An essential mission of psychotherapy is to guide a patient toward feeling. A central purpose of psychotropic medications is to relieve patients of feeling. This presents a major clinical challenge. Prozac, Wellbutrin, Lexapro, Effexor, Ativan… There’s an endless list of … Read more
I spent my first semester after high school, when most of my peers had gone off to college, in a halfway house. I was 18, fresh out of rehab and now living in downtown Baltimore with men 30 and up. … Read more
As a clinician, the most common diagnosis I see by far is ADHD. This never comes from me, because in all my years in clinical practice I’ve never diagnosed anyone as having ADHD (more on that below). It comes from … Read more
As one not shy about current events I often get asked how I handle patients sharing their political views in session. Despite our hyper-partisan times I’ve never had a problem in my private practice with a patient’s politics. How is … Read more
We could easily say our modern world is rife with problems. And we could just as easily say we’re obsessed with fixing those problems. This shows up in therapy. After all, the patient and therapist meet to solve a problem … Read more
Perhaps it’s because I watch too much Cesar Milan, or because I need to correct my own dog after he’s spent several days with my ex, but it seems far too many people struggle with their dogs. On any given … Read more
There’s a common belief that guilt—the feeling of having done something wrong—serves a needed function, that as a “prosocial emotion” it pushes those in its grips to mend the harm caused to another. While this sometimes occurs, my work in … Read more
Most patients come to therapy carrying unbearable pain. This pain is kept hidden from others. It is also kept hidden from the self by acts of splitting, i.e., by removing them from consciousness. So the patient lives in a state … Read more
With a mix of pride and shame I confess to having clocked hundreds of hours playing Red Dead Redemption 2. Like my all-time favorite video game, Witcher 3, I most enjoy moving my character through open worlds, exploring vast territories … Read more
Therapy has been trending. From athletes to school systems to social media it’s hard to go anywhere without seeing some mention of mental health. And while awareness of mental health may be a good thing, we do run the risk of diluting … Read more
