You may be familiar with the image of a patient on a couch free associating while a therapist nods along silently. While therapy is intended to be a safe space for you to explore and express your concerns, experiences, and feelings; it is also a place where we actively colloborate to identify where you would like to see positive change happen and introduce interventions that might help you meet your goals. We work together to help you relate differently to difficult feelings and thoughts, improve your relationships with others, and make behavioral changes that can help you live a better life.
Therapy is most effective when it is consistent and regular. In my clinical experience, a weekly 50 minute session allows us to build momentum toward positive change and meeting your goals. Some clients prefer more frequent sessions when things are challenging and others prefer less frequent sessions. You and I will work together to determine what is most appropriate for you.
There is no one answer to this one. It really depends on your goals and the amount of work you would like to do. Some clients come to therapy with a specific timeframe and goals that they wish to address. Others may wish to do long term, deeper work around their core beliefs and histories or resolve traumas that still feel very present in their lives.
You and I will collaborate as a team to ensure that you are making progress. I regularly check in to see if we are meeting your goals and to identify when you are ready to finish therapy.
Keep in mind that progress also depends on what happens outside of therapy. We will often consider actions that you can take between sessions to move you forward.
As a psychotherapy client, all of our work and communications are confidential. This means that every thing that happens in therapy - what we talk about, any notes that I take about our work together, even the fact that you are my client, is confidential. In fact, I need your written persmission to communicate with anyone about our work together.
Please note that California law dictates some exceptions to this. I am required by law to disclose information when there is a reasonable suspicion of child, dependent or elder abuse or neglect and when a client presents a danger to self, to others, or is gravely disabled.
I think there are two important parts to ensure therapy works: setting goals and ongoing collaboration.
First, we start in early sessions by identifying your goals and the kinds of change you would like to see. What will you observe that will be different in your life as therapy progresses? Getting clear on measurable outcomes helps ensure that our work is on track.
Second, throughout therapy you and I will be working as a team, collaborating on your treatment and checking in to see if things are working and you're seeing positive change. If you feel like things are stuck or not moving, then we collaborate and identify new ways to move you forward.
I believe all therapy is about creating positive change. The good news is that there is a lot of research on how people can improve their relationships, manage anxiety, depression and other issues, and create healthier behaviors in their lives. I think it is important to focus on and utilize what actually works to make positive change happen. My job as a therapist is twofold: to work with you in ways that research shows to be effective, and to constantly innovate by keeping up on new research and bringing it to our sessions when it is appropriate.
I'm a therapist because I understand the power of change. I'm an optimist and I believe that we really can relate to pain in a different way and move our lives forward.
Mindfulness is about paying attention to the present moment, in a nonjudgmental way. It is about getting in touch with your internal experience from a place of curiosity. While it seems simple, it can have a huge impact on your life. Being present to what is actually going on inside of you can allow you to create space to make changes, understand yourself better, and live a fuller, richer life.
We often don't notice the thoughts, memories, urges, and feelings that show up inside but they have a powerful effect on our behavior. Mindfulness has many forms and is simply a way of noticing these things. Once they are in your awareness you have the power and space to do something with them. There is a great deal of research on how mindfulness can help with a variety of issues such as anxiety, depression, anger, negative thoughts and other issues that many struggle with.
There are many ways to bring more mindfulness to your life and meditation is one approach that works well for many people. While meditation is a formal practice that fosters mindfulness, there are many techniques and approaches that can help you be more mindful in your life.
There are lots of different kinds of anxiety symptoms and experiences and every individual has different ways of coping. The most effective approach to dealing with anxiety is learning how to have a different relationship to it. This could include learning ways to soothe yourself when you feel anxious or changing the way you deal with the anxious thoughts and feelings that show up. There are a variety of approaches that we use in therapy so that you feel like you are living a fuller, richer life where anxiety doesn't have the same effect on you.
Meditation (and more broadly, mindfulness) provides many benefits that help with anxiety. First, many meditation practices involve the breath which can calm the nervous system. Second, meditation helps to create an observer experience. Being able to create space between you and your anxiety by becoming an observer often means being able to relate to it differently and suffering less. Finally, meditation hones your focusing skills. When anxiety feels overwhelming, being able to shift your focus can be helpful in reducing the painfulness of anxiety.
One way to better understand your sexual identity is to embrace it's complexity. Your sexual identity is not necessarily a fixed aspect of your personality. It can be fluid and evolve over your lifetime. Your experiences have an effect on your identity, including cultural and family influences. Adding to the complexity is that while society and popular culture often view sexuality as a binary (gay vs. straight, male vs. female, femme vs. masculine, etc.), there are actually many gradations to how you experience sexuality and where you land isn't necessarily where you stay. Starting from a place of curiosity can be helpful in understanding who you are.
Stay curious. Pay attention to your thoughts and feelings and the experiences you have. Notice if you have thoughts that sound rigid or absolute - I should, I must, I never, I always. Be open to where you are today and see if you can hold it from a nonjudgmental place. Notice thoughts that sound like society telling you to be or feel a certain way. Notice beliefs that sound like there is something wrong with you or defective.
The best way to understand and integrate your identity is to be open to what your actual experience is. We often take in what the prevaling culture tells us even when it doesn't necessarily make sense or match how we intuitively see ourselves. We can often hold old messages from childhood and adolescence that no longer work. Taking a more open stance can be helpful in better understanding yourself and feeling more integrated.
Sexual desire (also called libido) is a complex human experience and lots of factors contribute to it. Consider it the intersection of your physical body, your mental/emotional experience and your relationships with others, as well as the impact that external stressors and experiences have on you. All of these things can influence your libido.
In therapy, we always check to see if there are any physical causes of desire issues by working with a physician. We also explore what thoughts and feelings may be contributing to low desire, as well as sexual and other interactions with others that may be contributing factors. Finally, we address stressors that may be having a negative effect on your desire levels as well.