Psychodynamic Psychotherapy

I provide evidence-based psychodynamic psychotherapy.  “Evidence-based” is a term that is used to mean that the effectiveness of a treatment approach has been rigorously demonstrated by research.  Psychodynamic psychotherapy is a “talk therapy” in which a trusting, safe and collaborative relationship allows you to discuss and explore the nature of your problems and to understand them deeply in the context of your current circumstances, your life history and your unique personality.  Working in the ‘here and now’ we will come to understand the origins and meanings of your symptoms, feelings, self esteem difficulties, and problematic behaviour or relational patterns, and use this knowledge to work through core problems so that something about you changes.  These psychological changes assure that the problems that you are having resolve and stay resolved.

Research shows that psychodynamic psychotherapy is very effective in both the short term and long term, meaning, that the majority of people who undergo it tend to hold onto their gains in treatment.   Compared to other evidence-based psychotherapies (such as cognitive-behaviour therapy or CBT) it is at least as effective in the short term (when change is measured immediately post-treatment) but research shows that it may be more effective in the long run (more patients hold onto their gains in psychodynamic psychotherapy than they do in CBT).  Moreover, this research shows that psychodynamic psychotherapy may be more effective for more complex and long-standing psychological disorders, especially when it is more intensive (more sessions) and provided for a longer time frame.

Psychoanalysis

Psychoanalysis is chosen or recommended when there are deep seated personality problems that are longstanding and that interfere with your life in significant ways, and/or for those for whom other psychological and psychiatric treatments have had limited or no significant lasting benefit. The aim of psychoanalysis is to transform aspects of your personality that do not work for you – those aspects of your self-identity, feelings, behaviour and relationship patterns, that make you feel like you are stuck, repeating the same old patterns, in the same kinds of relationships, struggling with self esteem problems, or fears, or psychiatric symptoms, and unable to find happiness, contentment, security or self esteem despite your best efforts.

Psychoanalysis is an intensive form of psychotherapy that involves meeting several times a week (3-5 times) and lying down on an analytic couch with the therapist or analyst seated behind you. The increased frequency of sessions along with the use of the couch results in a continuity and intensity of experience that makes psychoanalysis a more powerful treatment than psychotherapy. It allows for the quicker formation of a trusting and safe relationship that allows you to eventually discuss whatever comes to mind and helps you to re-experience warded-off patterns of feeling and relating which repeatedly make you suffer. Once these patterns are brought into awareness and understood in depth, they can be worked through and transformed. This makes way for the development of new and more effective ways of experiencing yourself and others.

Research shows that psychoanalysis is very effective. We know that the changes in personality and mental functioning that are made in psychoanalysis contribute to lasting changes in self-experience, in relational patterns, in emotional functioning and resiliency. We also know that once an analysis is completed, that people tend to hold onto those changes and that no further treatment is needed in the future.

Psychotherapy for Depression

Psychotherapy for depression is very effective. In fact, it is just as effective in the short term as antidepressant medication and more effective in the long term because the psychological changes that occur can reduce or eliminate the risk of future depressive episodes. And because psychotherapy does not have the unpleasant and sometimes dangerous side effects of antidepressant medications, which can include weight gain, loss of sexual desire or functioning, emotional numbing and sometimes violent or suicidal thoughts and feelings, psychotherapy is easier to tolerate and very safe. Patients typically recover from a depressive episode fairly quickly (4-10 weeks) but psychotherapy is often recommended beyond symptom relief to address psychological and social factors that make you vulnerable to depression.

Psychotherapy for Anxiety

Anxiety disorders are very common and can express as excessive worry, fears and preoccupations, as physical tension and alterations in physical functioning (e.g., (gastrointestinal problems, breathing difficulties), and avoidance or maladaptive defense mechanisms that interfere with your life. Psychotherapy for anxiety provides an opportunity to deeply understand and face your fears so that you can overcome them and gain relief from your anxiety symptoms.

Psychotherapy for Panic Disorder

Panic attacks can be very frightening and can lead one to restrict one’s life to such a degree that one might even refuse to leave the house (called agoraphobia). Psychotherapy has been shown to be a very highly effective for panic disorder. I use an evidence-based approach called Panic Focused Psychodynamic Psychotherapy. With this approach, panic attacks usually decrease or disappear within 4-6 weeks. Once you understand why you are having panic attacks you can begin to address the underlying fears causing them. Psychotherapy beyond this period will assure that the panic attacks stop for good.

Psychotherapy for Psychological Trauma and PTSD

I am a clinical member for the International Society for Traumatic Stress Studies and the International Association for the Study of Trauma and Dissociation and formally the Deputy Clinic Head of the Psychological Trauma Program at the Centre for Addiction and Mental Health and Deputy Director of the Trauma Program at Whitby Mental Health Center. I am currently a Service Provider to Veteran’s Affairs Canada and the Worker’s Safety and Insurance Board of Ontario.

I have expertise in the assessment and treatment of both acute and severe complex psychological trauma. This includes persistently severe posttraumatic stress disorders, dissociative disorders (such as “multiple personality disorder”) and trauma-related borderline personality disorder, as well as ancillary psychological and behaviour disturbances that are often the sequela of prolonged traumatic experiences such as substance abuse, self-harm and suicidality, depression, violent behaviour, and a tendency to be involved in abusive or otherwise self-destructive relationships.

Following a comprehensive assessment, and using an evidence-based stage model of treatment, you will learn how to escape patterns of self-harm and instability, reduce trauma symptoms (such as flashbacks), obtain greater integration in identity and behaviour, and make a recovery from your traumatic past so that you can live more effectively in the present.

Psychotherapy for Psychosis

Psychosis refers to a psychological process in which someone develops delusions (beliefs that are not generally accepted or shared by society) and hallucinations (such as hearing voices or seeing images). Significant social and emotional withdrawal, as well as disorganised thinking and other problems with cognition also often occur during psychosis. While schizophrenia is the diagnosis most closely associated with symptoms of psychosis, symptoms of psychosis including delusions and hallucinations are a core feature of a number of different classifications including schizophreniform disorder, schizoaffective disorder, brief psychotic disorder, and delusional disorder. In addition, psychotic experiences can also be a primary feature of mood disorders such as bipolar disorder and, less frequently, major depressive disorder.

While medications, referred to as “antipsychotics,” can be helpful and even sometimes life saving, psychological approaches to psychosis can also be very helpful. Psychotherapy for psychosis is very commonly offered in European countries, such as Findland, Germany and the UK and there is very good evidence that it is effective and that outcomes are better if psychotherapy is offered to patients who have psychosis. The need for psychological therapies for psychosis is now slowly but increasingly being recognised in North America.

I offer psychodynamic psychotherapy for people suffering psychosis. Psychodynamic psychotherapy has been extensively studied and shown to be effective in reducing and eliminating delusions and hallucinations as well improving social and adaptive functioning in people with psychosis. Because medication is often an important part of the treatment for psychosis, I always work closely with your psychiatrist or family physician.

Psychotherapy for Personality Disorders

Personality disorders are long-standing patterns of thinking, feeling and behaving that persistently and seriously compromises your ability to form and maintain healthy satisfying relationships, work and social functioning, and make one prone to serious instability in identity and mood (sometimes accompanied by non-suicidal self-injury such as cutting, or actual suicidal thoughts and impulses, or serious problems with substance abuse or high risk behaviour or impulsivity). These can include borderline personality disorder, narcissistic personality disorder and paranoid personality disorder (among others). Using intensive psychodynamic psychotherapy, an evidence-based treatment approach, it is possible to greatly improve psychological, social and occupational functioning, and some patients can even be “cured” of their personality disorder.

Psychotherapy for Repetitive Maladaptive Relationship Patterns

Our internal models of relationships and adult attachment styles, as well as most aspects of our interpersonal behaviour, are a result of past attachments and developmental experiences with significant others during childhood and adolescence. Sometimes early attachment difficulties and subsequent developmental experiences can you give rise to repetitive maladaptive relationship patterns that make it difficult for us to form healthy attachments and relationships in adulthood. Psychodynamic-interpersonal psychotherapy helps you to identify these maladaptive relational patterns, their underlying beliefs and internal relationship models, and their developmental origins, and helps you to change how are experience and relate to other people to improve the quality of your attachments and relationship functioning.

Psychotherapy for Compulsions, Addictions and Self-Defeating Behaviour

These include the compulsive use of, or addictions to, Internet pornography, sex eating, gambling, shopping and alcohol and chemical substances, as well as patterns of destructive for self-defeating behaviour whereby you seem motivated to sabotage aspects of your life including your relationships, your work, and even your health. Psychodynamic psychotherapy helps you to understand the nature of these difficulties and address underlying problems so that you can gain control over your behaviour.

Supervision

I provide individual supervision in both time-limited and long-term psychoanalytic psychotherapy and psychoanalysis, as well as case consultation, to qualified psychologists, psychiatrists, social workers, GP psychotherapists, and other regulated mental health professionals. I have over 15 years of experience in teaching psychotherapy and supervising psychotherapy cases. I currently teach and supervise psychotherapy and psychoanalysis in the University of Toronto Psychiatry Residency Program at the University Health Network, and at both the Toronto Institute for Contemporary Psychoanalysis and the Institute for the Advancement of Self Psychology where I am on Faculty and a Supervising Analyst.