My communication with my daughter, who was a teenager then, was not going well. I was leaning on coping strategies that had served me at some point and were no longer serving me at all. And I was struggling with my own self-esteem in ways I would have been reluctant to say out loud to a colleague.
None of that is unusual. What made it awkward is that I am a psychiatric provider, and I knew perfectly well what I would have suggested to a patient describing the same thing.
The study that reorganized my thinking
Around that time I came across research comparing an SSRI with psilocybin in depression. I want to be honest about my first reaction, which was skepticism.
I come from a culture where psychedelics were understood as dangerous drugs and the subject was more or less taboo. That was not a considered position I had arrived at. It was simply the water I grew up in, and I had never examined it.
So I went and read, expecting to find something thin. Instead I found decades of institutional research conducted carefully by serious people. That was uncomfortable in a useful way. It is a particular experience to discover that a belief you held firmly was inherited rather than reasoned.
What integrative actually means to me
It is not a rejection of what I was trained in. I still prescribe, and I still think medication is genuinely valuable.
What it means is that I try to look at the whole person rather than the symptom list. In my experience depression and anxiety are often not isolated disorders so much as signals from a nervous system indicating that something underneath wants attention. Sometimes the useful response to that signal is medication. Sometimes it is breath work, or mindfulness, or a change to how someone sleeps or moves or spends a Tuesday. Often it is several of those at once.
Medication is one tool. It is a good one and I reach for it regularly. What I try to avoid is treating it as the only question worth asking, because when it is the only question, the answer to every stall is a higher dose or a different molecule, and eventually someone concludes that they are the problem.
Many of the people I work with have been through that sequence. They come having tried medications, often several, sometimes therapy as well, and the pattern is still there.
The part I believe most
The inner healer is already inside a person. My job is largely to remind them of that and then walk alongside them, rather than to heal them myself.
That sounds softer than it is in practice. It means one of my early agreements with a patient is that we do not bring judgment into our interactions, mine or theirs. It means I disclose more about myself than some of my colleagues would, because I have found that if I am willing to be vulnerable, it becomes easier for the person across from me to be vulnerable back.
And it means I do the things I recommend. Yoga most days. Meditation. Walking my dog somewhere green instead of driving. Once in a while I dance in my bathroom, and that counts as journaling as far as I am concerned. I would not ask someone to build a practice I had not tested on myself.
If you are hesitant
Being hesitant about therapy is completely normal, and I think most of us go through it.
Starting is often the hardest part. It is a little like starting to exercise: the decision and getting yourself through the door are usually harder than the thing itself. If that is where you are, that is a perfectly ordinary place to be, and it does not have to be resolved before you make a first appointment.
I see adults across Oregon by telehealth. If you would like to talk about whether this is a fit, there is a short consultation and no obligation attached to it.
