Psychotherapy in D.C.
In-person & telehealth
My Approach
1
The quality of the therapy relationship is a better predictor of positive outcomes for patients than the use of one particular modality or approach over another.
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In other words, the research suggests that what seems to matter far more than the use of one approach versus another is whether the therapist can stay flexible and choose therapeutic interventions in a manner which is responsive to who you actually are—your personality, temperament, shifting moods, values, and core beliefs—and whether they bring the warmth, empathy, and genuine care that make meaningful change in therapy possible. This is contrary to what the loudest advocates for one specific technique will tell you (internal family systems, CBT, psychodynamic therapy, take your pick). To me, this finding has a clear and practical implication. While many clinicians settle into one or two favored approaches, patients are better served by a therapist who has mastered as many as possible, and has cultivated the ability to switch gears and combine seemingly unrelated approaches in creative ways to fit each unique person—and to adjust as the treatment develops. With this in mind, I’ve sought rigorous training in most evidence-based modalities rather than focusing on the handful which resonated with me most immediately. I have also focused my teaching and research—including my doctoral thesis—on the development and dissemination of novel methods for integrating multiple modalities into a single treatment.
So what does this mean for you, should you decide to work with me? In our first few sessions, my priority is simply to understand you—what’s brought you in, what it’s like to be you, and how you’ve come to be the person you are—while working to earn the trust that everything else depends on. From there, based on this initial assessment, we discuss a range of approaches I think might fit you best, and collaboratively set a treatment plan and goals for therapy. This “menu of options” for therapeutic approaches spans a spectrum from highly structured on one end to open and exploratory on the other. Structured approaches might include specific exercises and skills to practice, worksheets and symptom logs, problem-solving, behavioral protocols, and homework between sessions. These draw on therapies like CBT, behavioral activation, ERP and other exposure therapies, CPT, CBT-I, DBT, and mindfulness-based practices. Exploratory approaches focus on building insight, working through uncertainty and ambivalence, navigating difficult relationships, meaning-making, and clarifying values. They also focus on understanding the parts of yourself you may not be fully aware of which inform the ways you experience and behave. These types of approaches draw on psychodynamic or psychoanalytic therapy, existential therapy, narrative therapy, and acceptance and commitment therapy (ACT). I work collaboratively with each patient to create the level of structure and bespoke blend of approaches that fit them best.
2
Psychological growth and healing require both insight and action. Therapy that includes one of these elements but not the other often leaves patients feeling unresolved.
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To build a life worth living, we need to understand how our own minds work — what helps us genuinely flourish, and what gets in the way. But we also need the concrete skills to get there and to overcome the obstacles, internal and external, that we’ll run into. Having one without the other doesn’t get you very far. If each of us is an archer, insight is knowing what to aim at and why, while action is the strength and skill to draw the bow and actually hit the target.
Psychological science and clinical experience over the last century have demonstrated again and again that we often don’t know our minds as well as we might think. Much of mental life occurs unconsciously, and we are all prone to self-deception, cognitive biases, and a general difficulty in fully understanding all the reasons behind our thoughts, feelings, behaviors, and intentions. While we are each the expert on what it feels like to be us, we are generally not the expert on why it feels that way. This is why we tend to heal best in the company of someone willing to really listen, be curious about us, and help us to look at ourselves from angles we can’t quite reach on our own. And, just as none of us are born with the capacity for perfect insight, we are also not born with the complete set of skills for acting on it: for coping with difficult truths, living in accordance with our values, and turning self-knowledge into meaningful change. Good therapy, then, attends to both: the understanding and the doing.
Unfortunately, many clinicians and behavioral health programs privilege one half of this equation at the expense of the other. It’s a frustration I hear often from patients who come to me after leaving another therapist or program. They’ll say something like, “All we did was talk about my past, discuss my feelings, and work to understand myself better, which was really nice, but I never learned how to actually do anything about any of it, so I’m still stuck.” Or: “They gave me a lot of worksheets, skills, and techniques; it helped a bit with my depression symptoms, but we never looked at why I had all the self-esteem, identity, and relationship issues in the first place, so I still feel pretty lost.”
In therapy, I lean on my training in the wide variety of approaches I described in section 1 to incorporate both essential elements of change into all of my treatment plans. In many cases, this means integrating more unstructured, exploratory work with more structured, action-oriented work. In practice, this means we won’t spend months excavating your past without ever building the tools to change your present, nor will we drill breathing exercises for your anxiety without understanding why it’s there to begin with. We’ll do both, and we’ll do it in a way that is tailored to your unique personality, preferences, and presenting concerns.
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