Additional treatments include:
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Self-harming behaviors
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Personality disorders
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Bipolar disorder
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Frequent conflicts or avoidance of conflict
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Functioning at work or school
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Fear of competition or fear of success
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Internalizing issues
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Externalizing issues
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Insecurity and lack of self-confidence
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Marriage or divorce, pregnancy, children
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Relationship break-up
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Grief and mourning
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Coping with change
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Cultural issues
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Gender issues
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Childhood abuse or trauma
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Coping and acting out behaviors
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Bullying and social media concerns
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Others
This is not a comprehensive list, as there are more treatments not listed. Call to discuss more about specific disorders or treatments, or to find about more areas of focus not listed above.
Anxiety Disorders
This is one topic near and dear to my heart, because of my past struggles.
Understanding the sources of your anxiety, fear and compulsions may help you to find strategies for moderating the disruptiveness of your emotions.
Anxiety caused by persistent worry, fear and nervousness can deeply stress the body and mind, and can interfere with sleep, health, and normal physiological functioning. We all experience anxiety from time to time. Some people may be predisposed to worry, while for others, anxiety can take the form of emotional storms. Sometimes anxiety can be so debilitating that it can interfere with personality and a normal social life. Anxiety is a broad-spectrum, internalizing disorder. Normal, adaptive anxiety is based in fear; it’s the body’s natural alert mechanism. A little anxiety can be a good thing, but clinical levels of anxiety may be caused by temperament, inadequately resolved experiences of psychosocial trauma, or be part of another disorder such as depression or other medical problem. It might even be a side effect of drugs or medications. Anxiety puts the mind on high alert, and has emotional, cognitive and behavioral consequences. Anxiety disorders range from generalized anxiety, to panic attacks, to social anxiety, to OCD, to a variety of phobias. Though it feels like anxiety will never go away, it is actually treatable and manageable with the proper techniques.
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Cognitive Behavioral Therapy (CBT) for Anxiety
Part of the treatment for anxiety is to “unlearn” the thinking process that underlies it. For example, in phobic reactions there may be an irrational belief that the object of phobia is linked to a danger, which provokes anxiety or even a panic reaction that is often self-perpetuating. A gradual and structured loosening of this noxious conditioning empowers the individual with more control over their feelings. CBT is very effective for treating anxiety and panic and helping people overcome this debilitating condition.
Medication for Treating Anxiety
For acute anxiety, physicians often prescribe some form of sedative-hypnotic or anxiolytic (tranquilizing) drugs to interrupt the escalation of anxiety. Such drugs can be habit-forming, not to mention dangerous in combination with other drugs and alcohol, but can also be helpful if used the right way. A proper assessment will determine the need for medication.
Anxiety Experience
Anxiety can be particularly powerful and visceral because it activates the core nervous system, sympathetic and parasympathetic, affecting the cardiovascular, respiratory, motor and gastrointestinal systems, not to mention what happens in one’s mind! For many people, simply by understanding what is occurring in the brain and body, and understanding how one can control the symptoms the anxiety begins to dissipate. People often feel like they are “going crazy” with anxiety attacks; that “nobody gets it”. What to do, and how to managing symptoms is what I focus on immediately in anxiety therapy, for the fastest route to relief.
Physiological Symptoms of Anxiety
* Persistent worrying
* Gastrointestinal symptoms such as upset stomach, diarrhea, frequent urination or difficulty with urination
* Rapid heart beat
*Tremors or nervousness, pacing or agitation
* Dizziness
* Peripheral nervous symptoms such as tingling of fingers or toes
* Difficulty falling asleep
* Restlessness
* Sweating
* Dry mouth
Obsessive Compulsive Disorder (OCD)
OCD (Obsessive-Compulsive Disorder), a form of intense anxiety, involves recurrent intrusive thoughts, obsessions or compulsions that most likely interfere with normal functioning and routines. Modern research suggests a strong genetic basis to OCD, although genetics is not a sufficient condition to developing symptoms of OCD.
People suffering from OCD often know that their compulsion to do something or avoid something, like compulsive checking, or repetitive behavior like hand-washing, is irrational, but nevertheless have trouble preventing themselves from acting on it. OCD can cause enormous psychic distress, not to mention its interference at work or at home. The symptoms of OCD can respond to psychotropic drugs and behaviorally based therapies in ways that diminish the power of the symptoms.
Depression
Depression can be debilitating, lonely, isolating, and can feel like an insurmountable burden. It has as many faces as it has causes. For some it can feel like a crushing weight, for others a floating or emptiness. Some people may become angry, irritable, or agitated when they’re depressed, while others may feel passive, hopeless or withdrawn.
Whether mild or severe, depression can lock one’s frame of mind in a different cast. It can affect motivation and, if serious enough, become completely debilitating.
Everybody can get depressed at some time or another. People can be more vulnerable to depression when they experience disappointment, discouragement, sadness, loss, or life change—as well as for seemingly inexplicable reasons. In some cases depression can be more a function of biological or genetic vulnerability, independent of life circumstances.
The symptoms of depression can persist over a long period of time or, in some cases, all the time, and can significantly impact one’s normal functioning. When a pattern of depressive symptoms appears together, clinical depression, also known as Major Affective Disorder or Major Depression, may be one possible diagnosis.
People who experience one or more symptoms of depression may not be suffering from clinical depression at all but may have either a different psychological problem or a biological problem such as metabolic dysfunction, like thyroid disease.
Understanding the unique “footprint” of a person’s depression requires a careful and methodical exploration of its nature, its underlying causes and its severity. Therapy provides a formative, structured setting in which a skilled psychologist can work closely with the individual to learn and uncover the sources of deep or lingering depression.
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Dana’s treatment for depression starts with a thorough evaluation of a new patient. The treatment may then include therapy such as: CBT, psychodynamic, elements of mindfulness-based therapies, referral to a psychiatrist for a medication evaluation, or other combinations of approaches, depending on the person. Though it feels like overwhelming, unexplainable sadness and hopelessness, there is help for those who reach out. I experienced deep depression in my earlier years and thought it would never end. I never believed that it was possible to overcome the depth of depression that I felt. I sought therapy out of desperation and it saved my life.
Symptoms of depression:
* Lack of interest or pleasure, lack of engagement
* Lack of libido or interest in sex
* Decreased ability to function at work or school or do normal chores
* Diminished self esteem
* Social withdrawal or avoidance of others
* Guilt or self-recrimination, self-criticism and self-doubt
* Feeling behind or unable to keep up, feeling overwhelmed
* Sadness or depressed mood
* Hopelessness or helplessness
* Lethargy, low energy
* Loss of appetite or increased appetite, including significant weight gain or weight loss
* Increased sleep or sleep disturbance, including waking up spontaneously earlier in the morning than usual
* Anger or irritability, or agitation
* Difficulty concentrating
* Anxiety
* Pessimism about the future
* Difficulty making decisions
* Difficulty finishing tasks or initiating new projects
* Thoughts of suicide
Discovering how your habits and compulsions control you is the first step in understanding how to break free from them.
Using nicotine, alcohol or drugs as an habitual way to cope may point to an addiction. Similarly, compulsions to eat, shop, work, or exercise may also signal a deeper emotional difficulty. The first step in addiction recovery is recognition that doing what feels good or what relieves stress may actually be exacting an unacceptable toll.
The word “addiction” implies an habitual behavior that cannot be controlled or that has become a compulsion. Most who suffer from an addiction are in considerable mental pain, caused either by stress or by the cost of the addiction itself. Their suffering drives an addiction that helps them to cope, feel good, or just get by. Behavior, brain and biology all get caught up under the wheels of the addiction cycle, making it harder to break free.
Dana’s approach in helping people with addiction recovery is to help them to learn skills to slow down the sequence between impulse and addictive action, to develop alternative skills to relieve tension, to recognize their motivations, such as understanding what purpose their addiction serves, and to gradually help them to find ways of being more self-sufficient and less dependent on their “drug” of choice.
Dana’s approach for addiction recovery is to work from a mindfulness therapy and psychodynamic perspective. Addiction is heavily action-oriented while mindfulness recruits attention, among other ways, as a brake between impulse and action. Mindfulness therapy can also provide skills that offer deeper relief than the addiction itself.
Working with addiction recovery from a psychodynamic therapy perspective, people engage in addictive behaviors because they are trying to use either a substance, like alcohol or drugs, or behavior, like sex or internet or shopping, to manage their mental and emotional states. The addiction may help to manage intense anxiety, or be used to manage feelings of emotional hunger or deprivation. Sometimes it helps them get through a difficult day, manage the rough patches or help in times of frustration and anger. Others feel it helps them manage boredom and emptiness. Many don’t know why they do it.
Dana works with patients interested in addiction recovery to identify what might be motivating addictive behavior or compulsions and to develop new skills of coping.
Addiction can affect you in many ways:
* You may feel shame and blame yourself, but feel unable to get a handle on it
* There may be blame by your family members, coworkers or others about your addictive behavior
* Addictions are often expensive and time-consuming; they can hog your time and resources
* Your addiction can lead to increasing isolation and loneliness, as relationships and the quality of those relationships are forfeited for the addiction itself
* You feel the inevitable let-down; after shopping, drinking or exercising you don’t find peace or fulfillment, just more hunger and need
* Your alcohol or drug addiction kills brain cells, leading to shrinkage of the brain, while compulsive addictive behavior has a “dumbing down” effect, reducing instead of increasing your ability to cope with your environment.
People usually come to psychotherapy at the point when their addictive behavior threatens their jobs, relationships, or their health. Many seek help when they’ve been advised by their families, physicians or workplace, or as an outpatient follow-up to inpatient rehabs. The line gets crossed from bad habits to addiction when the behavior persists despite the harmfulness of the behavior. Smokers and heavy drinkers know that their behavior invites severe health consequences, yet they feel that they either don’t want to stop or simply cannot stop.
Addiction persists because the reward is felt to be more desirable than the consequences, even if those consequences are dire. Part of this is biological: drugs like cocaine are so effective at activating the reward centers in the brain that some people will literally die for it.
Finding New Focus with ADD and ADHD
Identifying the causes of your attention problems may help you reclaim your self-confidence and learn how to slow down, recognize and organize your thoughts and emotions.
Moving too quickly from one subject to another or difficulty following through on tasks may point to an attention disorder. A lack of focus and concentration can diminish your self-confidence and inhibit your professional life and personal relationships.
Attention problems including ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder) can be a part of your biology or temperament, or it can be related to anxiety about an event or circumstance in your life. It can also be a side-effect of depression or stress: you’re distracted when you have other things on your mind.
Dana Williams helps patients to develop and improve functions that are often compromised along with attention. These may include:
* Problems regulating the ups and downs of your emotions and thoughts, which can disrupt your focus and concentration;
* Improving your understanding of your mental and emotional states and those of others
* Slowing down and breaking down your cognitive and emotional experiences
* Organizing your thoughts and emotions and the information around you
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Attention problems, including ADD, can affect you in many ways:
*You may underestimate yourself or question your ability to reach the goals you care about
*You might feel misunderstood or you have a history of being perceived as having personality problems or being less intelligent than you are
*Others might think that you’re irresponsible which can hinder your professional success
*Sometimes you find it hard to predict what you’re going to do or how you’re going to feel, and how to bring yourself to a neutral place as a starting point
*It can be hard to read other people and to understand what they expect of you
*It takes you longer to do things than you would expect
*The little things you miss can snowball into bigger things that get you into trouble
*You find it difficult to concentrate or you get bored easily
*Sometimes it seems like there are just too many choices, and it’s hard to make decisions
*You can feel paralyzed by the expectations and demands of others
*It’s hard to follow through on assignments
*It’s hard to focus on which relationships are good for you
*It’s hard to know what you want
Psychotherapy helps you to tease out what might be causing your shortened attention or concentration. Psychodynamic psychotherapy is particularly well suited to comprehending the breadth and complexity of interwoven factors that may look like a disorder or diagnosis. Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) tend to be over-diagnosed or inappropriately diagnosed.
For many, whose symptoms may have long been misunderstood or misdiagnosed, getting the appropriate diagnosis and, subsequently, the proper medication that could improve symptoms may come as a significant relief.
But, problems involving attention reach into many areas of personal, professional, and social functioning, that simply taking medication seldom resolves the diversity of challenges facing those who live with them.
Coping with Stress
In today’s competitive environment, work-related stress, with its pressures and demands, is one of the most frequent challenges in coping with stress. Difficulties that arise in relationships or life events can also test our ways to cope with stress; our own high expectations or feelings of guilt, anxiety or self-criticism can tax our emotional resources.
People have different ways to cope with stress and with varying degrees of success. In the face of so many sources of stress, psychotherapy is a direct effort to improve coping and build bio-psycho-social resilience by increasing the ability for regulating difficult emotions, by generating improved coping skills, and by strengthening the capacity for emotional safety.
Stress has strong biological and psychological components and occurs when internal or external demands are greater than a person’s capacity to cope with them, or when one’s coping mechanisms are persistently tested. Prolonged stress and its effects on the body and mind can severely compromise health and can cause chronic disease.
In today’s world stress levels are almost pandemic, and our competitive, deadline-driven work environments are often the most persistent cause of it. Professional demands and the pressure to perform; fear of losing one’s job; competition and difficult interpersonal interactions are all significant sources of stress, particularly if one’s resources and capacity to cope are low.
Relationships are also a significant source of stress. Difficult interpersonal dynamics and the feelings they provoke can be challenging and draining, and at times can feel impossible. Similarly, life events like an injury, a difficult pregnancy, or an ailing family member are a source of stress or trauma, and can feel insurmountable. Too much stress early in life may also predispose an individual to have difficulty coping with it later in life.
Perhaps one of the most painful sources of stress is from the self; high expectations, guilt, anxiety, depression and self-criticism can be emotionally taxing.
Dana’s approach with mindfulness-based stress reduction is a systematic evaluation of the experience of distress in the mind and body, in all its forms, including physical pain, physiological stress and negative mental states. By focusing and expanding awareness together, mindfulness opens new pathways for coping with old stressors.
Trauma and PTSD
Trauma has many faces and touches millions of people in the form of childhood abuse domestic violence, car accidents sexual assault, life-threatening illnesses, experience of war, neglect, or other exposures to traumatic events. PTSD or post-traumatic stress disorder is a condition that suggests a person has not recovered from a traumatic event, whether it happened recently or in the past. The trauma literally becomes stuck inside of us. As a consequence, the brain, body and emotions are wired to fear experiences that remind us of the past. For many trauma survivors, the world is not a safe place. It leaves victims with unresolved feelings of shame and guilt, helplessness, powerlessness and pain. Therapy might open the space to share, discuss and sort out this complex experience with the needed safety and nurturance required to help the healing process.
Children are particularly susceptible the effects of traumatic events, as their neuropsychology is still developing and may be adversely altered by the stress. The more intense the trauma, the more likely it is that an individual will suffer PTSD. While the bleeding and damage of a physical wound is a result of severe physical trauma, the mental breakdown and damage of a psychic wound is a result of severe psychological trauma. PTSD may occur shortly after a traumatic event but, unlike the body, it may occur many years afterward, or something in between, with many recurring episodes.
Individuals suffering from symptoms of PTSD are effectively re-living their trauma, attempting to cope with the memory of it by avoiding or outright blocking the re-experience of it, and experiencing anticipatory anxiety against the fear that the trauma or some equivalent threat may re-occur.
PTSD caused by an acute, single event, like a traumatic accident, can be easier to heal from than from protracted exposure to trauma, such as living through a war, or surviving a noxious family or political regime. People who suffer post-traumatic stress often have other psychological difficulties at the same time. It’s not unusual for people with symptoms of PTSD to also suffer depression, anxiety, anger, attention problems, compromised immune systems, etc.
Dana’s approach with PTSD is to help the individual to process the trauma in a safe setting at a controllable pace, and to work through the strong reactions and emotions associated with it, including survivor guilt, anger and fear. Dana has been additionally trained in Trauma Focused Therapy and EMDR.
Rebuilding Self-Esteem
Identifying negative self-thinking and using mindfulness skills to develop confidence and to cultivate a more positive self-image.
People who believe in their self-worth tend to take more risks and expand their options, while people who have low self-esteem act to buffer themselves from failure and avoid situations that may risk internal or external criticism.
Self-esteem—what makes an individual think well of themself—is at the core of our psychology. Positive self-esteem engenders resilience, optimism and strength. While self-esteem may vary from culture to culture, how people view themselves may affect almost everything they do, think, or feel. It can influence their choices and decisions, who they have relationships with and how they respond to events in their lives. In our society, self-evaluation and judgment is a constant process for many, and it is impressed on us by the trends of the workplace and popular psychology, which heighten consciousness of capability and performance in myriad ways.
High or low self-esteem or self-confidence also tends to be self-perpetuating. Legions of experiments in social psychology indicate that people who seem self-confident and happy with themselves attract positive attention, while people who seem uncertain and who doubt themselves tend to avoid social contact and come to expect, and receive, more negative attention.
Dana’s approach in helping people to improve self-esteem is to combine cognitive behavioral techniques to identify negative self-thinking and criticism, and mindfulness skills to bring into finer focus the mental states that form ideas about the self. Psychodynamic psychotherapy can effect change and growth at the deepest level of psyche by tracking self-esteem in the context of relationship.
Low self-esteem and self-confidence can affect you in many ways:
* Indecisiveness and uncertainty
* Reluctance to share opinions
* Avoidance of groups, withdrawn socially
* Self-critical or emotionally conflicted
* Social and professional isolation
Life Changes and Challenges
Finding emotional strength in life’s challenges and developing new insights that may help you to meet difficult transitions constructively.
Important life changes and periods of transition, such as moving, a breakup, losing a job or a parent, or suffering an illness, can be challenging and create emotional difficulties, stress, or relationship problems.
When stress—or distress—becomes sufficiently strong and cannot be ignored, therapy can help to moderate the emotional impact of such transitions, and offers the opportunity for significant emotional and psychological growth and insight.
For some people the issue is not just coping with the pressures and expectations imposed by a major life change, but understanding what has changed for them, or what they find difficult about the situation. Particularly during stressful life changes, the tendency is to take on the challenge while ignoring what’s going on internally.
While we accept that “change is good” and that life would be boring without transitions, we can often become so attached to our routines that we go to great lengths to avoid changes. Some people embrace change and avoid routine or “settling down.” Others—even when situations are uncomfortable and they don’t like their job, their marriage, their neighbor, or the layout of their furniture—may still prefer to adapt and accommodate than to face the unknown.
Whether you prefer one end of the spectrum or the other, most people find that major life changes and transitions challenge their personalities and their mindset, sometimes very painfully so. Therapy offers support and insight during these transitions, and a sense of containment that brings a revitalizing, rather than a depleting attitude to life crises.
Examples of major life changes and transitions are:
* New relationships
* Graduation and starting a new direction in life
* Breakups or loss of relationship
* Coping with illness
* Aging
* Moving or relocation
* Mourning and bereavement
* Job or career change
* Divorce
* Pregnancy and childbirth
* Marriages or stepfamilies
* Caring for elderly dependents
Anger Management Counseling
Managing anger consists of being able to acknowledge and understand your strong emotions, and anger management counseling will help you to develop new skills to recognize, channel and express them constructively.
A quick temper or a tendency for showing negative emotions may indicate a difficulty controlling or coping with strong emotions, including anger. Learning to manage anger includes learning to tolerate difficult feelings rather than being controlled by them.
Anger can be among the most difficult emotions to feel. People are often afraid of anger because it is associated with aggression, a reality that is often exacerbated by the fact that many haven’t been socialized to know how to express their anger appropriately. More common is avoidance or inhibition of anger, leading it to build up over time, creating more serious problems.
When you lose your temper or show negative emotions, you can quickly lose social capital in the workplace, and it can take a toll on personal relationships, even when there is more room for forgiveness. It can be difficult to regain trust and respect if you lose control, which is why many people have been socialized to keep a tight rein on their emotions. But suppressing your anger comes with consequences: the buildup of stress creates the conditions for serious physiological diseases.
Strong emotions, including anger, can be a source of emotional depth and growth, if managed the right way; a process that psychotherapy could help with.
Dana helps patients with anger management counseling. Her approach is to help you to work with difficult or painful feelings, rather than suppressing them, by investigating and understanding the context in which they occur, and to replace unskillful responses with skillful ones. Recognizing how your anger starts and controlling how you react to it are two of the most important skills in managing anger. Only by understanding what triggers your anger can you do something constructive with it.
Mindfulness-based therapy can be particularly helpful and relevant to the management of strong emotions, including anger, because it focuses on developing skills to help you slow down, calm down, and increase your capacity for awareness and positive emotions, which can be a powerful antidote.
Improving Relationships
Uncovering the patterns in how you relate to others and helping you find new ways of keeping and nurturing your relationships.
Difficult relationships can leave us frustrated, angry and unfulfilled. Recognizing how our attitudes and behavior influence one another is the key to understanding why a relationship can become unhappy, antagonistic or counter-productive.
Human beings are social beings. So much of what we value is invested in good relationships because they make us feel successful and happy. Even for those who might eschew the importance of relationships, they can find themselves adrift when things go wrong.
Our principal relationships are the ones with family, a spouse or partner, a child or a sibling, while our social relationships are with friends and coworkers. Whether or not we maintain a relationship with someone, we are always relating to people, even strangers we interact with on the street or online.
A good part of how we relate to others is colored by how others have related to us. With a little examination we can often find patterns in how we act in relationships. There may be patterns of conflict or difficulty getting along. Some may find it difficult making commitments or finding or keeping good relationships while others may feel that they are unable to be in a relationship and still be authentic. Through the psychodynamic therapy process Dr. Wu helps patients uncover these patterns and helps them find new and more satisfying ways of relating to others.
The core of psychotherapy is in its specialized ability to look closely at how people operate within relationships. In psychodynamic psychotherapy the therapeutic relationship itself may be used to provide insights into the patient about their ways of relating.
Types of problems people have in relationships:
* Getting along
* Communication problems
* Important relationships that are not working well
* When you detect unhelpful patterns in certain types of * relationships
Types of relationships Dana helps with:
* Relationships with children
* Relationships with parents
* Relationships with siblings
* Professional relationships with coworkers and bosses
* Social relationships with friends and community
* Intimate relationships with a spouse or partner
Panic Attacks
Panic attacks or panic disorder can be understood as a pattern of uncontrolled escalation of anxiety. It feels like an anxiety attack on steroids! It is important to rule out the possibility that these symptoms are caused by other medical conditions, such as a heart attack, endocrine or metabolic problems such as hyperthyroidism, or other drug effects. They are treatable and can be overcome with proper treatment.
Symptoms of Panic Attacks
* Shortness of breath
* Sensation of smothering or inability to breathe
* Racing or rapid heartbeat
* Sweating
* Dizziness or fainting
* Fear of dying, going crazy, or losing control of one’s actions
* Upset stomach, nausea
* Numbness or tingling sensations
Obsessive Compulsive Disorder (OCD)
Obsessive Compulsive Disorder (OCD)
OCD (Obsessive-Compulsive Disorder), a form of intense anxiety, involves recurrent intrusive thoughts, obsessions or compulsions that most likely interfere with normal functioning and routines. Modern research suggests a strong genetic basis to OCD, although genetics is not a sufficient condition to developing symptoms of OCD.
People suffering from OCD often know that their compulsion to do something or avoid something, like compulsive checking, or repetitive behavior like hand-washing, is irrational, but nevertheless have trouble preventing themselves from acting on it. OCD can cause enormous psychic distress, not to mention its interference at work or at home. The symptoms of OCD can respond to psychotropic drugs and behaviorally based therapies in ways that diminish the power of the symptoms.
Procrastination
Understanding the causes of your procrastination and clearing the way forward with new confidence to meet the tasks before you.
Meeting a deadline, despite one’s habit for procrastination, can be difficult, but it can become debilitating when those deadlines are missed altogether, or projects are left unfinished. The consequences of this can often snowball, creating a vicious cycle. Many people who procrastinate have been doing so for a long time, as it can become habitual, but not everyone acknowledges that they procrastinate. They may tell themselves that they work best under pressure, or that they are waiting for the right mood or the right energy to tackle their project. High achievers often procrastinate because they find it difficult to meet their own high expectations.
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Procrastination can be temporary, a symptom of overload, or a secondary symptom to another problem like depression. Sometimes procrastination can stem from a broader set of problems, such as distractibility or lack of focus, difficulty managing frustration or tension, anxiety, or challenges to self-confidence. In its effect on one’s mindset and functioning, procrastination can be quite painful. Like addictions, the behavior underlying procrastination can itself become a bigger problem than merely the task it delays. Dana’s approach is to work with you to explore the internal and external pressures that may be causing you to procrastinate, and to work with underlying issues of self-confidence, fears of success or failure, and help you release the hold it has on you.