Anxiety.  There are so many ways anxiety and worry can show up and hijack one's life. In my work with both children and adults, I treat many anxiety and related conditions, including generalized anxiety disorder (GAD), specific phobias, and OCD. I draw from cognitive-behavioral therapy (CBT), evidence-based exposure and response prevention (ERP), mindfulness techniques, psychodynamic exploration, and family systems approaches to learn the root causes of the anxiety and give clients the tools they need to "talk back" to anxious thoughts and behavior patterns.

 

Neurodiversity.  Neurodiverse people see the world and learn differently and often perceive things more intensely. Neurodiversity is not a disease or diagnosis; on the contrary, it usually comes with many exceptional strengths. But too often people experience feeling like a fraud ("impostor syndrome") or like they don't fit in. I believe this stems from a lifetime of being misunderstood by others and receiving feedback that doesn't resonate with one's inner experience.​ I bring a deep appreciation for neurodiversity to my work. Key therapeutic themes and goals often include:

• most importantly, honoring, celebrating, and applying strengths;

• learning to name feelings and attune to internal body (somatic) experiences;

• finding community;

• identifying and addressing areas that require skill building, such as executive functioning, self advocacy, or social skills.

• finding creative ways to prevent or adapt to times when sensory intensities are overwhelming.

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Attention Deficit/Hyperactivity Disorder (ADHD).  ADHD is a neurological disorder that impacts one's ability to focus and inhibit impulses. But more significantly, ADHD often comes with far reaching difficulties with motivation and self-directed behavior. In fact, ADHD expert Dr. Russell Barkley believes deficient emotional self-regulation (DESR) should be explicitly recognized as a hallmark trait of the disorder. These self-regulation challenges can impede everyday functioning and affect all aspects of life.

 

When ADHD is in the picture, a first step is "de-shaming" the difficulties. Usually there are many "can't vs. won't" questions; that is, people wonder if the hardships are caused by willful refusals or ability deficits. The answer is likely to be a complex combination of each, and more often than not, I find that there are many "can't" behaviors that have been mislabeled as "won't." A comprehensive review of the family history combined with an analysis of all available information can provide clarity and shed light on helpful treatment directions. Through this process, people often experience huge relief as they come to realize that they are not lazy or otherwise flawed. Treatment involves self-esteem boosting, creatively harnessing support resources, increasing self-advocacy, and working within a client's motivational system to create pathways for skill building and growth.

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Learning Differences.  Often by the time a child or adult with learning differences seeks help, they have endured significantly more corrective and negative feedback and less positive feedback than their typically-learning peers. Related problems often include anxiety, low self-esteem, learned helplessness, and even school-based trauma. The much-celebrated "growth mindset" can feel painfully out of reach. People with learning challenges often have significant talents and gifts, and these may obscure the picture. Gifts may be overshadowed by learning differences, and learning differences may remain unflagged and untreated due to a student's compensatory abilities. Students may be accused of laziness or willful avoidance by those who wrongly assume that high performance in one area implies the presence of capabilities in other areas.

Whether you are seeking an educational/neuropsychological assessment or psychotherapy, we'll start with discovering and celebrating strengths and "de-shaming" the challenges. Assessments can be enormously helpful in unpacking the various cognitive, emotional, social, behavioral, and executive functioning strengths and difficulties. Psychotherapy goals may include treating underlying or coexisting anxiety, low self-esteem, or depression, increasing self advocacy, and educating the client, family, and school personnel about helpful types of support. I also participate in IEP meetings and coordinate care with other treating professionals, such as learning specialists, occupational therapists, speech therapists, and psychiatrists.

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PTSD & Complex PTSD.  If traumatic events overwhelm our innate coping mechanisms, post traumatic stress symptoms may occur and lead to post traumatic stress disorder (PTSD).​ A more severe form of PTSD, complex PTSD, also called developmental trauma, may result if a traumatic experience occurs early in life and in the context of important attachment relationships. For example, complex PTSD may occur with child abuse, neglect, domestic violence, or other severe betrayals. Complex PTSD may also result even when caregivers are loving and well-intentioned if there is a significant disruption of a child's sense of safety and continuity. For example, complex-PTSD may occur if there is a history of early surgeries, NICU hospitalizations, traumatic separations, caregiver illnesses, or natural or political disasters.

 

Distinguishing "ordinary" anxiety from trauma-related symptoms is a delicate and nuanced process. Also, standard psychotherapy approaches that work for PTSD may not be as effective with complex-PTSD, especially if the trauma resulted in severe symptoms or loss of basic trust. But hope and healing are possible with specialized, trauma-informed treatment in the context of a safe and compassionate therapeutic relationship. Using a gentle, collaborative approach, I help clients discover the right goals and pace for trauma recovery. Treatment techniques I use include EMDR, somatic-based therapies, internal family systems "parts" work, and trauma-informed CBT.