People enter therapy for many reasons, but most of my patients come with the primary objective of symptom relief – they want to feel better. Symptoms include: sadness, hopelessness, anxiety, interpersonal difficulties (professional or romantic), anger, intrusive thoughts, low self-esteem, emptiness, grief, and so on. Symptoms can be recent or long term, debilitating or just unbearable.
Many patients come because of relationship difficulties. Maybe they are searching for a relationship and finding it difficult to date, or to make a relationship stick. Maybe they are in a relationship that just isn't working. Or maybe they are ambivalent about partnering and are grappling with the expectations that they do so. Some patients with relationship issues come alone, others come with their partner (see my work with couples below).
Some of my patients are also seeking to develop a sense of their own agency. They are tired of being controlled by their symptoms, external validators, such as monetary or professional success, or other people, situations, or prior experiences over which they feel powerless. They want to gain a solid sense of self that comes from within -- a self confidence that allows them to steer the course of their lives in ways that are satisfying and of their own making.
Related to a desire for a greater sense of personal control is a wish for a solid personal identity. These patients would like a better understanding of what they believe and feel and of their strengths and challenges. They do not like feeling shut down, even by themselves, as though they are just going through the motions of life; they want to feel more alive and connected.
Some of my patients are self proclaimed outsiders, be it professionally, socially or within society as a whole. Some take pride in their outsider status but feel it comes with unintended and unsettling consequences, others feel lonely and alienated and long to fit in.
Some patients are struggling with workplace difficulties. They are looking for work, feel they are in the wrong job or profession or are struggling with workplace dynamics and need support and counseling to understand and respond to their situation.
Some are trying to maintain sobriety and deal with the issues underlying their addiction.
Finally, some patients are unclear about their pain. They can't quite put their finger on what is wrong or how to change it, but they have a sense that things can't stay the way they are. These patients often look to me to help them get started; to uncover and unravel what is bothering them.
I work with numerous couples. Some are disillusioned about love or partnership and are considering separation, others are deciding whether to marry or have children. Some couples are struggling raising children, or are also in professional relationships together that have become problematic. Some want to reduce fighting, process betrayal, hurt or anger, and to improve communication and trust. Others want help deepening their sense of connection and intimacy with their partner.