No. Asking for help when you need it takes more courage than white-knuckling it alone — most of my clients are people who handled things on their own for years, until “handling it” stopped working. You’ll do the work; I’m not here to fix you or carry you. But you don’t have to figure out the process by yourself. You do the reps. I’ll spot you.

Here’s my take, and I’ll own it as mine: no. The idea that depression or anxiety comes from a chemical imbalance in the brain was repeated for decades until it felt like settled science, but the research doesn’t back it up — a major 2022 umbrella review found no consistent evidence that depression is caused by low serotonin. That story stuck around partly because it was convenient: simple to explain, and it sold a lot of medication.

That doesn’t mean your suffering isn’t real, and it doesn’t mean medication never helps — see my answer on medication below. It means the explanation you may have been given for your suffering deserves a harder look. I find it more accurate, and more hopeful, to understand struggles like these as responses to your history, your relationships, and your patterns — things you can actually work on.

Two honest answers. First, you’re paying for training, experience, and full attention on your situation — this is skilled work, and I’ve spent years getting good at it.

Second, I believe in skin in the game. When you invest real money in your own change, you show up differently: you do the homework, you stay in the uncomfortable conversations, you don’t drift. That commitment is half the outcome. The fee isn’t just the price of my time — it’s part of what makes the work work.

A good friend listens. I’m trained to do something with what I hear — teach you skills, show you the patterns you can’t see from inside them, and tell you the truth without needing anything from you in return. That last part matters more than people think: your friends and family are inside your system. They have a stake in you staying the way you are, even when they love you. I don’t.

Also: therapy is confidential. Nobody knows your business. And you’ll never have to avoid me at Thanksgiving because I’ve seen you at your worst.

Medication can help, and sometimes it belongs alongside therapy — that’s a conversation for you and your prescriber, and I’ll never tell you to stop taking something.

But medication doesn’t teach you anything. It can turn the volume down; it can’t show you why the noise is there or what to do differently. My work is about the patterns underneath — your thinking, your relationships, your family system — so that you’re not dependent on volume control forever. And worth knowing: the popular idea that antidepressants work by fixing a serotonin shortage isn’t supported by the research. They do something; “correcting an imbalance” isn’t a proven account of what.

The specifics depend on you — your situation, your goals, your pace. But I don’t wing it. I follow a specific methodology, organized around The Six Pillars of Making a Life That Works. Do you have a process for change? I do, and I can teach it to you. See The Process.

Yes — through coaching. My therapy licenses cover California and Wyoming, but my Bowen Family Systems Coaching is available anywhere in the world. In short: I help you get your family system’s dysfunction out of you, so you can live your life instead of your assigned role. If that’s your situation, coaching is the door.

You don’t need to prepare much. Bring what’s actually going on — not the polished version. A little curiosity and a little willingness go further than a rehearsed speech. It’s not a test; it’s a conversation.

I can’t answer that honestly on an FAQ page, and I’d be careful with any therapist who does. It depends on what you’re working on, how much of it there is, and how much you’re willing to do between sessions. What I can tell you: we’ll set clear goals, you’ll know what we’re working toward, and you’ll be able to see whether it’s working.

It can be, if it’s important to you. My own faith matters to me, and I understand why yours might matter to you — and I also work with plenty of clients for whom spirituality isn’t part of the picture, and that’s fine too. Your beliefs are yours. If integrating them into the work would help, we will. If not, we won’t. I’m not here to convert anyone in either direction.

Yes. The research consistently finds online therapy comparable to in-person for most concerns — what drives outcomes is the quality of the work and the fit between us, not the room. All of my sessions are online, which also means privacy (no shared waiting room), consistency (no canceled sessions for weather or road time), and access to the right therapist rather than the nearest one.

Politics may come up — it’s part of life, and life is what we talk about. But I hold a neutral, non-judgmental stance, and I don’t promote any political agenda in session. My job is your mental health, not your vote. For a fuller explanation, see my page on Politics in Therapy.

Four things. Tell me the truth, especially when it’s uncomfortable — I can only work with what you bring. Know what you want; we’ll set clear goals and aim at them. Do the work between sessions — one hour a week doesn’t change a life, but what you practice the other 167 hours does. And be patient with the process: change is hard, but it’s straightforward.

Sessions are online, so your cat was always going to be there anyway. Fine by me.