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Peter Strisik, Ph.D.
Suzanne Strisik, Ph.D.
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In Zeke's Memory

 

 

 

Peter Strisik, Ph.D.
Licensed Clinical Psychologist
Independent Clinical Practice
(907) 222-0899

 

Photo: Peter Strisik

Introduction

My primary work is with adults in individual, couples, and group psychotherapy.  I consider myself a generalist working with a wide range of goals and difficulties.  This comes from my training working with people and with process rather than with particular problems.  There are common threads running through the human experience that make therapeutic elements such as listening, understanding, sharing depth of experience, and quality of the interactive therapeutic relationship healing with most everyone.  I believe connection to others, to community, to spirit, and to oneself to be fundamental in both the problems people bring to me and in the solutions that people find in working with me.  I also believe that finding meaning in one's life is also fundamental to satisfying living. 

While keeping an ear to connection and meaning, I also work with people in a very pragmatic way.  I believe in drawing on whatever resources are available.  This can include medication, exercise, nutrition, reading, therapeutic homework, journaling, art, family research, etc.  I also believe it is often important to collaborate with others (with permission, of course).  I am always glad to talk with primary care doctors, psychiatric professionals, or anyone else that may be important in understanding and working with the particular challenges presented.

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Growth, Healing, Recovery, Relief, or Cure?

These are the broadest terms for the goals set for most coming into psychotherapy.  Which term is most appropriate will depend on the approach of the therapist, the views of the client, and the nature of the challenge.  We often refer to growth when life is basically going ok yet more is sought.  In healthy human development, growth is continual from birth to death.  Healing is most often used when there has been some identifiable injurious event, analagous to a physical wound.  Recovery emerged from the field of alcoholism and addiction and has been applied to codepency as well.  Relief might be considered shorter term but not complete or permanent, while cure would be complete and permanent.  Early in the therapy, some sense of what goal or goals are most appropriate needs to be established.

Another way to think about differing approaches in therapy is in terms of a growth model vs. a medical model.  If we think in terms of growth, we are taking a healthy, positive view.  A medical model is based on pathology and diagnosis.  A growth model works the whole person while the medical model works with the psychopathology.  Each is appropriate in different cases.  I tend to blend these models.  If there is a clear diagnosable problem, it is helpful to use the accumulated knowledge in the field to work with the diagnosed problem.  The diagnosis works as a shorthand means of communicating a great deal about the difficulty.  On the other hand, each person is unique.  And each person with depression is unique, as is each person with a phobia.  It is this problem, this person, this time, this context that we have to work with.  You will see how these two models work together in the overviews of some selected psychological challenges presented below.

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Some Areas of My Therapy Work

This first group of categories do not necessarily meet criteria for mental health diagnoses.  They are in the range of "normal" life events and challenges that most everyone faces at some time in their lives. 

Grief and Loss:  Grief is the expected reaction to loss.  Loss is an inevitable part of life.  The most significant losses are due to deaths of loved ones, separation, loss of health, or loss of an important job.  For many, grief is painful but natural.  They grieve in a healthy manner and move forward.  For others, however, grieving is too painful to bear or the fear of the pain prevents them from grieving well.  The mainstream western culture contributes to the avoidance of a full grieving process, particularly for men who have been taught not to cry.  When someone has difficulty grieving, letting go, and moving forward, and their usual supports are not enough help, a support group or a period of therapy can be of great help in facilitating this natural and necessary process.

Life Transition:  Significant life changes can often make for a difficult adjustment.  Even positive changes such as a marriage, a graduation, a move, empty nest, or retirement, contain elements of loss.  Many transitions require a new way of looking at things, a change in habits, or other changes that all require adaptation and adjustment.  Sometimes these transitions are smooth, sometimes not.  Support is almost always necessary.  When a person's usual supports are not enough, therapy can be of help.

Relationship:  People are relationship oriented.  Our relationships are extremely important to us.  When we have difficulty finding or maintaining relationships, or when we have distress within our relationships, it can be distressing to us individually.  Individual therapy almost always devotes some focus to relationship issues.  In fact, therapy is a relationship!  I view the therapeutic relationship as a core component of the therapeutic process.  It is not exactly a friendship, not exactly a business relationship.  The therapeutic relationship is a special kind of relationship that works within a safe and consistent context designed to allow for understanding, healing, and change.  When therapist and client have established a trusting therapeutic relationship, other aspects of the therapy, such as education, exercises, etc., will be more effective than when the relationship is more neutral.

Couples therapy is a mode of therapy that is devoted to working on relationship.  Couples therapy most often is utilized by partners in a committed primary relationship, but can be useful to any two people in relationship.  Other examples are brothers or sisters with a significant impasse in their relationship, a parent and adult child, or even two business partners.  My work with couples primarily focuses on mutual understanding of differences, needs, and on effective communication.  I have found that most couples are very able to solve their own problems when they learn to communicate such that both partners feel heard, understood, and validated, even if disagreement remains.  Our unique histories, however, often lead us to interpret events differently from each other and to have different needs.  Understanding how our histories combine to make a unique relationship "chemistry" is also an important component of good couples work.

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This next group of categories represent some of the traditional diagnostic categories used in the medical model.  That is, there is enough difficulty to assign a mental health diagnosis and, when considering these diagnoses, we are are thinking in terms of psychopathology.

Depression:  Depression and anxiety are the most common of the psychological disorders.  Most people will experience problematic depression sometime in their lives.  Whether primarily biological or situational, depression is very treatable.  With severe depression, medication is often indicated.  Less severe depression can still be quite troublesome, particularly if chronic or recurrent.  Some of the questions I ask when someone comes to me with depression are:  What has been lost?  What has changed?  Is there a lack of meaning or purpose?  One approach is to transform the depression from something terrible to something productive.  This is most applicable when there has been loss, change, or lack of meaning.  The depression can be viewed as the fertile void from which something new will emerge. 

Bipolar Disorder:  Formerly called "Manic-Depression," Bipolar Disorder involves mood swings both up and down, though movement towards one end or the other of the spectrum might predominate.  Bipolar Disorder almost always has a strong biological component and medication is usually indicated.  Psychotherapy is helpful in accepting the reality of the diagnosis, addressing compliance with medication, learning about one's mood cycle and early warning signs of changes, skills for coping with the difficulties presented at individual, relational, and spiritual levels.

Anxiety:  Anxiety can take many forms... phobias, general worry, panic attacks, obsessive-compulsive disorder, acute stress disorder, and posttraumatic stress disorder.  Some forms are best approached with a cognitive-behavioral strategy.  For example, phobias and panic attacks can be treated with "systematic desensitization," a method of teaching relaxation skills, then pairing the relaxation with the anxiety provoking stimulus until the person desensitizes to the stimulus and the anxiety response is extinquished.  Some forms of anxiety can be seen as existential problems often involving the fear of loss of control with intimate ties to confidence and faith. 

Posttraumatic Stress:  I prefer to consider posttraumatic stress disorder (PTSD) as distinct, though it is technically an anxiety disorder.  When an exposure to a traumatic event causes later psychological problems, it is usually due to the need to protect oneself psychologically from the full experience of that event when it originally occurred.  As a result the event is not fully integrated into one's experience and memory and can disrupt day to day living with intrusive memories, nightmares, panic attacks and other anxious responses, depression, and avoidance of situations that might trigger these symptoms.  The work in therapy is primarily to achieve integration of the traumatic experience by developing the strength and ability to confront the trauma, put the dissociated aspects of the experience together, and to make meaning of what happened.

Personality Disorders:  We all have personality traits that make us interesting, sometimes bothersome to others, lovable, and always unique.  It is not uncommon for people to seek psychotherapy for a personality trait or pattern that is problematic.  However, it is when these traits become so inflexible, maladaptive, or distressful to cause social or occupational impairment that we consider a personality disorder diagnosis.  Work in this area is most productive in regular longer-term therapy that links childhood experience, current relationships, and the therapeutic relationship to promote insight into maladaptive patterns and opportunity for change.

Thought Disorder:  Strictly defined, disorders of thought encompass a wide range of cognitive dysfunction that can be a part of depression and anxiety (loss of concentration, catastrophic or unrealistically pessimistic thinking, extreme self-consciousness, etc.), however, the phrase "thought disorder" in mental health has generally come to mean the same as "psychosis."  The hallmark of psychosis is hallucinations (perceiving things that are not there) and delusions (believing things that are not true).  Psychosis can also include disorganized speech and disorganized behavior.  Psychosis generally involves some degree of loss of "reality testing," or being able to disguish what is real from what is not.  More severe psychosis involves loss of "insight," or the ability to know that these psychotic experiences are symptoms and not objective reality.  The diagnostic category that is defined by psychosis is Schizophrenia and its variants though a person might experience psychotic symptoms during a manic episode, when intoxicated with or in withdrawal from alcohol or drugs, some forms of dementia, and in severe depressive episodes.  Medication is usually indicated in these disorders.  Psychotherapy can be helpful when there is some degree of insight and the person is organized enough to participate.

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