Specialties and Services

Stress- and anxiety-related disorders

Stress and anxiety that occur frequently or seem out of proportion to the stressor may be signs of an anxiety disorder. An estimated 40 million Americans live with some type of anxiety disorder.

People with these disorders may feel anxious and stressed on a daily basis and for prolonged periods of time. These disorders include the following:

• Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by uncontrollable worrying. Sometimes people worry about bad things happening to them or their loved ones, and at other times they may not be able to identify any source of worry.
• Panic disorder is a condition that causes panic attacks, which are moments of extreme fear accompanied by a pounding heart, shortness of breath, and a fear of impending doom.
• Post-traumatic stress disorder (PTSD) is a condition that causes flashbacks or anxiety as the result of a traumatic experience.
• Social phobia is a condition that causes intense feelings of anxiety in situations that involve interacting with others.
• Obsessive-compulsive disorder is a condition that causes repetitive thoughts and the compulsion to complete certain ritual actions.

Sex therapy is a specialized type of psychotherapy — a general term for treating mental health problems by talking with a mental health professional, like myself. Through sex therapy, you can address concerns about sexual function, sexual feelings and intimacy, either in individual therapy or couples or family therapy. Sex therapy can be effective for individuals of any age, gender or sexual orientation.

Sex therapists do not have sexual contact with clients, in the office or anywhere else. 

Sex therapy is typically short term in duration, with a limited number of sessions. However, treatment plans depend on the concerns and goals being addressed.

Sex therapy can help you resolve various sexual issues, from concerns about sexual functioning to difficulties in your sexual relationship. Through sex therapy, you may focus on issues such as:

• Concerns about sexual desire or arousal
• Concerns about sexual interests or sexual orientation
• Impulsive or compulsive sexual behavior
• Erectile functioning concerns
• Ejaculating early (premature ejaculation)
• Difficulty with sexual arousal
• Trouble reaching orgasm (anorgasmia)
• Painful intercourse (dyspareunia)
• Intimacy issues related to a disability or chronic condition
• Concerns regarding past unwanted sexual experiences

Conflict can happen when family members have different views or beliefs that clash. Sometimes conflict can occur when people misunderstand each other and jump to the wrong conclusion. Issues of conflict that are not resolved peacefully can lead to arguments and resentment.

It is normal to disagree with each other from time to time. Occasional conflict is part of family life. However, ongoing conflict can be stressful and damaging to relationships. Some people find it difficult to manage their feelings and become intentionally hurtful, aggressive or even violent.

Communicating in a positive way can help reduce conflict so that family members can reach a peaceful resolution. This usually means that everyone agrees to a compromise or agrees to disagree.

Sometimes, strong emotions or the power imbalances that can be present in relationships are difficult to resolve and can only be addressed in a counselling situation.

Grief is usually associated with the death of a loved one, but there are other areas of life in which loss results in grief that is just as real. One of these is being experienced more and more often due to the current trend of companies to “down-size.” The majority of today’s working population are likely to experience at least one job loss.

For many people today, there are two major phases of job loss. In past years, it was common for firings to be swift and merciless, but more and more companies are now providing a transition period. This is the period of time beginning with advance notification of job termination and ending with the actual job loss.

The “terminated” phase begins with the actual job loss, and unfortunately is still the only phase for many people. Even though the impact of actual unemployment can be lessened by a period of preparation, the grief process is still different for this phase. Many of the emotions do carry over, but the grief is more like that associated with the loss of a loved one. A way of life has ended, along with the security it provided.

Even when a person finds a replacement job before unemployment begins it doesn’t totally eliminate the next phase. A new job still means a new environment, new people, and possible relocation. This often involves a pay cut, reduced benefits, and starting over at the bottom of the seniority ladder.

Beyond the loss of income, losing a job also comes with other major losses, some of which may be even more difficult to face:

• Loss of your professional identity
• Loss of self-esteem and self-confidence
• Loss of your daily routine
• Loss of purposeful activity
• Loss of your work-based social network
• Loss of your sense of security

Fear, depression, and anxiety will make it harder to get back on the job market, so it’s important to actively deal with your feelings and find healthy ways to grieve. Acknowledging your feelings and challenging your negative thoughts will help you deal with the loss and move on.

A counselor can assist with job loss and helping you find the career move that is right for you.

Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

Depression symptoms can vary from mild to severe and can include:

• Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite — weight loss or gain unrelated to dieting
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide

Symptoms must last at least two weeks for a diagnosis of depression.

Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency) can mimic symptoms of depression so it is important to rule out general medical causes.

Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime.

Is it possible to rebuild trust after your partner has been unfaithful? The loss of the relationship you envisioned can cause intense rage, jealousy, and sadness, and also raises many questions. Should you stay? Will things ever be the same? One thing is certain: learning to love again is a slow process.

Although regaining trust offers extreme challenges for both partners, there is reason to be hopeful.

Over time, the unfaithful partner must be willing to put the relationship first and demonstrate trustworthiness through their words and actions.

Recovering from an affair is complex and almost always requires an experienced therapist. Being able to express hurt feelings in a safe environment can facilitate healing.  I employ the Gottman Method with couples and have found it very beneficial in helping couples find a path to reconciliation.