My approach to psychotherapy is primarily psychoanalytic. People often ask: what is the difference between a psychoanalytic approach and a cognitive/behavioral one? There is an important difference. A cognitive behavioral therapist will help the patient identify problematic thought patterns and associated behaviors that are largely conscious. And they will help the patient to find concrete ways of addressing their symptoms. Cognitive behavioral treatment works directly and concretely on this plane and can be very helpful. This work is structured and sometimes and sometimes “homework” is involved.

A psychoanalytic approach comes at symptoms from a different angle: symptoms (like anxiety, for instance) are understood as the side effects of emotional conflicts that are lodged at a deeper, less accessible, sometimes altogether unconscious level. I believe that the patient and therapist must gain access to these inner conflicts. And they must understand the purpose and meanings of the symptom so that it ceases to be necessary and can be given up. Anxiety, for example, as a symptom, may sometimes be serving a purpose for the anxious person. Unless we become aware of the anxiety itself, and then also understand what its purpose is, it can be impossible to let it go. People often admit about anxiety that they hold onto it because they have the sense that without it, they won’t be prepared for anticipated stressors. But this leads to a life lived in fear.

I am psychoanalytically trained and it is my belief that this is the most transformative and long-lasting form of therapeutic treatment. However, I think any excellent psychotherapist, whatever their training, has to be flexible and adaptive to the unique needs of the individual. Some people need more concrete interventions and others less. I make an effort to be as eclectic as I can – sometimes adopting a more interventional/behavioral approach – while maintaining a strong foothold in my own belief that deep, insight-oriented work is necessary for lasting psychological change.