Approach

“The greatest hazard of all, losing one's self, can occur very quietly in the world, as if it were nothing at all.” — Søren Kierkegaard

All of my work is psychodynamic or psychoanalytic. That means we pay less attention to managing a symptom and more to understanding the pattern that keeps producing it — the unconscious dynamics that shape mood, relationships, and self-esteem.

Psychotherapy

Weekly individual psychodynamic therapy — the kind of work where we're not just solving the surface problem but understanding why it keeps showing up. Sessions are 55 minutes, typically once a week, in my Brooklyn Heights office or by telehealth. Most people start here.

Psychoanalysis

Psychoanalysis is therapy at a different frequency and depth — typically three or more sessions per week. It's not for everyone, and it's not better than therapy the way a bigger dose is better. It's a different kind of process entirely: slower, stranger, more open-ended. The structure of meeting frequently allows things to surface that can't emerge in once-a-week work. If you're curious about it, we can talk about whether it makes sense.

What a session is actually like

You talk about whatever is on your mind, and I respond. I ask questions, point out connections, and tell you what I notice — including what happens between us, since the patterns that shape your relationships tend to show up in this one too. That's where they become visible enough to change.

It is not a silent therapist and a couch, unless you eventually want the couch.

How it differs from skills-based therapy

Approaches like CBT teach tools for managing a problem, and they can help. Psychoanalytic work asks what the problem is doing for you, and where it came from. People often come to it after skills-based therapy helped with the symptom but left the pattern in place.

How long it takes

This is open-ended work, not indefinite work. The first few sessions are a chance for both of us to get oriented: what brings you in, what you've tried, and what you hope will be different. After that, we review together how it's going and what you want from it. Many people stay for a year or more because the changes it makes tend to deepen with time.

Is it evidence-based?

Yes. A widely cited 2010 review in American Psychologist by Jonathan Shedler found that psychodynamic therapy produces benefits as large as those of other evidence-based treatments, including CBT — and that the benefits tend to last after therapy ends, and often keep growing. Longer-term psychodynamic treatment has also shown strong results for complex, long-standing difficulties (Leichsenring & Rabung, JAMA, 2008).

Shedler, 2010 · Leichsenring & Rabung, 2008