FAQ

Psychotherapy is a collaborative process between a professional helper and a client that facilitates the process of emotional growth and change. The supportive environment of psychotherapy helps people in several ways. Here are just a few:

• It promotes the healing of old wounds by encouraging deeper contact with feelings that have otherwise been avoided.
• It helps develop insight into what makes us tick so that we can learn greater compassion for ourselves and others.
• It promotes a more mindful encounter with the present moment, thus leading to a more vital experience of living.
• It helps us clarify what's really important and valuable in life.
• It encourages a greater commitment to taking actions that will lead us toward what we value.

For all intents and purposes, the terms counseling and psychotherapy are interchangeable. In order to advertise as a counselor or psychotherapist in Oregon, a person must possess a Master’s degree in psychology, counseling or social work, and must be either a registered intern under clinical supervision or be licensed by the state.

Life-coaching grew out of the human potential movement and tends to focus on motivation, organization, and achievement. There are currently no state credentialing requirements for a person advertising as a life coach.

Yes. My Oregon license number is C3059.

Good psychotherapy has been described as a balance between science and art. Too much science, and the process becomes rigid, cold and clinical. Too much art and the process becomes ungrounded -- what some might call "flakey."

I start with a client-centered approach. I believe that at the core of any effective therapeutic intervention must be a sense of trust and mutual respect. For some clients, this trust comes easy. For others, it takes time to cultivate. What emerges from the early stages of therapy is each client’s unique set of needs.

Once therapeutic goals are understood and agreed upon, I typically employ a variety of therapeutic interventions, depending on a client’s needs at any given moment. Mindfulness approaches help cultivate a "self-in-presence," the part of us that is able to be present with and attend to other parts. A psychodynamic approach is useful when a client would benefit from understanding conflicting or confusing inner forces. A cognitive approach can help clients understand distorted, problematic beliefs and thought patterns. Body-focussed therapy helps clients release habitual tensions that manifest as a result of chronic psychological stress. A solutions-oriented approach can help clients sort out practical answers to concrete problems.

I have found that no one therapeutic approach works with any client 100% of the time. Choosing what approach to use, and when, is part of the art of psychotherapy.

Yes, I work with couples primarily from an Emotionally Focused Therapy (EFT) perspective, based on the work of Susan Johnson and Les Greenberg.

I work with people who have had addictions, but I am not a certified addictions counselor. If an addiction or substance abuse problem becomes so acute that it interferes with therapeutic progress, I will make an outside referral for addictions treatment.

Depression manifests in many different ways. Symptoms include a pervasive sad mood that affects most aspects of life, an inability to experience pleasure or joy like you used to, irritability and a short fuse, feelings of guilt, worthlessness, hopelessness or self-hatred, problems with sleep and problems with appetite.

For some individuals, depressive symptoms tend to emerge during the winter months, when natural light is limited. This form of depression is known as Seasonal Affective Disorder (or SAD). Portland, which typically experiences many overcast days during the winter months, has a particularly high incidence of SAD.

Feelings of loneliness and depression often go hand-in-hand. People who feel depressed often isolate and people who isolate are often depressed.

Most people who have been diagnosed with depression also report a sense of feeling stuck. Counseling for depression focuses on creating a supportive environment in which to explore ways to move forward. By becoming more aware of the thought and behavior patterns that may be leading to the symptoms of depression, it is possible to learn how to let go of these patterns and to instead move toward a more vital experience of living. Also, an exploration of an individual’s history, in which depression is understood to be a result of unresolved loss, anger, self-blame, rejection or abandonment, can lead to a relief of symptoms.

Anger is often considered a "negative" emotion. While chronic, unresolved anger can be destructive to our relationships and our own physical and emotional wellbeing, anger itself can actually be helpful. When understood as a kind of emotional warning system to a perceived threat, either physical or psychological, we can then try to understand the threat. Doing so requires us to use the higher centers of our brains, thus taking us out of the heat of the moment. Learning to listen to our anger is the first step in being able to approach it more effectively.

Anger is a complex response to either external or internal triggers. Physiologically, it is the "fight" part of the fight/flight/freeze response. When we become angry, our heart rate increases, our breathing becomes more rapid, our muscles tighten, our blood pressure increases, and our attention narrows in focus.

The part of the brain responsible for this set of responses is called the amygdala, which is located deep within the more primitive layers of our brains. We can actually learn to use the higher centers of our brains responsible for judgment and reason to actively soothe our agitated amydalas. This is the essence of all anger management techniques.

We all experience loss. It is part of the human experience. Sometimes, however, the feelings that get stirred up during the grieving process become overwhelming. We may even question our ability to carry on with life. When grief interferes with our ability to live our lives, it’s important to reach out for help.

Typically, we go through five stages of grief that have been categorized as: denial, anger, bargaining, depression and acceptance. However, sometimes we do not go through these stages in a nice straight line. We can jump stages or we can feel stuck in one stage for a long time or we can even backslide into previous stages. This is a good time to seek out a therapist who can gently provide support.

Sometimes the loss of an intimate relationship can be the most difficult loss to bear. The accompanying feelings of loneliness, abandonment, rejection, fear for the future, and anger can present us with a flood of emotional pain that most people never previously experienced. Many people have found counseling to be an important resource in helping to navigate the inner turmoil of relationship loss.

There are many different types of anxiety. Phobias, panic attacks, social anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and generalized anxiety are among them. Anxiety episodes are typically accompanied by physiological responses such as sweating, rapid heart rate, rapid or labored breathing, tremors, and digestive distress.

Phobias are persistent fears of objects or situations that a person usually attempts to avoid. The fear is generally seen as being disproportional to the actual danger involved. When a sufferer is unable to avoid the feared object or situation, there is typically a reaction of intense distress.

Panic attacks are experiences of intense fear lasting for a short duration. While the experience usually peaks within 15 minutes, they can last for hours, depending on how they are handled. The experience is often reported as being the most frightening and upsetting experiences of a person’s life. A person who has repeated panic attacks is said to suffer from panic disorder.

Social anxiety is an experience of intense fear or distress in some social situations that leads to an impairment of functioning in one or more aspects of life. It is typically triggered by real or imagined judgment or ridicule by others.

PTSD is a condition that sometimes develops after a person has been exposed to one or more traumatic events. Such events may include childhood sexual or physical assault, witnessing or being directly victimized by other violent crimes, exposure to military combat, or serious injury or threat of death caused by accident or natural disaster. Symptoms include recurrent nightmares or flashbacks more than one month after the event(s), avoidance of emotional triggers, and numbing, dissociative or out-of-body sensations.

OCD is characterized by intrusive thoughts that lead to feelings of fear and worry, often triggering extreme behaviors aimed at alleviating those feelings. Excessive hand-washing, repeated checking that doors are locked and stoves are turned off, and superstitious rituals are common manifestations of OCD.

There are a variety of counseling techniques that are helpful in the treatment of anxiety symptoms. Mindfulness techniques have been found to be significantly helpful in the treatment of anxiety. These techniques allow for an exploration of the external triggers and subsequent thought processes that lead to anxiety. This ability to step back from the sequence allows individuals to let go of their "control agenda." For some individuals, a psychodynamic exploration of inner conflict, in which anxiety is understood to be a clash of opposed impulses and motivations, can relieve symptoms. Somatic techniques which focus on the body’s responses can also be helpful. Certain simple behavioral choices such as exercise, adequate water consumption, and an awareness of food sensitivities can also contribute to a relief of anxiety symptoms.

My full fee is $135/55 minute session. I have a limited number of sliding scale appointments available. My lowest rate is $85. If you need a reduced rate, please do not hesitate to ask if I have an opening available. I offer a free initial consultation.

Yes, I am a member of the preferred provider network for Aetna, First Choice Health and Pacific Source. My services are also covered out-of-network under most other policies. Please check with your insurance company to determine co-pays and deductibles.

First thing I usually do is offer my clients some nice hot tea or cold water.

After some brief initial paperwork, we'll go into a private counseling room and begin discussing the reasons you decided to seek counseling. I'll typically ask some relevant questions about the issues you identify to start better understanding your concerns. For example, I may want to know something about the history of your concerns, how long you've experienced them as a source of distress, and some ways in which you've already gone about trying to address them. I may ask you to identify the kinds of external events that tend to trigger internal distress. I'll then help you to identify goals for therapy. I may ask you to reflect on what would be different for you if you had a successful therapeutic outcome.

Of course, you will also have an opportunity to ask me questions about my therapeutic approach, my experience level in working with your type of concern, a therapy time frame, or any other relevant question regarding our potential work together.

On a very basic level, an initial session will provide you with the opportunity to decide if you feel like it's going to be a good fit.

Contact me. You can send me a confidential email message, or you can leave me a confidential voice mail. I will get back to you within 24 hours in most instances.