While we come to therapy for a variety of reasons, what we want most is to suffer less and to live better. A client on a first visit said to me “My previous therapist was like a friend. But I was not getting any better and I realized I needed more than a friend”. All of us can benefit from talking to someone. And at times, this is all we may need. But for so many, particularly those who have experienced early life trauma and/or have had struggles with depression, anxiety and significant relationships challenges, a therapist who has the capacity and training to work at a deeper, visceral level may be needed.
STRUCTURE AND APPROACH
Sessions are typically 55 minutes, generally requiring one session per week. In some cases, more than once per week may be clinically necessary. We will begin where you are and find out what is most important to you. Within the first four sessions, we should have clarity about your difficulties, what gets in the way, and begin working through things to get to a better place. In this way, the therapy will not feel mysterious and/or open-ended.
While I draw upon a variety of theories to inform how I work (cognitive, behavioral, psychodynamic, experiential, mindfulness), I have been extensively trained in ISTDP and train other seasoned clinicians in this approach. Most importantly, I tailor my approach to the uniqueness of each client and meet them where they are.
WHAT IS ISTDP?
ISTDP stands for Intensive Short-Term Dynamic Psychotherapy. As an ISTDP-informed therapist, I have been trained and continue to train in a in a way that makes me as effective as possible in helping clients overcome barriers and obstacles to emotional healing.
ISTDP is evidence-based and has been shown in numerous studies to be effective with a variety of mental health issues. While it is a complex psychotherapy training approach, it is grounded in the following three important elements:
Incisive means making the most of the time in sessions and being as clear as possible about the goals and objectives of therapy. It is about tapping into your natural strengths from the very beginning, helping you see what gets in the way, and helping you face your difficulties more directly.
Experiential means we will pay a lot of attention to your visceral experience (emotions and body experience). By attending to your experience in the here-and-now, you learn to become mindful and present to yourself. In essence, we relate to who you are beyond thoughts, concepts, and ideas you have about yourself.
Psychodynamic means becoming aware of and working through inner conflicts, often out of our awareness. These conflicts develop early in life and become habitual ways of behaving and thinking that don’t serve us well over time. In this way, the work is strongly informed by attachment theory – how we have learned to relate to others from an early age.
A DELIBERATE PRACTICE
ISTDP-informed therapy is grounded in deliberate practice. Deliberate practice means that I put great care and thought into what I am doing to see what is effective and what is not. It means that I strive through performance feedback to become increasingly effective with the clients I am working with. As part of deliberate practice, I videotape my sessions. By studying tapes, I learn what can help an individual and what works overall. Other professions use videotape to improve effectiveness, why not therapists? Of course, written videotape consent is required from the client for me to do this. In addition, I follow strict confidentiality and privacy guidelines. It is completely voluntary and not something you need to agree to to begin therapy.
CHANGES THAT CAN BE EXPECTED
Psychotherapy requires work and commitment from both the therapist and the client for genuine change to occur. Change can no doubt be uncomfortable. And sometimes it can be painful. However, the rewards can be great.
In the beginning, clients often do not know what gets in the way or what is really possible for themselves. After all, you can’t know what you don’t know. And at a core level, who really does not want to get better?
I am not effective with everyone who comes to my office. No therapist is. However, my promise is that if progress is not happening, we don’t just continue working “hoping” for the best. We work to find out why. And if need be, we refer out to appropriate resources. It becomes a mutual exploration and acceptance of the reality of the circumstances, not a failure.
Clients who I have been effective working with have reported the following improvement and changes:
- A significant reduction or remission of symptoms of anxiety, depression, medically unexplained symptoms.
- A greater feeling of connection with significant partners, friends, and family
- An increased comfort around people in general
- The ability to express and communicate feelings in ways that are appropriate
- Significant improvement in the ability to notice and experience emotions
- Become more aware of negative thinking patterns and learn to cultivate positive thinking
- Ability to feel and express anger appropriately without losing control
- Greater confidence, self-esteem, and self-regard
- A greater commitment to their life goals related to lifestyle, work, and family