in our first few meetings, we find one or two major problems you’d like to work on. It could be something as all-encompassing as depression, as straightforward as a fear of spiders, or as nebulous as just feeling that there’s something missing from your life—as long as it’s something we can name and start to work on together.
Once we’ve named the problem, we explore together what it means. We’ll look at when the problem started and how it’s been affecting your life. We’ll look at what you’ve done already to try to fix it—what worked, what didn’t work, what worked for a little while and then stopped working, what seemed to work but wasn’t worth what you had to give up to do it. We’ll try to figure out whether there’s some need that your behavior is meeting that you can’t figure out any other way of meeting—what is it you’re getting from the way you’re living now? What would you lose if things changed? Quite often, problematic ways of acting or feeling are the way we learned to survive through difficult, painful situations. We may have gotten away from those hard times, but we keep on doing whatever got us through them, even though doing that may cause us new problems.
Once you and I feel we understand the problem enough to go on with (though we’ll keep learning new aspects of it throughout the year), we start looking for new solutions to it. You’ve probably learned a lot from what you’ve been through so far, and we’ll explore your strengths, trying to see how we can apply them to solving the problem. Finding solutions isn’t always easy, and we’ll take our time with it. If one solution doesn’t work, we’ll talk about what didn’t work about it, and keep on until we find something better. Once we’ve found a solution that seems to be working, you’ll put it into practice for a while, and we’ll talk about how it’s going until we can be sure that it’s going to keep on working for you even after we’re no longer seeing each other.
How long each of these steps takes varies. Some people may find that we’ve solved the problem they came in with within a few months. Others may find that a year is the right amount of time. Still others may do a year of work, and then find that there is another, related problem they would like to work on, or that the problem is simply too big to solve in just a year. I stay flexible, working with each person to find the right pace for him, her, sie, or them.
Sessions may look very different for different people, or from week to week. Some clients find it most useful for me to teach them techniques, or give them “homework assignments” of things to practice. Other people find it most useful for us to simply talk. Sometimes you may find it useful for me to help you examine and understand what’s going on; other times, you may just need me to listen. Whatever we do, my goal will be to help you feel comfortable enough to accept yourself without judgment. By the end of the year, I expect that the changes in your life will make you happier, more at ease, and better able to succeed at your goals. At the same time, though, I hope you may learn to feel that you would still have been a worthwhile and lovable person even if you had never changed at all.
In terms of theory, the way I think about people can best be described as psychodynamic—one of the oldest schools of psychotherapy, started by Sigmund Freud but significantly changed, improved, and expanded by the theorists who came after him. Thinking psychodynamically means I’m curious about people’s stories and their deepest feelings—how they understand the world around them and their role in it. My actions in session, though, often fit a solution-focused approach; I believe that change is possible, and I read widely to learn new ways to help people change as they need to. I will sometimes use dialectical-behavioral techniques, which were originally designed to help people with Borderline Personality Disorder, but which have useful lessons for many people without that diagnosis in how to understand emotions and get through difficult times and conflicted relationships. I’m always open to learning new techniques; I want to do whatever will best help the person in front of me, no matter where that idea may come from.
Once we’ve named the problem, we explore together what it means. We’ll look at when the problem started and how it’s been affecting your life. We’ll look at what you’ve done already to try to fix it—what worked, what didn’t work, what worked for a little while and then stopped working, what seemed to work but wasn’t worth what you had to give up to do it. We’ll try to figure out whether there’s some need that your behavior is meeting that you can’t figure out any other way of meeting—what is it you’re getting from the way you’re living now? What would you lose if things changed? Quite often, problematic ways of acting or feeling are the way we learned to survive through difficult, painful situations. We may have gotten away from those hard times, but we keep on doing whatever got us through them, even though doing that may cause us new problems.
Once you and I feel we understand the problem enough to go on with (though we’ll keep learning new aspects of it throughout the year), we start looking for new solutions to it. You’ve probably learned a lot from what you’ve been through so far, and we’ll explore your strengths, trying to see how we can apply them to solving the problem. Finding solutions isn’t always easy, and we’ll take our time with it. If one solution doesn’t work, we’ll talk about what didn’t work about it, and keep on until we find something better. Once we’ve found a solution that seems to be working, you’ll put it into practice for a while, and we’ll talk about how it’s going until we can be sure that it’s going to keep on working for you even after we’re no longer seeing each other.
How long each of these steps takes varies. Some people may find that we’ve solved the problem they came in with within a few months. Others may find that a year is the right amount of time. Still others may do a year of work, and then find that there is another, related problem they would like to work on, or that the problem is simply too big to solve in just a year. I stay flexible, working with each person to find the right pace for him, her, sie, or them.
Sessions may look very different for different people, or from week to week. Some clients find it most useful for me to teach them techniques, or give them “homework assignments” of things to practice. Other people find it most useful for us to simply talk. Sometimes you may find it useful for me to help you examine and understand what’s going on; other times, you may just need me to listen. Whatever we do, my goal will be to help you feel comfortable enough to accept yourself without judgment. By the end of the year, I expect that the changes in your life will make you happier, more at ease, and better able to succeed at your goals. At the same time, though, I hope you may learn to feel that you would still have been a worthwhile and lovable person even if you had never changed at all.
In terms of theory, the way I think about people can best be described as psychodynamic—one of the oldest schools of psychotherapy, started by Sigmund Freud but significantly changed, improved, and expanded by the theorists who came after him. Thinking psychodynamically means I’m curious about people’s stories and their deepest feelings—how they understand the world around them and their role in it. My actions in session, though, often fit a solution-focused approach; I believe that change is possible, and I read widely to learn new ways to help people change as they need to. I will sometimes use dialectical-behavioral techniques, which were originally designed to help people with Borderline Personality Disorder, but which have useful lessons for many people without that diagnosis in how to understand emotions and get through difficult times and conflicted relationships. I’m always open to learning new techniques; I want to do whatever will best help the person in front of me, no matter where that idea may come from.