Issues I Work With

These aren't diagnoses. They're the actual problems people arrive with. The specific pattern. The specific stuckness. The exact words people use when they first reach out. You will likely find yours below. Perfectionism. Impostor syndrome. Self-sabotage. People-pleasing. Overthinking. High-functioning depression. Each page describes one pattern the way clients actually live it. It traces the pattern back to what holds it in place. And it explains what the work looks like.

Most people don't fit neatly into a single box. The anxious overachiever is usually also the perfectionist. The impostor. The people-pleaser. The person who can't rest. These aren't separate conditions. They're surfaces of the same underlying structure. That structure is what the therapy actually works on. If you're not sure which page fits, pick the description that feels most accurate right now. The rest will come up.

The page has two halves. Individual issues (things happening inside you) and Relationship issues (things happening between you and someone else). Most people have both. Individual therapy and couples therapy are distinct formats. But the same kinds of patterns show up across them. If you're deciding which makes sense, the FAQ covers the common cases, and Start Here walks through what the work is actually like before you commit to anything.

How I think about what brings you here

Most of what is on this page did not start as a problem. It started as a solution. The perfectionism organized a chaotic household. The people-pleasing kept a volatile parent calm. The vigilance saw trouble coming before it arrived. The numbness got you through something that would have been unbearable felt at full strength. These were intelligent adaptations, built early and built well, and they worked. The trouble is that they are still running long after the situation they were built for has ended, and now they are producing the anxiety, the flatness, the stuck relationships, the sense of living at one remove from your own life.

That is why the work here does not treat each item below as a separate condition with its own separate technique. Scratch the surface of the overthinking and you usually find the same structure that drives the perfectionism and the difficulty resting. The recurring fights in a marriage usually run on the same engine as the recurring dead ends at work. What therapy works on is that underlying structure: the way you learned to manage feeling, closeness, and threat, and the way that management style now runs your life automatically. You can read about how that happens in practice on the approach page, and what is psychodynamic therapy explains the thinking behind it.

Each page below takes one pattern and describes it from the inside: what it feels like, what it is protecting, what keeps it in place, and what actually changes it. Some of these run deep enough that reading will only take you so far. If a page describes you closely enough that reading it is uncomfortable, that is usually the sign it is worth a conversation.