Psych Garden is …

A place we’d send our own family. A caring community that reaches for excellence, and works hard for transformation.

Focused on healing the core issues, not superficial tweaks. Lasting change needs deep therapies that rewire emotions and memories. Only then can people feel hope, expect success and experience connection and meaning.

True to your valued goals. Our agenda is your happiness and safety. We don’t tell you what you should do or judge you for your choices, whether those are about your relationships, medications, or drug use.

For complex people that deserve better. We welcome people others find too challenging, think it through and use whatever modalities are necessary to succeed.

An integrated team of doctors, nurses, psychotherapists, and life-wellness coaches selected for education, experience and character. We put our heads together daily to make sure we are doing our utmost for you.

Expert in the science. We use CBT, DBT, AEDP, EFT, CRA-FT, psychopharmacology including medication-assisted therapies for detox, maintenance and cravings.

With you over the long-term. Whatever is holding you back – depression, anxiety, trauma, addictive behaviors, relationship issues – we’ll figure it out with you, patiently, collaboratively, unfailingly.

We offer the best treatment for psychotherapy, general and addictions psychiatry in the Boston area and north west suburbs.

Our team are or have been Harvard Faculty and are highly sought after supervisors and teachers.

We use evidence based practices including emotions focused therapies.

We are experts in moderation management and harm reduction.

We offer a boutique and concierge type practice where your particular needs are carefully evaluated, met and monitored, where you get a rapid response from an elite team and where you will feel truly cared about.

What is Good Therapy?

Good therapy = a strong therapeutic alliance + specific targeted skills.

Too often therapy can feel like venting to someone who is understanding. That’s all well and good, but people don’t need to pay for that. They can get that from anyone.

We believe that it is essential to focus on valued goals, decrease avoidance behaviors, increase sense of control and attain secure attachments.

At Psych Garden we are trained to maximize the therapeutic alliance and provide specific evidence-based therapies expertly. We measure outcomes so we know if we’re on the right track.

Our approaches are less specific to disorders and address issues common to many diagnoses. This is a trend evident in many centers of excellence (see for example the work of P Fonagy, A Caspi, D Barlow, A Abbass and D Fosha).

Experiential and Emotion-Focused Approaches:

A key approach we follow is emotion focused, or experiential dynamic therapies, primarily AEDP and IFS. Emotions are core organizers of the self, the fundamental mechanism evolved to sense, understand and react to our worlds – both outside and inside our bodies. They are the drivers of thought and behavior.

If we learned in childhood that certain situations are dangerous, overwhelming or hopeless then, as adults, we learn ways to manage those unbearable feelings – by avoidance, denial, anxiety or addictions. But as adults we have power, options, and understanding that we never had in our youth. With the help of a therapist we can re-do experiences that taught us lessons then that are no longer needed now. We want to help people experience their feelings fully and to be able to use these feelings to guide effective behavior and connection to others, instead of living in fear and avoidance.

In the therapy work we identify defenses, or maladaptive coping strategies, that have got in the way of effective functioning; and titrate anxiety to the optimal level to allow change. Our therapies will invite you into uncomfortable areas because that is where deep change happens. In some ways the work is reactivates anachronistic memory engrams together with the hot emotions, and reworks those memories in a secure setting. This is a corrective emotional experience.

Complex Cases:

We see many patients for second (or fifth!) opinions. What we usually find is that other practices focus on one particular issue and treat the heck out of it, often using escalating medication regimens that only bring more side effects.

Incorrect diagnosis wastes time and money, costs relationships and fulfillment and prolongs the agony. Come to us and we’ll get it right. The answer may not to straightforward, but we will get you beyond on-track.

We realize that there are many interacting influences dragging you down and that smaller changes on many different fronts may be needed simultaneously.

The following is a partial list of issues will commonly find are contributing to your difficulty:

  • Treatment resistant mood disorders which may include bipolar spectrum disorders.
  • Unrecognized attention deficit disorders.
  • Medication interactions and errors.
  • Genotypes that make medications less effective.
  • Medical illnesses including hormonal abnormalities.
  • Sleep disorders including sleep apnea, narcolepsy, circadian rhythm disorders and seasonal disorders.
  • Pain and Addiction
  • Lower level drug and alcohol use disorders that are still negatively impacting your life
    Early trauma and attachment disorders that make certain realms of emotional experience frightening and so drive maladaptive coping strategies

How We View Addiction

  • No one starts using with the idea they may become addicted. It starts either as fun or as a way to cope, a way to manage feelings and different conflictual aspects of ourselves: There were some good reasons why the addictive behavior was so compelling.
  • Addiction changes the way our body perceives and manages stress via the stress hormone circuits. It changes the very way we feel about the dangers in the world and how we decide how to manage. While never the intention, we end up more anxious, more miserable, more reactive.
  • Addiction’s a learned habit, tugging on our thinking, changing our values & taking effort to resist.
  • We can come back from addictions stronger. We need to carve a new identity for ourselves but the resiliency is always there.
  • There is no one right treatment. Instead, treatment follows careful diagnosis and the individualized application of evidence based strategies, kindly.
  • Abstinence is not always necessary. It is possible to learn to use moderately.
  • The goal is not to cease the behavior or use. It is to live safer, more fully, more connected and more mindfully. We follow a Harm Reduction approach, as best described by Andrew Tatarsky.
  • To change, people need to respond to triggers differently and stay away from triggers altogether. But to change deeply, in ways that go way beyond the addiction, that will make their whole life richer and more meaningful, people need to unwrap the emotions and thoughts that lie deep within automatic behavior, to face what has been avoided, to discover the stifled and stunted parts of themselves that need to be heard, need to contribute. We do this with you.

How We View Psychiatry

  • People need goals that they believe in, have innate strengths that guide them, and need help navigating the challenges that impede them.
  • Medications can be great, but are blunt weapons without direction and therapy. Complex problems demand complex solutions.
  • All medications are poisons too: Sometimes less is more.
  • Emotions usurp cognition and people live more freely and fully when therapy helps us to tolerate, accept and use these instead of drowning in them or suppressing them.
  • Profound transformation and recovery does occur.
  • We’ve evolved over a long time but are stretching ourselves to fit a new world, violating honed biological processes and rhythms. We need to pay attention to our selves more carefully.

Neurobiology

We have evolved to survive and move forth in the World, sensing our environment and maintaining integrity, a sense of self, as we do. This process is called autopoiesis, but the less precise term homeostasis is often used. We must feel anything that threatens that balance and respond. That’s relatively simple for unicellular organisms but for us, embedded in complex social worlds, with long life spans and competing immediate and longer-term demands, it requires memory, emotion, planning and interpersonal effectiveness.

Behavior, motivation, will and emotion are brain events and humans function best when they are balanced. The image below conveys some of the systems involved and how therapies address each.