447 Broadway 2nd Floor New York, NY 10013 | 26 Court Street, Brooklyn New York, NY 11242

Treatment Approach

Cognitive-Behavioral Therapy

How many times have we been told, “you’re overthinking,” or, “you’re just imagining things”? These statements are common gaslighting tactics, and they cause us not to believe what we see, hear, think, or feel. The reason we may be compelled to believe these often harmful statements is that sometimes we do overthink, and sometimes we do imagine, and that is okay. Checking whether our thoughts are valid or not can be helpful when they cause us negative symptoms, such as depression, anxiety, hypervigilance, panic, dread, fear, and other feelings that may become debilitating. Sometimes it is hard to know whether our thoughts are rational or not. Especially for those of us who are used to being invalidated. Cognitive behavioral therapy (CBT), originally developed by the late Dr. Aaron Beck, helps us to assess our thoughts in talk therapy so we can determine just how helpful they are. CBT is built on the premise that believing our thoughts affect our feelings, which, in turn, affect our behaviors or actions. By this logic, if we can learn to not believe our thoughts, we inevitably change the way we feel and act, and the cycle of thoughts, feelings, and behaviors can continue in a more positive direction.

It can be difficult to evaluate one’s own thoughts. Whether you live a busy life, and don’t have much time to think about your thoughts, or you tend to have rushing thoughts, and sitting down to untangle them feels far too overwhelming, you don’t have to do it alone. That is what therapists are here for! CBT was originally designed as a tool to be used in therapy, so while it can be used alone, and there are terrific homework exercises to train your mind, it is best used in session, at first. With time, you will learn to be your own CBT coach. To make sure you are getting the full benefits of CBT sessions, it is important to seek a therapist who was trained to use CBT tools. There are many tools and workbooks to be used in CBT, and a trained practitioner can help choose the ones most suited to your unique symptoms and ways of thinking. At our NYC practice, The Compassion Practice therapists have been trained to use CBT resources and tools to help treat you, while utilizing other therapies to enhance the treatment. We incorporate compassion and mindfulness-focused therapies and understand the strength it takes to do the work. Without compassion and learning to mindfully see your experience from a nonjudgmental lens, CBT may feel like those harmful statements mentioned before, such as “you’re imagining things.”

We understand that you may have concerns about beginning CBT, because of all the active work that is required in retraining the ways we think. That is why we use a gentle approach. You will see that with time, the exercises used in session become second nature out of session. If your therapist provides you with a homework exercise, it won’t be homework forever. Our minds can easily be trained to think differently, with the right treatment and therapist. Not sure if CBT is a treatment you would like? Schedule a free consultation with one of our NYC therapists, and you will have the opportunity to discuss CBT and other talk therapies available. There is hope to see a more positively-painted future.

Acceptance and Commitment Therapy

Third-wave CBT therapies have been becoming increasingly more popular in psychology, social work, and counseling in recent years, and for good reason. These evidence-based approaches combine most effective tools from some older modalities that have been proven to be successful over many years, within many communities. One such modality is called Acceptance and Commitment Therapy, otherwise known as ACT. Little-known fun fact: ACT is pronounced “act” and rhymes with fact. While CBT has been proven effective, little emphasis on attributing meaning to life is given. As well, there is a heavy emphasis on metacognitions, or thinking about thinking. For some people, letting go of intrusive thoughts is a more helpful approach. They know them not to be true, so invalidating them through CBT may not be useful. That’s not to say that CBT cannot be effective; ACT is just another perspective on the treatment of thoughts, emotions, and behaviors.

In a nutshell, ACT is not just about combatting ruminations, depression, anxiety, and OCD. It is so much more than that. It is about discovering happiness through the eradication of negativity. One such way is through mindfulness. Being mindful of ourselves as we relate to our surroundings can help lessen the impact that our thoughts have on our overall moods and feelings. Our thoughts can only be as influential as the attention we pay to them. Another way to discover joy is through finding meaning in our lives and the actions that we do. When we work toward a goal, every step of the way can feel like an accomplishment; we are that much closer to our goals by taking even small steps. Those steps hold as much meaning as the goal means to us. ACT helps us discover what matters to us and how to construct those goals to satisfy the meaning we wish to incorporate in our lives.

ACT is composed of six steps, and they do not have to be completed in a linear fashion. In fact, your ACT therapist may encourage you to use any of the six skills as applicable situations arise. The foundation of ACT, psychological flexibility, is required to properly incorporate the six steps into our lives. Psychological flexibility is the ability to be open, present, and willing to do what is necessary. The six steps built on that foundation are: 

    1. Acceptance- the ability to allow ourselves to experience our realities, thoughts, and feelings without avoidance or denial.
    2. Cognitive defusion- the act of interacting with our thoughts without trying to change them. This can look like making light of them, watching them at a distance, etc.
  • Being present- simply put, this is nonjudgmental mindfulness.
  • Self-as-context- the recognition that I am observing my thoughts.
  • Values- discovering the qualities that lead you to action most purposefully
  • Committed action- setting up attainable goals in the context of values, mindfulness, and a true sense of self

If you think ACT is a modality you may find helpful, The Compassion Practice in NYC has ACT-trained practitioners who are ready to provide you with a free phone consultation. Learn more about our compassionate therapists by booking your consultation today!

Couples Therapy

Couples therapy differs from individual-focused therapies due to its multiple foci. While individual therapy sessions are centered around discovering individual clients’ strengths, concerns, moods, thoughts, emotions, and behaviors, couples therapy focuses on these factors as they present in each of the individuals that make up the couple, as well as the interconnection of the two. The way two individuals’ strengths, problems, experiences, and tendencies combine is unique and complex. Therapists tend to gravitate toward specific modalities; however, we also make sure to incorporate practices and tools that can be useful specifically to each individual that we treat. When it comes to work with couples, it is important for us to take both individuals’ needs and experiences into account and recognize what will be helpful in addressing the dynamic between the two individuals.

Sometimes couples have expectations of each other due to their personal upbringing, childhood culture, life experience, or personalities and personal preferences. It can often be hard to articulate our desires before we recognize that they are not being met, and once we feel they are neglected, it can be hard to approach the issue without blaming, shaming, or becoming overly defensive. Misunderstanding is often at the root of relationship troubles. Romantic relationship struggles are also complicated, because we often rely on our partners to play many roles. If we have children with them, they are our parenting partners. If we share finances, they are our earnings and spending partners. The list goes on. Partners also fill roles such as friends, coworkers, love partners, caretakers, advisors, etc. Our partners have the ability to fulfill so many of our attachment needs, which makes us all the more vulnerable to relationship hardships. Sometimes solutions to couples dilemmas come easily to us; often, because we are biased, and compromise may be necessary, they do not. At times it can be hard to recognize where contention stems from or why we feel as if we are falling out of love or less interested.

That is where therapy comes into the picture. Therapists play the role of mediator and an objective set of eyes, not siding with either party, yet focusing on understanding the feelings and needs of each. Your couples therapist may focus on the psychodynamics between the two partners, which can include patterns of behavior, common reactions to “triggers,” the underlying relational patterns and expectations, and other dynamic factors that exist between those in the room. Clients can feel safe expressing their desires and disappointments with a therapist who is trained to help their partner to understand them better. As well, clients may find that the compassion and understanding modeled by their therapist can help them keep more of an open mind when listening to their partners. Compassion focused therapy (CFT), acceptance and commitment therapy (ACT), and emotionally focused therapy (EFT) are often used in developing self-understanding, understanding of others, and radical acceptance of dynamics and situations. At The Compassion Practice in NYC, our New York State licensed therapists are trained in these, and more, therapeutic modalities to best treat you and your partner’s relationship. Our goal is to treat the relationship in a way that allows both partners to experience the safest, most peaceful resolution.

Psychedelic Safety and Integration Therapy

Psychedelics, often referred to as hallucinogens, are substances often used recreationally or therapeutically for the purpose of spiritual healing or connecting to one’s deeper sense of consciousness. Examples of psychedelics you may have heard of are ayahuasca, ketamine, or psilocybin. These drugs are known for altering people’s moods, cognitions, and perception of themselves and the world around them. The use of psychedelics, such as is the case with any mind-altering substance, is advised to be carefully planned, monitored, and processed so you gain the optimal benefits of your experience. When done right, people describe their experiences with these hallucinogens as life-altering, in a good way.

So where does safety and integration therapy come into the picture? While hallucinogenic experiences can have many benefits, it is important to be aware that the overall experience can be quite intense. People describe experiencing disorganization of thoughts, panic, euphoria, a lack of coordination, hallucinations (hence the name), and a steep change in body temperature. While some of these effects may sound loose or interesting, a bad trip is far from fun. Therefore, it is important that engagement in psychedelics is done safely and with the proper guidance and care.

Therapists working with those who plan to use psychedelics use a harm-reduction approach to ensure that their clients exercise caution when using mind-altering substances. It is important to clients to approach the drug with set intentions, and it is important that those intentions will prove to be beneficial and therapeutic. As well, once the person has had their psychedelic experience, the insights and useful awareness that occurred may need further processing in session, and sometimes integration of those realizations in daily life can be facilitated through therapy.

While we do not provide psychedelic drug administering practices at our NYC psychotherapy practice, the Compassion Practice therapists can help you with psychedelic safety, prior to your experience, and integration therapy when you have already experienced psychedelics. For more information, and to schedule a free consultation, reach out to us via our contact form!

Harm Reduction

The use of substances that are mind-altering (also known as psychoactive) has been around since the dawn of humanity. Humans are by nature exploratory and curious, interacting with their environment using the five senses and experimenting with different ways to consume a substance. In the modern era of medication arbitrary lines have been drawn between psychoactive “medication” (e.g. Xanax, Adderall, Ambien) and those that are “illicit” (e.g., cannabis, cocaine, psilocybin). Despite these arbitrary divisions the reality is that both types of substances can be misused. What do we do then?

The original approaches to substance misuse involved abstinence-only views. “Addiction” was seen as a brain disease inherent within the client that required intensive treatment ranging from support groups to outpatient treatment to inpatient and residential programs. To relapse meant that the client “failed” regarding treatment goals. After this failure the client was either forced out of the facility or had limited privileges, ousted from outpatient programs, and forced to start from Day 1 again in Anonymous groups.

What would it be like if we took a different approach to substance use, acknowledging that using substances is an incredibly common part of human nature? Imagine substance use treatment that rather than imposed an abstinence-only approach meets the client where they are at? “Harm reduction” embodies these viewpoints by arguing that substance use is not inherently pathological. Instead, substance use is on a spectrum from casual user to recreational use, to disorderly usage.

This is not to say that some people will require abstinence. What harm reduction does is expand the range of treatment options available to the client. Harm reduction treatment ranges from complete abstinence to moderation to risk reduction despite change in use. The goal is not necessarily for the substance user to stop using. Instead, the goal is for the client to use (or not use) substances in a way that reduces physical, mental, and social harm. The spirit of harm reduction is rooted in saving the person and not eliminating the drug. For more information, please give us a call.

Disclaimer: If you suspect that someone around you has overdosed immediately call 911 or go to your nearest emergency room if there is someone sober nearby. Note that you are largely protected by the 911 Good Samaritan Law when calling 911 should you have used as well. For more information on the 911 Good Samaritan law go to the following link here. For more information on opioid overdose prevention and intervention inquire with your therapist for referrals on other harm reduction methods including Narcan (naloxone) and Fentanyl Strips to test for with other drugs such as cocaine.