How do you see addiction? What is it doing for the person?
My work draws on experience with the 12 Steps and Edward Khantzian’s self-medication theory. In my approach, alcohol or drug use can be a way of managing painful feelings. Therapy explores those feelings and the role substances have played in coping with them.
What is your background in addiction treatment?
I am Clinical Director of Stairway Resource Center, an intensive outpatient addiction program. As adjunct faculty at Pacifica Graduate Institute, I teach addiction, clinical practice, and short-term dynamic psychotherapy.
What is the self-medication idea, in plain words?
Alcohol and drugs can work like a medicine for a feeling you can’t stand. Edward Khantzian’s idea is that people don’t pick a substance at random: it does a job for them. It might quiet anxiety, soften anger, or numb something that hurts.
So I don’t start with "why can’t you stop?" I start with "what does it do for you?" Once we can see the feeling underneath, the substance has less to do. I can’t guarantee how that goes for any one person, but it’s the question that makes the work make sense.
How does running an addiction program shape the way you work in private practice?
As Clinical Director of Stairway Resource Center, an intensive outpatient addiction program, I see every day how much people can carry and how little they say about it. That makes me direct and not easily shocked. Nothing you tell me will be a surprise.
It also means I know where my own limits are. I know what a higher level of care looks like, and I know when someone needs it. Private practice is individual therapy, one hour a week. The program is a different kind of structure, and I’m honest about which one a person needs.
Do I have to be sober, or in a 12-step program, to start therapy with you?
You don’t need full sobriety to start, and you don’t need to be in a 12-step program. But you can’t be intoxicated in a session. The work depends on you being present with your feelings, and that doesn’t happen if you’re under the influence.
If you’re physically dependent, so that stopping suddenly could be dangerous, you need detox or a higher level of care first, with medical support. Then therapy can follow. Some people go to 12-step meetings alongside therapy, and I’m comfortable with that. It’s your choice.
What if I’m not sure I’m ready?
A big thing for me is about honesty and integrity. I’m not going to waste your money. If you don’t want to work hard, don’t give me your money, because I don’t want it, because this will lead to nothing. If you’re not here for you, don’t waste your money. Wait until you’re really here for you.
What would you want someone who is ashamed of this to know before they write to you?
That you won’t be judged. Shame is usually part of the problem, and I’ve heard it all. Writing to me is a 20-minute free Zoom call: you tell me what’s going on, and I tell you honestly whether I can help.
You don’t need to have it figured out. You don’t need a speech. If you’re ashamed, that’s a feeling we can work with, and it’s often exactly where the work starts. And if you’re in crisis, call 911 now. Don’t wait for an appointment.
Do you work with behaviors like gambling or compulsive sex, not only alcohol and drugs?
Yes, I work with compulsive behaviors as well as substances. Gambling, compulsive sex, overeating, endless scrolling: the pattern is the same. A behavior is doing a job, usually managing a feeling you’d rather not have.
So the question is the same one: what is it doing for you, and what’s the feeling underneath? Whether it’s a substance or a behavior, the first step is the free 20-minute call, and we see if this is a fit.
Is this a replacement for detox or rehab?
No. If you’re physically dependent on alcohol or drugs, you need detox or a higher level of care first, with medical support. Stopping suddenly can be dangerous, and I won’t pretend therapy can handle that.
What I offer is individual psychotherapy: one hour a week, up to 26 sessions. It can follow detox or rehab, or run alongside other support such as meetings. I’ll tell you honestly in the first call if what you need is something other than what I do. I’m not going to waste your money.
What does progress look like in the first months?
Usually it starts small. You notice a feeling before you reach for the drink, the drug, or the habit. You notice it a few seconds earlier, then a few minutes. That gap matters.
Over weeks, there’s less pressure to escape, and more honesty about what’s going on. I can’t guarantee how fast, and everyone is different. We have up to 26 weekly sessions, roughly six months, and early on we’ll both have a clear sense of whether we’re moving. If we’re not, I’ll say so.