The approach
This page explains how I actually think, because you deserve to know that before you spend money and an hour a week on it. No acronym soup, no promises about rewiring anything.
You are not a broken machine that needs a technician. You are a person who has been adapting, intelligently, to circumstances that asked a lot of you.
Almost every symptom I meet started life as a solution. Hypervigilance was once the thing that kept a child safe in a volatile house. Numbing out was the only way to get through a job that would not stop. Perfectionism bought approval in a family where approval was scarce and conditional. These strategies worked. That is precisely why they are so hard to drop, and why being told to simply stop doing them is both useless and slightly insulting.
So the first job is not correction. It is understanding what the pattern was protecting you from, with enough respect for the pattern that you are not fighting yourself the whole time. From there, change tends to happen less through effort and more through no longer needing the old solution as badly.
Three frames I work inside
The base layer. You set the direction, I bring warmth, honesty and full attention, and I do not pretend to know your life better than you do. The three conditions Carl Rogers named still hold up: genuine regard, accurate empathy, and a clinician who is not performing a role. Most of what changes in therapy changes because someone was finally allowed to be exactly as they are in front of another person who did not flinch.
Not a technique so much as a set of commitments. Pace over intensity. Safety and choice before exposure. Attention to what your nervous system is doing while we talk, not only to what you are saying. We do not go digging for detail because a story would be dramatic. We work at the edge of what is tolerable and we stop before it stops being useful, because a session that overwhelms you has taught your body that therapy is unsafe.
Developed by Ignacio Martín Baró working with communities living under violence and poverty, this frame insists that psychological suffering is often produced by conditions rather than only by individuals. Applied to New York it means we can name the landlord, the manager, the debt, the racism, the whorephobia, without me turning your hour into an argument about politics. Naming the source is what makes the shame let go.
What a session is actually like
We start where you are, not where a protocol says week four should be.
Some weeks you arrive with something specific and we stay on it. Other weeks you arrive with nothing in particular and something surfaces around minute eighteen that neither of us saw coming. Both are productive. I will ask questions, I will notice things out loud, and I will occasionally say the uncomfortable version of what you have been circling. I will not fill every pause, because the pause is often where the real sentence is forming.
I take very few notes in the room. What is required clinically I write afterwards. I would rather look at you than at a legal pad.
Purity is not a clinical virtue. Where a tool is genuinely useful I will use it and I will tell you where it came from and why I reached for it.
What I do not do is sell a proprietary method or claim that a fixed number of sessions produces a fixed result. I have seen five sessions change a life and I have seen two years of steady unglamorous work do the same. Anyone promising you a timeline before they have met you is selling something.
Fair questions
No, and if it starts to feel that way I want you to say so. Talking with no direction is a well known failure mode of open ended therapy. We agree on what we are working towards, we return to it, and we review it out loud every six to eight weeks. If nothing has shifted after a reasonable stretch, the honest move is to change the approach or change the clinician, not to keep booking.
Not on my schedule. History comes up when it is relevant, and with many people it turns out to be extremely relevant, but you decide the pace. Nobody is required to narrate their worst years in order to qualify for help. If early material is doing active damage to your present, I will say so and we can decide together whether to go there.
Rarely, and never about the big life decisions, because a therapist who hands out verdicts on whether to leave a partner or quit a job is exceeding their competence. I will absolutely give you my honest read of a situation when you ask for it, I will point out patterns you are inside of and cannot see, and I will tell you when I think you are about to do something that will hurt.
Say it. Genuinely. Some of the most productive sessions I have had began with a client telling me I had got it wrong, and often they were right. Rupture and repair in the room is not a failure of the therapy, it is one of the mechanisms of it, and it is frequently the first time somebody has been able to disagree with an authority figure and have the relationship survive intact.
I do not prescribe. I have no ideological position for or against psychiatric medication and I have watched it help enormously and I have watched it be handed out as a substitute for treatment. If a psychiatric assessment would be useful I will refer you to prescribers I trust, and with your written consent I will coordinate so that you are not the one carrying messages between two clinicians.
Fifteen minutes on the phone will tell you more than any amount of reading. It is free and there is no expectation attached to it.