Therapy for anxiety and depression in New York City

Anxiety and depression are particularly intransigent symptoms. They often mislead people into doing things that do not help, like taking drugs, fighting, overeating or other compulsive behaviors.

These are perhaps natural responses but not helpful. Any kind of therapy that is any good is transformative in some way. I am talking about a shift in thinking and feeling state of the person.

Understand that I mean "transformation" quite literally. I want to help people "change the form" of their thinking and feeling, so that they experience more of the satisfactions available in life.

This does not mean changing the core, or soul, of a person. Rather, we seek to change form when the current form is not a useful vehicle for the soul's expression.

Depression therapy for childhood abuse and trauma

I often tell clients that the soul must be respected. I will also tell them if I feel they are not respecting their souls in the choices they make.

One woman I treated saw her life through a veil of tears as a result of physical and mental abuse from one of her parents. During our work together, she came in for a session and was in a very pleasant mood. I pointed that out.

The very next session, she was angry and depressed again. I noted that it seemed difficult for her to allow herself to be happy. It was as if being happy now would let her parents off the hook for what they did to her earlier in life.

She laughed aloud in recognition at the same time that she said to me, "I could kill you." She realized that she did not like pain, yet she had practically made a pledge not to forget the hurt. Now, she could make a choice not to keep living the hurt.

Transformation is not something I do for clients. It is something I allow them to do.

Self-esteem therapy for depression and anxiety in NYC

With depression, the goal is not that a client will never have a depressed feeling. Life is rarely, if ever, perfect. What is reasonable to expect s that depression becomes less frequent, less intense and less enduring. People learn not to fight normal feelings but incorporate and negotiate them. They learn timing and pacing - if it sounds like an art, it is, and an art that all can learn!

If a person feels blue for an hour or two, that is different than three days of despair. Feeling blue twice a month is better than twice a week.

Feeling a little crummy and out of sorts is entirely different than feeling hopeless and suicidal. And such a positive advance is to be valued and respected

With anxiety, I use a dual approach. I have techniques based on my background in yoga and other transforming arts. The other aspect is to help people gain insight into what lies behind their anxiety.

Anxiety is commonly characterized by a triangle of procrastination, clutter and perfectionism. It a client mentions one of these, I ask about the other two. The response is usually, "How did you know?"

I know because that triangle goes with anxiety. It helps clients realize that they are not lazy or whatever else they may have been calling themselves. Those symptoms are part of the disorder.

Medication for depression and anxiety

I am not averse to working with colleagues who can prescribe medication. I know some great people who are not "pill-pushers," but can offer medication (usually temporarily) for excessive symptoms. These colleagues have a good understanding of how much is needed for therapy and will not prescribe beyond that. They and I work well together.

Once someone's symptoms are reduced just enough to be able to work in therapy, we can go to the causes of depression and anxiety.

One young man, who was not usually prone to panic attacks, had one when he had to face a professor who was trying to get free research out of his students.

After a time, this young man realized that his anxiety was not so much fear as it was hatred and rage toward this exploitive authority figure.

The patient has to have the feeling of the insight and transformation, not just the cognitive information. It is not possible to get information from books and friends. Therapy is its own transformative process.

Therapy for depression in Manhattan and Brooklyn

Initially, I encourage my patients to talk as freely and openly as possible. My approach is to try to understand my client's communications as deeply as possible and clarify the connection between people's thoughts and emotions.

The aim of the therapy is to deepen the patient's understanding of him- or herself and unresolved conflicts.

When it is relevant and essential to the treatment, the focus turns to understanding how the client's past continues to influence adult life.

Therapy in Manhattan for repeating unhealthy relationships

A depressed woman came to treatment because she was repeating unhealthy patterns in her relationships. She continually tolerated abuse, fearing that if she tried to stand up for herself, it would jeopardize her relationship.

She would then shape her life around his needs and requirements. As she understood the connection between her submissive position in relationships and her fear of rejection and abandonment, she began to assert herself more effectively.

She also felt safer to share previously hidden aspects of her life, including sexual abuse that occurred when she was a child. It is common for patients who were raped or sexually abused to feel ashamed, as if they were responsible for the abuse.

Treatment for childhood abuse in Brooklyn

This was true for a client I saw who hoped to complete treatment without ever mentioning she had been sexually abused. During the treatment, she began to have dreams about being trapped, held down and attacked by me.

Increasingly, she felt stuck in the treatment and imagined she was going to be forced to talk about things she did not want to discuss. These frightening thoughts allowed us to understand her early traumatic experiences in a very immediate way and helped her appreciate how the experience of being raped still infiltrated her life.

As we understood the connection between the content of her dreams and the rape, we could then begin to understand other ways it contributed to her fears of intimacy. We were able to understand the shame she felt for allowing the rape to affect her.

Through talking about these feelings, she was able to reduce the shame, gradually began to feel safer in intimate relationships and was better able to trust herself and others.

Therapy for anxiety, depression in NYC and Rockland County

I respond first and foremost to people, not to theories. I draw upon both long-term psychodynamic therapy and shorter-term cognitive therapies. I also find EMDR (eye movement desensitization and reprocessing) useful for helping people process upsetting events in their current or past lives.

Sometimes there is a current situation that needs close attention, such as a couple facing the possibility of divorce, or sometimes a devastating loss leads to intense anxiety or thoughts of suicide.

Sometimes the issue that brings someone in is not so dire, but it reflects long-term problems that need to be explored for a fuller life experience.

I do not believe, as some therapists do, that short-term therapy is "only a band-aid", for I know it can help people make important changes. But I also find it is often a gateway to deeper and fuller exploration. I am able to focus on whatever needs clients bring to me, and tailor my approach to each person or couple's problems.

Treatment for depression related to trauma

Every change in our lives, chosen or not, provokes some degree of emotional stress. Changes include such events as loss of a job or beginning a new one, losing a parent, moving in with or marrying a partner, or having a new baby.

Some life events and changes set off major emotional or marital crises. The intensity of reactions often has to do with earlier feelings that bubble up into the present. At such times, people feel defenseless in the face of acute feelings of pain, fear, abandonment, anxiety and despair.

These overwhelming feelings that flood us at certain times may be caused by what we all understand as Trauma with a capital T, such as childhood abuse, early loss, sexual assault, accidents or disasters.

Family-of-origin therapy in NYC and Rockland County

However, it is not always "big traumas" that create painful feelings. These may also come from repeated "small" traumas in relationships with parents and others.

People learn that they cannot trust others or themselves to get what they want, or that they are weak, helpless or unworthy of love. In fact, a current life crisis can be the direct result of continuing to buy into these messages, which create self-defeating choices and habit patterns.

A man in his thirties came to see me for overwhelming depression. He had avoided intimacy and 'kept his distance' in relationships. He ended a relationship and then regretted the decision, but it was too late.

Anxiety and depression triggered by grief

This man was barely functioning. He showed up for work each day, but he was not sleeping or eating well. He was not socializing at all. He worried about whether he could act like a "real man" in dealing with these feelings.

His first task was to vent the grief he felt about the loss of his relationship. He had to learn that "real men" grieve fully if they want to live fully.

Next was to realize why he had had second thoughts about this woman. His own history was that his parents suffered through many years of an unhappy marriage.

Therapy for relationships in New York City

Getting in touch with these truths made him realize two things. One was that he had some fears about relationships. The other was that his decision might actually have been a good way to avoid repeating his parents' marriage.

Despite not knowing what the outcome would have been if he continued the relationship, my client became able to live with his choice and to work toward being more open in the future.

Through therapy, he could handle the adult responsibility of making a decision and living with it peacefully.

This case points to a two-way street between emotional crises and relationships. On one hand, an individual troubled with depression or anxiety is likely to also have trouble making and keeping relationships. Anxiety and depression put stress on relationships.

On the other hand, the relationship itself may trigger anxiety and depression. The dynamics of a couple's relationship may bring up old material that needs to be addressed in one or both partners.

Therapy for depression in New York City/Tri-State Area

People experience depression at various degrees. For some it can be debilitating, and for others, it can severely or moderately interfere with their lives.

Most people with depression experience themselves, others, and the world around them in a negatively distorted way. I use a range of interventions, depending on the client's specific needs.

For example, cognitive behavioral therapy (CBT) helps people challenge their negatively distorted thinking and beliefs. They learn to identify and assess the validity of such thinking and possible alternative ways of looking at the situation.

In some cases, changing behavior and/or the situation is a more adaptive and effective course of action.

The use of developmental needs meeting strategy

Developmental needs meeting strategy (DNMS) proves helpful when an adult client's developmental needs in childhood were not met. This can lead to depression not only in childhood, but later as an adult.

It is difficult for a child to make sense of disturbing or confusing experiences, and, without appropriate parenting at such times, can become stuck at the particular developmental stage they are in at the time.

In the more extreme cases of abuse or neglect by a dysfunctional parent, this is a common occurrence, but symptoms can be seen in less severe cases as well.

Being stuck in a childhood stage can show up in one's adult life when triggered and adversely impact the adult situation.

For example, a little girl who was hurt by her father during a violent outburst may carry a fear of men into adulthood and prevent her from establishing healthy relationships. This can leave her feeling lonely, empty, and depressed.

Therapy offers help for family-of-origin issues

A middle aged woman could not find enjoyment in any facet of her life. She generally felt helpless and hopeless and had to force herself to function at work and at home with her family. She had disconnected from her friends, and her family was concerned about her lack of interaction with them.

During the intake and assessment process in therapy, it became clear that she carried around many negative beliefs and perceptions about herself and others. She grew up with a highly critical father, and his negative and sometimes abusive remarks became part of her personal belief system.

Her mother was also depressed, suffering from the same emotional abuse from the husband, and it was apparent that many developmental needs between the ages of 5 and 11 were inadequately met for this client. This prevented her from internalizing appropriate resources during that developmental period.

CBT and DNMS resolve developmental issues

We worked together in challenging and restructuring her negative thoughts and beliefs with CBT and re-parented her developmental needs using DNMS.

In the very beginning of her therapy, while her depression was most extreme, she agreed to see a psychiatrist for medication to better focus and work in her therapy. (Not all depressed patients need medication, but it can be very helpful for those who do.)

She weaned off the medication within six-months. She used what she learned in therapy to enjoy her life and achieve some goals she never thought possible.

She obtained a Master's Degree, lost a great deal of weight, and developed a closer more loving relationship with her family. She also reconnected with friends, and found that particularly rewarding. They became great external resources and she was able to give back to them as well.

Family and husband included in therapy sessions

She brought her husband in for several couple's sessions and the children for a family session. In this way, her loved ones could better understand what she was going through, how they could be most supportive, and the ways she could better manage her own behavior in relationship to them.

It was also important for her children to understand Mom's problem was not about them, and not their fault--a place where young children often go in situations like this. She contacts me from time to time and is doing quite well now with no signs of recurring depression.

She learned how to prevent herself from plummeting into the negative abyss and has the internal and external resources and strength to accomplish this.

Therapist helps anxious client with social phobia

A woman who experienced severe anxiety when with groups of more than two people, particularly those she may not know well, also found it very difficult to date or even meet men. She reported not being assertive enough to approach men and develop a relationship.

By working in small steps with CBT and dual attention stimulation, we desensitized each aspect of her phobic reactions to social interactions.

She is now able to have fun in social groups - even with groups of people she does not know - and is now involved in her first long-term relationship.

Therapy for anxiety and depression in New York City

No matter what the issue that prompts someone to come to therapy, the common denominator is that people feel badly when out of control in their own lives. I help clients sort out what they can and cannot control.

When clients learn to trust themselves and what is right for them, they approach themselves and their relationships differently. One of my clients was a young college woman who lost her high-school sweetheart when the other woman went to a different college.

This young woman was very closeted and socially phobic, fearing she would not find people who would like her. She was so depressed she needed to take time out from college.

Relief from depression and social anxiety in NYC therapy

We started out by identifying the least anxiety-provoking social situations. Once she felt she could tolerate meeting new people, we identified situations where she could meet other lesbians and have a circle of support.

These small manageable steps are typical of how I practice. I much prefer that people give themselves small goals and experience a series of successes. That is much more effective than setting unrealistic objectives and then giving in to a feeling of failure.

Over time, this woman's depression began to lift. She became comfortable and confident that she could have control over her life choices, no matter what the reactions from other people.

After finishing college, she moved onto graduate school and completed a doctoral program. She did all this in the context of a supportive circle of friends. She also met a woman with whom to spend her life.

Self-esteem therapy for depression

I worked with a man approaching 30 who was incredibly depressed, but he was not interested in using medication. He level of sadness was so constant that he did not really recognize how depressed he was. He had never had a significant romance with a woman, and he wanted a marriage and family.

Although he was attractive, professionally successful and a parachutist, he believed he did not have much to offer. He felt he was not interesting to anyone and was ashamed that he had never graduated college. It became a joke between us that he found it easier to parachute out of an airplane with a piece of plastic on his back than to ask a woman for a date.

Having someone listen to him and be interested in him -- his thoughts, feelings and knowledge -- helped him think of himself more realistically. He came to see he had plenty to offer a mate.

During our work together, he began to date and eventually met the woman who became his wife. I understand they now have a child and are very happy.

Counseling for depression in New York City/Long Island

I work with a client's problem using a supportive psychodynamic approach. Reviewing personal and family history, insight is gained and reveals underlying issues as they show up in the present.

Past history may cause a person to unwittingly play out old behavior patterns in the present. I help my clients decipher and change these damaging behaviors.

A woman who came to see me was depressed and anxious because she kept finding men who were unavailable. It was my intuition that both individual and group therapy would help her.

While growing up, she was very close to her brother. He pushed her away when he became a teenager. He would belittle her and make her feel insecure and inferior, which hurt her greatly.

A particular group member reminded her of her brother. Through her interactions with him, she became aware of picking men similar to her charming but mistreating brother.

I encouraged her to feel safe, so we could go back and deal with her childhood issues. We talked about her present situation and current boyfriends, as well other issues such as trauma and an alcoholic father.

We spent time discussing how her brother treated and devalued her. She was then able to find and eventually marry a loving man.

New York/Long Island therapist treats trauma with EMDR

EMDR (eye movement desensitization and reprocessing) is a shortcut to releasing trauma. Developed in the early 1990s, it combines scientifically stimulating the patient and desensitizing him or her to the trauma experience while reprograming post-traumatic response.

A woman sought my help with a childhood trauma of being molested as a child by her mother. This kind of betrayal shakes the foundations of trust in a child's life. It is a very profound violation of trust.

Afterward, she felt like her "mother's little boy", a very confusing feeling for a young girl. She became very sensitive and isolated in life, a loner.

In order to cope with her confusion and shame, she retreated into alcohol and did not sober up until middle age.

After a few EMDR sessions, she was able to make a lot of connections. Her childhood memories made more sense and she was able to move forward in her life.

Exploring issues to resolve depression in New York City

This case was not a quick fix. When she got stuck we would get stuck together.

I would acknowledge being stuck and talk about how it feels. We explored what it is like, comparing the feeling to other situations.

As a result of our work together, she confronted her mother, who apologized. Her mother was haunted by her memories of the incident also.

The mother's apology was very healing for both mother and daughter. Although it was only one incident, it was very traumatic.

Therapy for depression in New York City

Depression is fostered by patterns, childhood relationships, and repeating unhelpful behaviors. Therapy is a process of unblocking obstacles in the way of a client's needs and desires, releasing depression and other disorders.

I use a psychodynamic approach in my practice called modern analysis. I work with a client in a positive way, validating experiences, like cheerleading. Understanding his or her motivations, I can help channel productive energy toward healing the depression.

Many times clients direct their own bad feelings inward. I help redirect these emotions more productively, not toward the self.

Depression helped with psychodynamic therapy in Brooklyn

I treated a depressed young woman putting herself through college. She was being bullied by her fellow students and professors to the point where she considered quitting school. Her instinct was to run away from obstacles in her way.

In course of therapy, we looked at mistreatment she endured from her brother and the many sacrifices she made while growing up in a poor family.

I took a very firm stand and sided with her strongly. We worked on shifting her focus from "what's wrong with me?" to the other person being objectively wrong.

In this case, her brother, family, and her professors were the forces she had to confront.

Depressed woman finishes college and graduate school

I coached her to finish her education. She accomplished this goal and more. She completed graduate school and earned a PhD. She later married and secured a good job.

Shortly after beginning her new work, a colleague began spreading rumors about her. She handled the situation very well.

She expressed to the instigator her disappointment in the rumor, and set the record straight about the true situation. She accomplished this without making enemies, a huge improvement in her life.

She sucessfully overcame her problem and asserted herself. Several months later, she sent me a photo of her new baby. I am truly proud of her achievements.

Manhattan therapist counsels depressed clients

I have a deep appreciation for the interpersonal as well as the personal aspects of a problem. I focus on strengthening and healing the inner connection to one's Self and inner life.

The exploration of spiritual values, conflicts or crises can often be a focus of therapy that can impact the ways in which an individual handles life's problems.

Western society is very extroverted, and so we think that learning to be aware of and communicate our needs and feelings appropriately are enough.

Another fallacy is that insight into how we got this way is enough. However, we also need to develop an ability to watch and experience our feelings, needs, drives, opinions, judgments, and compulsions--without always taking them so seriously or acting on them.

Holding and acceptance of these aspects of ourselves is part of the healing process. This advanced stage of therapy is more attuned to the willingness to use our everyday experience as spiritual practice.

Therapy for depression in Manhattan

I see many clients whose lives are becoming unmanageable in relation to the demands of their career. Generally, their home and family life is in crisis and either physical or emotional symptoms develop and interfere with their job performance.

As clients develop more of a balance between an inner and outer life, they establish a means of recharging themselves so that they have more to give both at home and at work.

My approach is eclectic, supportive and Jungian-like. Every client is different, and I assess his or her capabilities and goals in choosing a specific treatment.

Artist overcomes "block" in Manhattan

Creative and performing artists may go through a period of time when the well of creativity appears to dry up. This may signify the need to attend to other issues in their lives.

For one artist, the "high" she accessed from creating and going within was followed by an equally strong pull to reach outward, a difficult task for her.

To avoid feelings of depression, isolation and loneliness, she directed all of her energy to building a social identity as an artist.

This created a pressure and a compulsion to produce large quantities of better and more diverse art. These pressures essentially froze her creative process.

When becoming more able to tolerate feelings of loneliness, she was less driven by them. She stopped forcing all of her energy into career channels and began to allow social situations to emerge naturally.

This new equilibrium between her inner and outer needs balanced the creative energies that were frozen.

Fear of abandonment healed in therapy

A man's fear of abandonment was triggered by his girlfriend's retreat. She would go to her own apartment and seek out her friends when his feelings overwhelmed her.

He convinced her and himself that she was to blame for his issues with abandonment. In therapy, she learned that love does not mean that people always get along.

In addition, she learned to be assertive yet compassionate about the fact that she was not the source of his depression or abandonment fears. She also discovered ways to avoid accepting blame for his mood swings, and no longer had to flee.

He was able to resolve historical feelings of abandonment and his accompanying low self-image. When he no longer ignored his needs and feelings, he was free to interpret her leave-taking as an opportunity for both of them to enjoy time alone.

Recovery from long-term illness includes therapy

A mother and successful business executive suffered from symptoms of anxiety and depression after her recovery from cancer.

In the past, her time was devoted to others. Now her symptoms were a sign that she needed to turn her attention and caring inward.

She became able to transform her anger, frustration, impatience, and sadness by making herself a priority. She made time for herself by coming to understand and value her own feelings and frustrated needs.

Although she felt vulnerable at first, she was willing to communicate these needs in a manner that allowed others to really hear and respond to her.

The reinvestment in herself lead to more quality time at home and less difficulty in work relationships. Thus, a primary imbalance between doing and being, between other and self, between inner and outer lives was resolved.

Counseling for depression in New York and New Jersey

A client's current complaint often manifests as a result of his or her past history. Psychodynamic therapy, also known as insight-oriented therapy, focuses on unconscious processes as they show up in a person's present behavior.

A psychodynamic approach enables the client to examine unresolved conflicts that arise from past dysfunctional relationships.

A middle-aged man was experiencing depression, severe self-esteem issues and fear of his supervisor.

Between the years of 3 and 12, he remembers his older brother beating him mercilessly when his parents were not around. He would tell his parents, but they would ignore his complaints.

As a result, he believed he deserved this mistreatment. Throughout his teens, he excelled at all sports; so much so that he earned a football scholarship to a major university.

Help for low self-esteem in New York and New Jersey

His parents were not impressed by his athletic achievements and did not consider a non-academic scholarship significant. At college, he re-experienced his father's criticism in the form of a coach who did not appreciate him.

The coach played him very little and then moved him down to junior varsity. He experienced this move as a narcissistic injury, a lack of respect for his abilities.

Partly as a result of this experience and of relationship failures, particularly with women, he experienced a profound depression. The experiences with his sales manager seemed to repeat those with both his coach and father.

His weekly individual treatment explored feelings of inferiority and inadequacy in both his romantic and work life. In his romantic life, he felt "not good enough" for the Ivy League girls he met.

With the supervisor in his work life, he was re-experiencing his critical, rejecting father and unappreciative coach.

Therapist uses group approach to treat depression

After several months of individual therapy, he joined a group as well. He initially explored his failed relationships with women.

Some of the men and women were able to express similar feelings of inadequacy and fear of rejection. After several weeks, he focused on work experiences and their importance in his life.

He explained to the group that he was really good at socializing with clients and would spend evenings with them at bars, restaurants and other social events.

The clients liked him and saw him as a friend. He believed he was using a false persona to fool them into liking him. Several members of the group concurred, and one member responded by telling Sam, "I really like you. In fact, when you reveal yourself, I like you even better than when you're just charming."

As a result of his experiences in therapy, he approached his father and began a dialogue. He also started to see that his supervisor had personal issues.

Building confidence through New York and New Jersey therapy

He realized that the supervisor's destructive leadership was due to envy and the need to be appreciated.

My therapeutic work with this client involved exploring sources of low self-esteem from his parents'lack of appreciation and support of his earlier accomplishments.

In contrast, I had confidence in his abilities and the the group and I encouraged him to take on tasks or jobs that he had avoided.

Depression and anxiety counseling in Manhattan

A client presenting with depression and anxiety often needs to learn coping skills to help manage stress. This process gives him or her a sense of control and allows a more immediate benefit from therapy.

Two of the techniques I teach are deep breathing exercises and guided imagery. Simply focusing attention on breathing for a few minutes allows the mind to break out of the habit of reacting to anxiety with a fight-or-flight response.

Guided imagery involves imagining a safe and serene refuge in vivid detail. When anxious, a client can mentally retreat to this safe haven until the anxiety passes.

Progressive relaxation in New York City therapy

Progressive relaxation is a skill I teach anxious clients. In this process, I talk them through tensing and relaxing individual muscle groups and focusing on their physical state and relaxation.

Another tool I advocate in managing anxiety is participating in some form of exercise like walking to increase physical activity.

Also important is understanding the concept that although anxiety is not controllable, managing their response to it is possible. I teach clients not to be afraid of anxiety attacks through the knowledge that they can handle it.

Help for depression in Manhattan

A man in his 30s came to see me seeking counseling for emotional abuse he suffered as a child. He recently was examined by his physician.

I recommend a complete physical examination to new clients to ensure that there is no physical cause for their depression. We also consider an evaluation for medication.

In this case, the client wanted to start therapy first and see if he could skip taking anti-depressants.

In situations of severe depression without medication, frequent therapy sessions may be necessary at the start. This man decided to come twice a week to begin.

Because of the abuse he suffered, he was conditioned to doubt himself and question his strengths. This mode of thinking caused him to fear the ability to handle daily tasks and to develop anxiety attacks.

Counseling for anxiety attacks with Manhattan therapist

In relationships, he focused on meeting the needs of others in order to be accepted. This caused him to be anxious and depressed.

He was anxious to accurately predict the other's needs and depressed about not getting his own needs met.

I used our relationship as a model for him to see how a productive communication is established between two people who are getting acquainted.

Requesting that he not seek my acceptance, I offered him my unconditional acceptance without these efforts.

I challenged him to be authentically present and modeled expressing and confronting emotions for him.

When he was able to recognize and understand his own needs, he developed a healthy relationship and married. He and his wife now have three children.

Therapy for depression, anxiety in New York City

Most people come to see me because something is not working in their lives. They may be unhappy with their jobs or careers. Their relationships either are not working or are non-existent. There can be problems with their families.

Any or all of those things can make people feel anxious, depressed or both. Sometimes, however, people feel depressed or anxious without knowing why.

I work psychodynamically, which is just a fancy way of saying that I work with an understanding of the relationship between the conscious and unconscious elements that influence our behaviors and choices.

Sometimes people operate in ways that keep them from getting what they say they want, and they are not aware that they put obstacles in their own path. It is as if they set up those orange cones you see on the highway, blocking them from reaching the very lane they want.

Overcoming depression in Manhattan

Therapy is a process. It can sometimes be hard for a client to see progress from week to week. But then a person will look back over the last six months and say, "Wow, I really have changed." That really encourages people and makes them feel more hopeful.

I saw a young woman who was crying all the time but did not know why. She had earned a Bachelor's with mediocre grades and now held a frustrating low-level job in a bank. Her self-esteem level was almost zero.

In our first two sessions, she told me her whole history, which included verbal, physical and sexual abuse in her childhood. However, after those first two sessions she barely spoke another word for a long time.

In the winter, she would sit down without taking off her coat. She also kept her purse and a large tote bag on her lap.

Gradual approach to reducing fear and anxiety

The fact is, she was using the purse as a shield and the coat to cover her feelings. She did not feel safe revealing herself.

Taking off her coat symbolized exposing herself to physical danger. Opening up to me about her thoughts and feelings felt dangerous to her, too, because she was sure she would get the verbal abuse she received as a child.

For a while, I sat with her silence and continued to ask questions, which she answered in one or two words. Then we began to practice putting aside the shield.

I asked her to set the bags beside her on the chair for five seconds. She started out at two seconds, but the next time it was ten, then thirty and so on. Eventually, she could set her bags at her feet.

Next, she gradually worked toward taking off her coat, scarf and hat, sometimes just one button at a time. The gradual technique showed her it was safe to trust me.

Self-esteem therapy for depression

The more she revealed her physical self without being hurt, the more she started talking. Eventually, she came in like any other client and shared what was on her mind.

Her depression lifted, and we could work on what led to her depression and fear in the first place. The emotional growth was huge, and her self-esteem rose dramatically over time.

The last I heard, she had completed a Masters program with near-perfect grades and was considering a doctoral program. She had been promoted several times and was now a branch manager. She also had a boyfriend she liked a lot.

Therapy for depression in Manhattan

A client who comes to me for depression or anxiety is often "stuck" in undesirable thoughts and patterns of behavior.

Depression can also show up in physical pains such as headaches, backaches, and digestive problems.

My goal is to help him or her become more aware of thoughts and emotions. This awareness leads to better emotional control as well.

I use a very integrative approach combining Schema Therapy, relaxation, and Cognitive Therapy. Schema emphasizes combating negative thought patterns by weakening their hold, and solving the related problems.

Once I've helped someone reach a point where he or she can function and feel safe, I then work on helping him or her heal the emotional memories. Often family and personal history plays a part in depression.

Help for depressed man in Manhattan

A man came to me for support and help with his depression. His wife had recently left him and he was feeling rejected, anxious and depressed.

My first step with a depressed client is to get a full intake and determine the core schemas. Typically, a client with these symptoms has issues with assertiveness.

Fear and guilt are the overwhelming emotions. He fears that if he says what he means, people will shun him.

On the flip side, he feels that assertive statements are self-serving and this gives him feelings of guilt.

Exploring his family history together, he was able to see how his controling parents affected his failed relationship.

His learned submissiveness caused him to be less assertive leading to feelings of anger when his needs were not met. This anger causing his wife to reject him.

Depressed man sees his problem as a lack of assertiveness

He realized that his life was not moving forward due to his lack of assertiveness. He decided that he wanted to start meeting new women, but was unable to express his wants and feelings.

Setting priorities, he worked on expressing himself at work and in social situations. He discovered that when he could not tell others his wants and feelings, he got depressed. His lack of assertivness also caused him to feel fatigued, and he developed backaches and headaches.

Treatment has to be multidimensional. I look at thinking patterns, social skills, education, and emotional expression issues.

I help a client to be pro-active, take control of life, and stand up for what he or she wants. Encouraging activity, I advise him or her to find passtimes that make them feel better.

Crippling anxiety helped with CBT approach

Overwhelming and crippling anxiety responds well to Cognitive Behavioral Therapy. In a relatively short time, I teach a client skills to be relaxed and enjoy life.

Getting out and going places is very beneficial, and helps him or her get in touch with what makes them happy.

I point out patterns and help a client look at the benefits or detriments of each one.

CBT is effective for treating anxiety and depression, getting a client activated, doing exercises and homework that I assign.

I equate CBT with a short-term, commonsense approach to life. It is very here and now, I don't spend years obessing over a client's past.

Therapy for depression in Manhattan

Depression may be established in early childhood, or in the present. It is usually the result of feeling blocked or unseen in realizing what one needs or feels, and then feeling powerless and hopeless that change will ever come.

When people feel blocked or thwarted from getting what they need or want, they often feel like they want to disappear. This often keeps people from from feeling alive emotionally.

The initial step is how a person is welcomed and invited into therapy. It is important to show that whatever it is that they are dealing with, they are welcome.

I create a neutral, non-judgmental atmosphere for whatever they need to express and work on.

Therapist welcomes clients with a non-judgmental attitude

I act as his or her supportive guide and help them to organize and understand their own story, including why they are stuck or repeating unhelpful patterns.

Together we explore possible ways to change. I don't focus on family history. Although this piece is important, most work is focused on feelings he or she experiences day to day.

I worked with a depressed male client who was a software engineer. He came into treatment as a mid-level manager.

What he loved about his technical job was being able to research and design new products. He was very talented, but as he moved up the corporate ladder, he was stuck in a manager position doing administrative paperwork, feeling blocked in his creativity and unable to change.

He also suffered from performance anxiety. When the network was available, he was unable to speak to those who could help him move forward.

Client overcomes fear of the unknown

We engaged in exploration and information gathering about his circumstances. He noted whether he felt comfortable or uncomfortable about each situation.

I taught him active problem solving, moving from one difficulty to the next. It is important to have support in the process of taking a step into the unknown.

He felt as if no one had ever shown him how to take chances or succeed, and he was frightened about the unknown. As a result of our work together, he quit his job and moved to a new company.

He is now happily working in research and design. Everything is new: his coworkers, his responsibilities, and best of all, no stifling routines.