Psychotherapy is not easily described in general statements. It varies depending on the personalities of the psychotherapist and client, and the particular problems you are experiencing. There are many different methods which may be used to deal with the problems you hope to address. Psychotherapy is not like a medical doctor visit; instead, it is more organic and unfolds over time. Here are some of the modalities used in working with our clients:

D B T – Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is a system of therapy originally developed by Marsha M. Linehan, a psychology researcher at the University of Washington. DBT has strong clinical research to support its effectiveness in the treatment of difficult to treat disorders. DBT skills training focuses on teaching and strengthening skills necessary for emotion regulation. DBT skills training includes emotion regulation, interpersonal skills, distress tolerance and mindfulness. Emotion regulation training teaches a range of behavioral and cognitive strategies for reducing unwanted emotional responses as well as impulsive dysfunctional behaviors that occur in the context of intense emotions by teaching clients how to identify and describe emotions, how to stop avoiding negative emotions, how to increase positive emotions, and how to change unwanted negative emotions. Distress tolerance training teaches a number of impulse control and self soothing techniques aimed at surviving crises without attempting suicide, or engaging in other dysfunctional behavior. Interpersonal effectiveness teaches a variety of assertiveness skills to achieve one`s objective while maintaining relationships and one`s self respect. Mindfulness skills include focusing attention on observing oneself or one`s immediate context, describing observations, participating spontaneously, assuming a non judgmental stance, focusing awareness, and developing effectiveness or focusing on what "works".

E M D R – Eye Movement Desensitization and Reprocessing

"What if the brain had a similar mechanism for healing psychological injuries as the body does, just like a finger can heal a cut?" Dr. Francine Shapiro

Eye Movement Desensitization and Reprocessing (EMDR) is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma. We do know that when a person is very upset, their brain cannot process information as it does ordinarily. One moment becomes "frozen in time", and remembering a trauma may feel as bad as going through it the first time because the images, sounds, smells and feelings haven't changed. Such memories have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people.

EMDR seems to have a direct effect on the way that the brain processes information. Normal information processing is resumed, so following a successful EMDR session; a person no longer relives the images, sounds, and feelings when the event is brought to mind. You still remember what happened, but it is less upsetting. Many types of therapy have similar goals. However, EMDR appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep. Therefore, EMDR can be thought of as a physiologically based therapy that helps a person see disturbing material in a new and less distressing way.

"Posttraumatic Syndrome is the failure of time to heal all wounds." ---Bessel van der Kolk, M.D.

C B T – Cognitive-Behavioral Therapy

Cognitive-Behavioral Therapy (CBT) is an empirically supported treatment that focuses on patterns of thinking that are maladaptive and the beliefs that underlie such thinking. For example, a person who is depressed may have the belief, "I’m worthless," and a person with a phobia may have the belief, "I am in danger." While the person in distress likely holds such beliefs with great conviction, with a therapist’s help, the individual is encouraged to view such beliefs as hypotheses rather than facts and to test out such beliefs by running experiments. Furthermore, those in distress are encouraged to monitor and log thoughts that pop into their minds (called "automatic thoughts") in order to enable them to determine what patterns of biases in thinking may exist and to develop more adaptive alternatives to their thoughts.

People who seek CBT can expect their therapist to be active, problem-focused, and goal-directed. Studies of CBT have demonstrated its usefulness for a wide variety of problems, including mood disorders, anxiety disorders, personality disorders, eating disorders, substance abuse disorders, and psychotic disorders.

M I – Motivational Interviewing

Motivational Interviewing (MI) techniques were originally developed to help enhance motivation for change and reduce negative feelings towards treatment in individuals struggling with substance use disorders; however, these techniques are now being used to help people with who are resisting changes. The goal of motivational interviewing is to increase your motivation to change so that you can realize your goals such as sobriety, finding more fulfilling employment etc.

An essential part of motivational interviewing is exploring the factors that are helping to maintain the status quo, despite the harm and suffering you may be experiencing. For example, although someone with OCD may currently be spending over two hours a day washing their hands, the distress and disruption to their life caused by this behavior may be outweighed by their desire to avoid the anxiety that comes with feeling contaminated.

Barriers that could get in the way of you enrolling or completing therapy are identified and discussed at length. Once the barriers to change are identified, your therapist will work with you to identify both the advantages and disadvantages associated with participating in therapy. Following this, you and your therapist may have extensive discussions about your goals and whether the disadvantages of participating in therapy outweigh the goals you want to achieve or not.

Mindfulness

Mindfulness or being mindful is being aware of your present moment. You are not judging, reflecting or thinking. You simply are observing the moment in which you find yourself. Moments are like a breath. Each breath is replaced by the next breath. You're there with no other purpose than being awake and aware of that moment. Mindfulness may be defined as non-judgmental, moment-to-moment awareness. As John Kabit Zinn says reflecting on a Japanese mindfulness puzzle: "Wherever you go, there you are."

If you start by being aware of your breath, you know it comes and goes. It is like the end of one wave from among the endless ocean waves. They continue to come and disappear to be followed by another and another and another. They come. They disappear. They come, they end, they flow back to be covered by another incoming wave. You can hear the sound. It’s a rhythm were you may go far away but wherever you go, there you are.

Simple Mindfulness Technique

1. Find a quiet and comfortable place. Sit in a chair or on the floor with your head, neck and back straight but not stiff.

2. Try to put aside all thoughts of the past and the future and stay in the present.

3. Become aware of your breathing, focusing on the sensation of air moving in and out of your body as you breathe. Feel your belly rise and fall, the air enter your nostrils and leave your mouth. Pay attention to the way each breath changes and is different.

4. Watch every thought come and go, whether it is a worry, fear, anxiety or hope. When thoughts come up in your mind, don't ignore or suppress them but simply note them, remain calm and use your breathing as an anchor.

5. If you find yourself getting carried away in your thoughts, observe where your mind went off to, without judging, and simply return to your breathing. Remember not to be hard on yourself if this happens.

6. As the time comes to a close, sit for a minute or two, becoming aware of where you are. Get up gradually.