How Sam Works

Sam works extensively with trauma, including PTSD and complex or developmental trauma. Trauma often shows up in ways we don’t immediately associate with our traumatic experiences — in how we see ourselves, other people, and the world. Life often seems to get smaller after trauma, because we feel worse about things and avoid situations that will bring up painful feelings.

One of the evidence-based treatments Sam offers is Cognitive Processing Therapy (CPT), a structured, well-researched approach to PTSD developed within the U.S. Department of Veterans Affairs. Here is a firsthand account of one person’s experience of an intensive course of Cognitive Processing Therapy.

For many people there are deep and painful patterns in the way they relate to others and themselves that go back to the very beginning. Strategies that protected us when we were young — keeping quiet, keeping others at arm’s length, behaving a certain way to be approved of — cause nothing but problems as an adult. It’s easy to start believing “this is just who I am,” especially if others see you that way too. Sam can help you understand where those patterns come from and develop healthier ways to meet your needs and build more stable relationships.

Anxiety and depression can represent all kinds of unresolved issues from the past or current challenges. Sam will work with you to develop an approach that works for you, focusing on anything from practical skills and strategies to manage symptoms, to exploring issues from childhood and unconscious conflicts within you.

Sam draws primarily on cognitive-behavioral and psychodynamic approaches to this work. CBT focuses on developing insight into the connections between thoughts, feelings, and behavior in order to experience and react to old situations in new ways. Psychodynamic work looks at the deeper, often older patterns underneath.

Perhaps you view yourself as somehow “less than” those around you. You likely have reasons that you think are good evidence of that — you’ve done things you’re ashamed of, or been told that you should be ashamed. Maybe there are important things about you that you’ve hidden from those around you, or that you don’t really understand about yourself. Whatever the case is, when we live shame or insecurity about who we are, it’s like carrying a heavy backpack all the time. It feels normal after a while, but it weighs you down and limits how far you can go. Therapy can be a safe place to unpack what’s in there: harsh judgements about yourself, guilt and shame from past experiences, painful moments from decades ago, and true things about yourself that you haven’t accepted yet.

For many people there is no tidy distinction between symptoms like a depressed mood or excessive anxiety and the personality patterns that shape how we relate to others, ourselves, and the world. You may be certain you have a diagnosable personality disorder, or you may simply recognize patterns in your relationships, or in how you treat yourself, that get in the way of living the life you want.

Borderline personality disorder is the most common of these, and one of the most misunderstood. The people who live with it are often treated as difficult or dramatic, rather than as normal people in real agony. At its center are intense emotions, a shifting sense of self, fear of abandonment, and relationships that swing between closeness and chaos. These patterns often grow out of trauma or patterns of poor treatment in childhood. Sam offers both a psychodynamic approach to help you understand where unhealthy patterns came from, and structured trauma treatments to resolve PTSD symptoms and help you get “unstuck” from an overly negative view of yourself and others.

The transition from childhood to adulthood is an exceptionally complicated and stressful time for both kids and parents. Sam works with adolescents ages 14–18, and has worked with adolescents and families more extensively than any other population. He can work with adolescents and young adults on all of the issues listed here, as well as thoughtfully managing confidentiality, family communication, and helping families navigate the challenges associated with parenting a teenager as they move towards independence.

Most people had a plan, whether or not they knew it. When fertility problems come up, they’re not just medically exhausting — they’re lonely in a way that’s hard for people who haven’t been through it to understand. Sam offers supportive counseling for people navigating the long and uncertain paths of fertility, infertility, and assisted reproduction, as well as ASRM-compliant psychological evaluations for those pursuing third-party reproduction.