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Dr. L
Dr. L, Psychologist
Category: Mental Health
Satisfied Customers: 1153
Experience:  Psychologist, Marriage and Family Therapist
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For Dr. Levang only: New chat...

Customer Question

For Dr. Levang only: New chat...
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. L replied 1 year ago.

Dr. L :

Hello Tanya!

Customer: Hi. Thanks for meeting me!
Dr. L :

You are welcome!

Customer: So, I'm going to get right to it...
Dr. L :

Yes...great...

Customer: Dr. Altman is not working out. This therapy is painful. Not in a therapeutic kind of way, but in a hurtful, sickening kind of way. There is zero trust. He pushes me me trust him and the more pressure he puts on me to deliver, the more closed up I am. A recent symptom of this was that just this past Wed. he adjusted his sweater over his hip. I was convinced that what I saw was a tape recorder. It looked exactly like one. When I spotted it, I literally froze. I was unable to talk. "
Customer: ...
Customer: he said "it looks like you want to say something", I wanted to run the hell out of there...
Dr. L :

What stopped you from asking him if it was a tape recorder?

Customer: i emailed and said that I though I saw a recorder and asked directly if was recording me, and replied in what seemed like he was annoyed, that he "never records clients".
Dr. L :

Therapists cannot tape sessions without the permission of the client. You would need to sign a form indicating that you gave permission.

Customer: it didnt matter, in my head the damage was done.
Dr. L :

Yes...I understand. It scared you. I'm glad you did ask...that was important.

Dr. L :

But absolutely...the damage was done.

Customer: It is a symptom of complete lack of trust!
Dr. L :

And yes...the more he pressures you the more you are going to resist. That's very normal behavior. It is called psychological reactance...you can read up on that if you want. Basically...when we feel that our freedom is being taken away...we dig in.

Customer: He's kind of an ass to me sometimes...for example...I said "to,be honest..." And he interrupts me and says "a friend once told me that anytime someone starts out with "to be honest", the next thing out of their mouth will be complete bullshit.
Dr. L :

And yes...it is a symptom of lack of trust. But do you think that you would have felt that same way no matter who the therapist was? That is, that this is not about HIM...but about any one?

Customer: Yes. I do. This isn't working out. I need a new avenue. Maybe group is more my thing.
Customer: I don't feel safe and I have a hard time articulating myself. I mean, some things are just hard to explain. And I am opening up on some level and he pressure me for more.
Dr. L :

Well...I don't think group would be helpful...you would be fighting to trust a room full of people...ugh.

Customer: I know. I'm grasping for straws here.
Customer: Why does this have to be a race. I've only been with him for 3 months!
Dr. L :

In 3 months of therapy we would hope that some good progress has been made...that trust would be developed sufficiently to have made some real discoveries and to have brought down the emotional pain. But...when trust is so difficult that progress is going to be a bit slower. Still...I would say that in 3 months you should have developed enough trust to be willing to work on tough stuff.

Dr. L :

Obviously, he is pushing you in such a way that it is counter-productive.

Customer: I literally broke down in tears when I thought I was being recorded. And he was annoyed with me for questioning him. He picks and chooses what emails he replies to at all. And this was most hurtful of all. On Wed. He asked he strait out if I had suicidal thoughts. And here's the thing...I ALWAYS think about suicide. I have no intent, no plan, but I chronically think about death. I was honest about that, and I said that my children are really what keep,me going and he says "well, if you didn't have children, you don't know for certain if you would,have killed yourself by now or not". Ummmm, ok?
Customer: It's just not supportive!
Dr. L :

That question was really strange!

Dr. L :

And..I am surprised about the emails...but I do recall that he told you he won't answer all of them. Which may have been his way of saying...don't email me. I'm not sure...

Dr. L :

Why did he even ask you about the suicide?

Customer: He never says "that's normal for depression". I asked him what his therapy style was and he said that some therapists like CBT, but I don't do that because I think in the most simplistic terms that its about "oh, you're depressed, well, just stop doing that and be happy". He said it doesn't work. I asked what does work, and he said "talking about what happened to you". Couldn't I just do that with my husband? Where's the help???
Dr. L :

Again...a strange response.

Customer: It came up because of the things I've disclosed...he came right out and asked me "and you've not thought about suicide before?" I had told him about my previous attempts and he said "oh yeah, remind me of those again?"
Dr. L :

I respect his view of CBT....it isn't for every client. But...he certainly did not give you a thorough response about what works...

Customer: In my opinion, it's become adversarial. It's a tug of war. He pulling and I'm pulling back.
Dr. L :

Tanya...I find it odd that he does not remember about your suicidal thoughts. That ought to be a key thing he checks on with you. I can understand him not recalling very specific details...but in a general sense he ought to know that this is part of our profile.

Dr. L :

Yes...and that's what is going to happen in any situation where you don't feel that you have control of your own decision making. So again...this strategy is not working and is unlikely to work until you decide to trust him, he decides to back off, or you feel so pressured that you give in.

Dr. L :

Are you ready to quit working with him?

Dr. L :

If so, what will you do instead?

Customer: He does not direct the session. He sits there and wait for me to talk. I do not operate in that way. It's not who I am. We have addresses that numerous times, and he asks "what would you like me to do?", I have said "just be more engaging". Help me. His reply "I can't help you with that".
Dr. L :

Odd!

Customer: I don't know what to do, honestly. I have a clearer head today than I have in the past. I think I really know what I need, I've just not been able to get it. The thought of starting over does not sound like fun at all. And leaving Dr. A means being without any support for a while and I don't think that's a good idea right now.
Dr. L :

Tell me more about: I think I really know what I need...

Customer: I need direction. If someone sat with me and said "last week we talked about how you were feeling about having been arrested...", I'd be able to take off and talk. A starting point. I'm not looking for my therapist to read my mind and guess what it is that I want to talk about, but I'm looking for a running start. You and my husband have said that I need a plan for every session, know what I want to talk about and sit down and follow the plan. But that is very easily said than done. I literally have a blank mind. I feel so uncomfortable that I don't think or feel anything. I know that sounds weird, but it is the cold truth!
Dr. L :

I understand what you are saying...absolutely. Most therapists don't just sit there expecting you to get the session started...

Customer: Dr. Levang, it is a BIG problem!
Dr. L :

And...most clients do have some thoughts that they want to discuss with the therapist.

Dr. L :

I think the blank mind is because of the mistrust, and also because you do not know where to begin.

Customer: Yes.
Dr. L :

A good therapist is going to work to make sure you feel comfortable and then is going to say something along the lines of...where would you like to start today...or last week we talked about xyz, how are those things today...or last week we said we would focus on xyz today....

Dr. L :

I'm not sure what Dr. A's approach is here...but it really doesn't matter because it isn't working and you don't feel comfortable and you don't think you have made much progress...and it's way too painful for you.

Dr. L :

So....what would you like to do here?

Customer: My therapy starts off in the same painful way every single week. He invites me in. I say "hi, how are you?" He says "I'm well, thank you" then he says "welcome". I sit down and henstar
Dr. L :

And yes...finding a new therapist is not going to be easy...

Customer: and he stares at me...
Dr. L :

I like that he says welcome...that's quite nice really...

Dr. L :

But there has to be more then that...

Customer: then I say "pleas don't do that" and he says "do what?" And I say "pleas don't stare at me" and he says "well, what would,you like me to do?" And it's all down hill until mercifully, the time runs out!
Dr. L :

What makes you not say anything after he says welcome....why do you stare at him...what are you wanting from him? do you know?

Customer: Im waiting for him to begin.
Dr. L :

And..he's waiting for you to begin.

Customer: He stares at me!
Dr. L :

So who should begin...in your mind...

Customer: He should.
Dr. L :

Okay...and if he was an "ideal" therapist what would he say....

Customer: Last week..we talked about..." Anything, really, I don't care. Just make me feel like you want to know about me. I don't feel that.
Customer: I'm not the one with the most rational mind here! I'm going to him because I need help. I've been through a lot. I don't trust easily at all. So, he must figure out a way to make it easier for me to open up. I'm not like any of his other clients. His other clients are not like me. I'm just asking for help and I'm not getting it!
Customer: Do you think it's out of bounds to ask Dr. J for a consult?
Dr. L :

You have every right to talk to Dr. J. What would you ask him?

Customer: I hadn't thought that through yet.
Dr. L :

And absolutely...you are going to him to help you!!

Dr. L :

Okay...just wondering.

Customer: Any suggestions?
Dr. L :

About taking to Dr. J?

Customer: And how do you ask for a consult? In person with Dr. A, email?
Customer: Yes, about talking to Dr. J.
Dr. L :

If you want a consult with Dr. J then call him (or his office) and ask for that.

Customer: Do I see him privately or with Dr. A?
Dr. L :

Then what I think you want is some support from Dr. J about how to be a "good" patient... that is, a patient who makes progress with their therapist.

Customer: Yes. That sounds right.
Dr. L :

I think you have some doubts about what the therapist should be doing and what you should be doing.

Dr. L :

And you want verification (or instruction) from Dr. J about this...

Customer: I do. And from what I've ascertained it really seems like a very personal thing from therapist to therapist. And as a side note, Dr. J and Dr. A are very close friends and colleagues.
Customer: I don't know if that's good or bad. So should I ask to see them together or see Dr. J alone? And do I let Dr. A know in advance?
Dr. L :

Yes...I did remember they were co-workers...did not know about the friend part.

Dr. L :

No...see Dr. J alone.

Customer: Tell Dr. A?
Dr. L :

Dr. J and Dr. A....even if they are friends...need to treat this professionally...that is a issue of ethical practice.

Dr. L :

No.

Dr. L :

What I see is that you are wanting a private meeting with Dr. J to ask for his feedback about how you are approaching therapy and if there is something more/different you could be doing to have a better, more productive experience.

Customer: I know it's unethical, but Im pretty sure they'll discuss it, especially since I signed a waiver for sharing therapy notes, ect.
Customer: Is this my fault? I mean, am I my own worst enemy here? How can I trust? I just don't know. It's so sad. It really is.
Dr. L :

Tell me who the release is for...is it from sessions with Dr. J to Dr. A. Or vice versa?

Customer: Dr. J to Dr. A.
Dr. L :

This is not about fault Tanya. It's about reality. Are you your own worse enemy...to some degree yes...but you are unable to trust.

Dr. L :

Okay...so that means that Dr. J can talk to Dr. A about sessions. But usually there is a date on the release...a date that stipulates what period of time this release is effective.

Customer: I don't know what that date is.
Dr. L :

You might want to check this out.

Customer: I will.
Dr. L :

That would make a difference. That release may not be effective any longer so he can't share. And..you can remind him of that.

Customer: I will find out at the consult. At this point, I think that's the most reasonable and responsible thing to do. I hope.
Customer: I do not want to walk away from this relationship. I want that to be an absolute last resort.
Dr. L :

So...is your hope that Dr. J can talk to Dr. A and get Dr. A to change how he works with you?

Customer: I think I need to find a way to trust again, and I just have no idea how to do that.
Customer: I think so. Should that be the goal?
Customer: Or for me to adapt to his style?
Dr. L :

I don't think it's reasonable to put Dr. J in the position of having to tell Dr. A that you need him to change. What is reasonable is to say: Dr. J can you help me to look at how I am relating to Dr. A and what I might do to start to trust him and to get more out of therapy.

Customer: Ok, I agree.
Dr. L :

I don't know if your adapting to Dr. A is going to be a game changer...the best scenario would be that both of you adapt! He leads more....you feel more trust.

Customer: That would be awesome!
Dr. L :

You feel "welcomed" and "safe"...he feels that you are beginning to trust him.

Dr. L :

This would be a win-win.

Customer: I hope I can trust him. I really want to. I really, really do. I just can't let my guard down for a second to let him in. I feel very frustrated.
Dr. L :

So...make an appointment with Dr. J...come in prepared with what we have talked about this evening...make your case...see what he is willing to do. And...make sure what the date on that release is.

Customer: Got it, and will do.
Dr. L :

Yes..I agree it is a frustrating experience! And he likely feels some of that as well.

Dr. L :

That's why I said win-win...

Customer: can I let you know what happens?
Dr. L :

Yes...please do.

Customer: Ok...do you think it's ok to
Customer: send Dr, J an email to,ask for the consult or call?
Dr. L :

I think this is a good plan...it gets you the opportunity to get what you need from therapy...rather than feeling unsafe and frustrated.

Dr. L :

Call.

Customer: Ok, I will. Tomorrow, first thing.
Dr. L :

Great.

Dr. L :

I will say goodnight now.

Customer: Thank you, XXXXX XXXXX!
Customer: Good night! :)
Dr. L :

You are very welcome Tanya!

Dr. L :

Good night to you as well!

Customer: Hey! I'm called Friday morning and never got a reply by phone or email from Dr. J. It might be a little awkward if I have my next appt with Dr. A and he questions me about it.
Dr. L :

Hi Tanya,

Dr. L :

Do you mean if Dr. A questions why you would call Dr. J?

Dr. L :

Dr. A should not have that information. Calls coming into the office are confidential.

Dr. L :

No one should know this information...

Customer: I am pretty sure the release is still in effect. If that's the case, will be knkw?
Customer: knkw
Customer: Know
Customer: Sorry, typing to fast!
Dr. L :

Hmmmm. Well, it would be up to Dr. J to say that you called. But until you talk to Dr. J there is nothing to say to Dr. A right?

Customer: Not anything other than I called and requested a consult.
Dr. L :

I don't know why he would bring that up?

Customer: I won't be paranoid and speculate, but my sense is that they consult each other quite a bit on each other clients.
Dr. L :

Colleagues can and do talk about clients...but they do not use the clients name. That you signed a release of information means that they "could" be discussing you...but typically the identity of the client is not used. And..because you have not talked to Dr. J I just don't see what he would say to Dr. A? Even if he said you had called...that says nothing.

Dr. L :

What are you worried Dr. J would say...or how Dr. A would react?

Customer: How he will react. It not that he's not professional, but the relationship between Dr. A and I feels strained, and sessions are already awkward, so I don't really want it to be any more awkward.
Customer: The truth is, that therapy should be a place (in my opinion) where you go to feel like you are being heard and getting on a path to where you want to go in your life. For me, I'm just stressed out by it. I really am.
Dr. L :

I agree with your viewpoint of therapy.

Dr. L :

And..yes you have a strained relationship with Dr. A. But...if your going to Dr. J is going to upset him..then doesn't that tell you something about his ability to work with you?

Dr. L :

Then wouldn't give you more confidence that this is not the therapist you need.

Dr. L :

The goal of going to Dr. J is to get feedback on what you could or should be doing differently to engage with Dr. A.

Dr. L :

You are not meeting with him for the purpose of saying he is a bad therapist or unprofessional...so he would have nothing to fear.

Customer: Yes, it does. I think his annoyed attitude about me questioning the tape recorder and his ambivalence about emails is also a problem. I have trust issues...no doubt about that. But wouldn't it make sense to try a new approach? Is it my "job" in therapy to tell him what he should do differently? This is why I need a consult...what is my responsibility? What is his? If I can't trust, is there a way to form it, or is it just hopeless at this point--3 months in?
Dr. L :

I agree with the list of issues you have just written.

Dr. L :

I see two choices here...talk to Dr. J and ask for his help in addressing the above list. Or...talking directly to Dr. A about these issues.

Customer: If Dr. J does not get in touch with me by Wed., I will have a conversation with Dr. A. Why should this be so complicated? Ive never had a smooth relationship with any therapist for to long. I get the common denominator is me. I'll get this figured out.
Customer: I'll keep you posted.
Dr. L :

That sounds like a good plan. But I would encourage you to check back with Dr. J by Tuesday...unless he isn't in the office everyday.

Dr. L :

I feel frustrated with you...it shouldn't be this hard.

Dr. L :

Let me know how things go...

Dr. L :

Good night!

Customer: He is, as far as I know.
Customer: I will. Thank you. Good night!
Dr. L :

okay...

Dr. L :

that's good...

Customer:

Ok, so I've got an appt. for Thursday @ 3pm with Dr. J. I have my appt. with Dr. A on Wednesday. Any suggestions on how I can use my 50 minutes most effecively with Dr. J?

Dr. L :

Hello,

Dr. L :

Well....can you go in with some prepared thoughts?

Dr. L :

As you say..you need a running start. So...what if you were to go in with 3 or 4 things on a list that you would be comfortable talking about so that you can get "warmed up" .. sorta like ice breakers.

Dr. L :

I wouldn't put anything tough on the list...

Dr. L :

For instance, you might start off with saying:

Dr. L :

Dr. A I am willing to admit to having on-going difficulty trusting you. I would like to spend a few minutes talking about what progress I have made on this front and I want to hear from you what progress you think I've made.

Dr. L :

How does this sound?

Customer:

Yes, that sounds good for Dr. A, but what about my consult with Dr. J?

Dr. L :

With Dr. J is going to be an entirely different conversation...here is where you want more direction on how to open up...how to trust...what words of wisdom he can share that would help you feel that a trusting bond is possible. Correct?

Customer:

YES!

Dr. L :

Great!

Dr. L :

So...can you write out a few "softball" questions for Dr. A?

Dr. L :

Then...I suggest you do the same with Dr. J so that you don't waste time...that is have some thoughts down on paper about what you want from this consultation.

Customer:

I know what I want, im just not sure about how to articulate it.

Dr. L :

You might also want to ask Dr. J to what extend he talks to Dr. A with you and for him to explain that Release of Information.

Dr. L :

*about you (not with you)

Dr. L :

Why don't you put some thoughts down on paper and then I'll review them?

Customer:

Great. I'll post here when I'm done. Ok?

Dr. L :

Very good Tanya.

Customer:

Ok...THANK YOU!

Dr. L :

We will talk later then!

Dr. L :

You are welcome!

Customer:

later, gator! :)

Dr. L :

Yes...check with you later this evening.

Customer:

After talking with Dr. A today in session, I decided to cancel my appt. with Dr. J. I hope it was the right decision.

Dr. L :

Tell me what happened to change your mind? I hope that means that you had a good appointment and are feeling better about Dr. A.

Dr. L :

I'll be on for several hours....

Customer: Sorry I missed you. I changed my mind because I had a lengthy conversation with Dr. A about how uncomfortable I am and he agreed that he could lead, but it would never get me to the point of trusting this process. He said that this isn't about the therapy relationship, that its about the relationship I have with myself. I know that I trust to a certain degree. Obviously I must because I am married and have children, I'm highly involved in my children's school and in my community, I have friends that i'm close with, but still, I feel incredibly lonely. I don't have a fulfilling life because I believe that others are really out to hurt me. I don't ever give anyone the benefit of the doubt, I am trigger sensitive when it comes to my 6th sense. I waiver between being hollow inside and having so many emotions that I can't see straight. I want this to work, but I'm not very vested in the process because I can't get comfortable enough to just start talking about what haunts me. Maybe I never will. I don't know.
Dr. L :

Tanya,

Dr. L :

Somehow this posting got taken completely out of my list. I'm not sure why..but will attempt to find out.

Dr. L :

Give me a second here and I will respond.

Dr. L :

Okay...so how are you feeling about Dr. A? It seems to me that he was being completely honest about his approach...that so far he has attempted to let you lead so that you can be in charge of developing trust with him. Yet..he is willing to take the lead but wonders if that will be effective.

Dr. L :

Do you believe that if he were to lead that you would never trust the process?

Dr. L :

And yes..I agree that you have built trusting relationships with a number of people..your husband and children for sure..and others as well.

Dr. L :

Do you really think that the essence of why you don't feel fulfilled is because you "believe" that others are out to hurt you? Or is it more that you initially distrust people (in general) until you are able to gather enough evidence on them to decide if they are trustworthy or not?

Dr. L :

Again...I am very sorry that your posting disappeared from my list...I will check on this immediately.

Customer:

Im sorry it has taken me so long to get back to you. My life has been crazy lately. Dr. A had a planned vacation week, so I will not be seeing him tomorrow. I've decided to take more time off from therapy. I am planning to return in the first week of April. I'm not convinced that this is really helping me. It's costing me $240 a month out of pocket and my insurance is picking up $100 every week. I know therapy is not supposed to be "fun", but I hate it. I dont think Dr. A has it in him to give me what I need. I want to distance myself right now from this and see how I do on my own. I have not fired Dr. A, just taking a 6 week hiatus to see how I feel. Maybe it's a mistake, but I am relieved that I dont have to go back there for a while.

Customer:

This question states that its closed. Are you able to reply still?

Dr. L, Psychologist
Category: Mental Health
Satisfied Customers: 1153
Experience: Psychologist, Marriage and Family Therapist
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    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education