Field Notes

How I see therapy.

Therapy, as I practice it, is a meeting of two kinds of expertise. You're the expert on your life — no one knows its history, its textures, or its stakes the way you do. And I'm here with mine: how nervous systems change, how patterns loosen, how healing tends to move.

Decades of research say it's neither of those alone that predicts how therapy goes — it's the relationship between them. The therapeutic alliance is one of the most reliable predictors of outcome in all of psychotherapy research. This is a collaboration, and I take my half seriously.

Reference: Flückiger et al., meta-analysis of 295 studies on alliance and outcome →

Here's what that collaboration looks like — the things we'll work on together, about 90% of it. The rest is the part I can't put on a website: sitting with you, at the pace your nervous system sets, while you discover what these look like in your life.


Obs. I — Attention

Let's explore the difference between active and receptive mindfulness. One trains your ability to intentionally choose where attention goes (focused attention). The other trains your ability to observe thoughts, emotions, and sensations without getting pulled into them (open monitoring). Both are skills we can build together — one helps you choose your focus; the other helps you let things go.

Reference: Frontiers in Psychology, 2014 →

Obs. II — The Body's Language

Let's learn your body's language. Your nervous system is constantly communicating with your brain, and we'll practice recognizing your particular cues — breathing, muscle tension, heart rate, gut sensations, posture — so you can catch the signal earlier and respond instead of react.

Reference: Nature Reviews Neuroscience, 2016 →

Obs. III — The Window

Together, we'll map your window of tolerance — finding the edges where you begin to dysregulate, then building tools that work for your nervous system. Scales, maps, body cues, movement, rituals — whatever helps you stay connected to yourself.

Reference: NICABM on the window of tolerance →

Obs. IV — What You Got — and Didn't

We'll trace what you got — and didn't get — while you were developing. Early relationships and environments shape how we see ourselves, connect with others, and respond to stress. Awareness creates options.

Reference: Harvard Center on the Developing Child →

Obs. V — Your Neurotype

Let's get to know your neurotype. Sometimes what people spend years trying to "fix" is actually how their brain is wired — and understanding that, whether it's ADHD, autism, or something else, can change how you approach work, relationships, sensory needs, emotional regulation, and self-compassion. Our work isn't about making you more "normal." It's about building a life that works for your brain.

Reference: American Psychological Association on neurodiversity →

Obs. VI — The Story-Telling Brain

Let's talk about your Default Mode Network. It's involved in self-referential thinking — the story your brain tells about who you are. Sometimes those stories become rigid. Emerging research suggests psychedelic-assisted therapy may temporarily increase psychological flexibility by altering activity in these networks when paired with skilled psychotherapy. It's promising science, but it's still evolving and isn't appropriate for everyone.

Reference: PNAS, 2012 →

Reference: PubMed, 2022 →

Obs. VII — Acceptance & Compassion

Together, we'll discover what acceptance and compassion mean to you. They aren't the same as approval, giving up, or weakness. If either word brings up resistance, that's often worth exploring — and we will, gently.

Reference: The research on self-compassion →

Obs. VIII — Two Nervous Systems

Everything above applies double in a relationship. A couple is two nervous systems learning to co-regulate — and most recurring fights aren't really about the dishes; they're two dysregulated bodies trying to feel safe at the same time. We'll practice noticing when you or your partner has left the window of tolerance — it changes what's possible mid-argument. In mixed-neurotype relationships, the same message is often sent in one language and received in another, so our work is translation, not fixing. And repair matters more than never rupturing: what happens after the fight tells you more about a relationship than the fight itself.

Reference: The Gottman Institute's research →

Obs. IX — Creativity

Let's find what creating looks like for you — it's one of the best antidotes to anxiety I know, and it doesn't have to be painting. It might be cooking, dancing, gardening, music, woodworking, coding, writing, or making terrible memes. Creating interrupts rumination and invites engagement.

Obs. X — Humor

And let's laugh — humor belongs in therapy. Sometimes healing looks like crying. Sometimes it looks like laughing so hard you snort. Fart jokes are always welcome.


Curious what this looks like in practice?

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