Psychopharmacology 

 

I have a strong background in psychopharmacology services, research and teaching. I trained at Columbia University where antidepressants were first systematically studied. I continue to participate in an online community of colleagues from Columbia. In addition I was on the faculty at UCSF/Langley Porter where I created the psychopharmacology teaching services and have supervised hundreds of cases in that clinic over many years. My approach to medication treatments in psychiatry is to be as parsimonious as possible to use medications as sparingly as possible, ie. at the lowest effective dose.

 

People are constantly bombarded by pharmaceutical advertising and this has lead to a culture of misinformation as well as exaggerated expectations. I do not receive any financial support from any pharmaceutical firm, nor do I participate in any pharmaceutical industry sponsored activities. Consultation with a skilled psychopharmacologist offers patients choices about what medications are safe and clinically indicated.

 

I offer pharmacogenomic testing in my practice in collaboration with genomind.com. My training and experience helps me to understand how to use medications and to thoughtfully monitor whether they are beneficial or not.

 

Psychotherapy

 

I have years of experience as a psychotherapist. It is the most gratifying part of my work. I am honored to participate with patients as they work hard to grow and change. My feeling about successful therapies is that the key elements are empathy, trust and compassion. Theoretical perspectives and biases are much less important in comparison. When people feel safe and can have an honest and open ongoing conversation about their concerns, hopes and fears then change will follow. Psychotherapy is fundamentally an educational experience in which people grow and change. Beliefs and ideas that evolve in therapy are lasting. In this respect therapy is a far superior treatment than medications for many problems and conditions. Medications are only active when they are in your body, whereas psychotherapy can have lasting effects.

 

Alternative

 

My training is in western allopathic medicine. I have become increasingly aware of the faith that many people place in naturopathic, homeopathic and non-western healing traditions. I am in no way qualified to evaluate or comment on those methodologies. In the final analysis every individual who wants to make changes in their lives has to find the appropriate set of beliefs and activities that is non harming and works for them. In my work I try to take other treatment choices into account when planning and conducting any type of therapy. I also recommend that patients attend to their diets in order to improve their overall health, blood pressure and glucose control

 

Exercise

 

My own personal experience has shown what the clinical literature has long suggested: Regular exercise is the basis for stable mental and physical function. I support any form of exercise that people enjoy and tolerate so that they can dependably maintain a regimen. The discipline and commitment to an exercise program is a key part of the foundation for improvements in mental health. I personally believe that exercising outdoors away from televisions and music and in the weather is the most beneficial and invigorating type of work. We are fortunate to live in one of the most treasured and beautiful places on earth and are energized and renewed every time we go out into nature as hikers, runners, bikers, dog walkers. Simply being exposed to sunlight has antidepressant action. Improving muscle tone and core strength through exercise such as yoga is essential to well-being for people of all ages. Patients with anxiety disorders benefit enormously from the discipline and self awareness that comes with regular yoga practice.