Approaches to therapy

I believe that engaging in a therapeutic process, essentially sharing your internal world—requires feeling understood, safe, and connected. My goal is to build a trusting dynamic with you, where you feel safe enough to explore and express all parts of yourself. I recognize you as the expert of your own experience, and also understand that we, as human beings, often confront our unconsciousness, which can manifest as pain- an area ripe for growth.

Drawing primarily from psychodynamic theory, I prioritize self-reflection and insight into both conscious and unconscious processes.

I am deeply curious about the language you use to describe your experiences and am committed to exploring the intertwined nature of your intellectual and emotional expressions. I also specialize in treating OCD through ERP, and specialize in working with the overlap of trauma + OCD.

I have extensive experience working with the LGBTQIA+ community, providing a warm, supportive environment to navigate life’s challenges and transitions. I am deeply committed to anti-oppressive and anti-racist work, ensuring my practice is inclusive and supportive for all of my clients.

Anxiety

If you are seeking therapy for an overwhelming presence of anxiety or panic in your life, my approach would be to first equip you with the tools you need to better manage your anxiety and or panic and bring the “baseline” of anxiety down. We might work on specific grounding techniques, mindfulness, and somatic (meaning body-based) practices.

Once the baseline of your anxiety has been brought down we can begin to do more of the exploratory work, or psychodynamic therapy.

You might be curious as to why you are the way you are, why you have knee-jerk reactions and responses in certain scenarios, why you find yourself in a specific relational pattern, or why you choose a specific type of person in relationships. I look forward to partnering with you in the exploration of yourself.

OCD

If you are seeking therapy to manage your OCD, my approach to our work would be the gold-standard, ERP or exposure and response prevention. OCD is characterized by obsessive or intrusive thoughts and compulsive behaviors. Behaviors include "mental behaviors," like thought blocking, thought avoidance, distracting, trying to replace intrusive thoughts with positive thoughts (neutralizing), thought checking, and so on.

How does ERP work?

The primary goal of ERP is to help individuals confront their fears and be able to tolerate the anxiety associated with those fears through systematic and controlled exposure.

Exposure

In ERP, individuals deliberately face situations, thoughts, or objects that trigger their anxiety or compulsions. We will plan these exposures together. This exposure is gradual, starting with less distressing triggers and incrementally progressing to more anxiety-provoking stimuli.

Response Prevention

While exposed to the anxiety-inducing stimuli, individuals are encouraged to resist engaging in their typical compulsive behaviors or rituals. By preventing the usual responses (compulsions), the therapy aims to teach that the anxiety is tolerable and the individual has the capacity to control the behavioral part of their OCD. One may also experience that their distress naturally diminishes over time when the compulsive behaviors are not performed, otherwise known as "habituation." Habituation however, does not necessarily predict treatment outcome or success, but it can be a nice "side effect," as a result of repeatedly demonstrating willingness to engage with activating and avoidance-inducing stimuli.

ERP is based on the principle of inhibitory learning, where anxiety tolerance, and willingness to move through discomfort and uncertainty are most stressed. The individual learns that compulsions aren't necessary for safety, the anxiety and discomfort associated with intrusive thoughts are tolerable, and intrusive thoughts are less probable and intense than anticipated.

Combination of Process Work and Response Prevention

My work as a therapist integrates the cognitive-behavioral treatment of OCD, anxiety and related disorders with psychodynamic and psychoanalytic perspectives to both address the symptoms of OCD but also underlying dynamics that generate these self-protective symptoms/ coping responses. Understanding the context of your OCD themes can help us tailor the behavioral portion of treatment, and also open up more space for you, process-wise around emotional-relational factors that have existed over the course of your life, and perhaps continue to exist.

Relational issues

In my practice, I provide a safe, supportive space for individuals and couples facing relationship challenges. As psychotherapist Esther Perel aptly says, "the quality of our lives depends on the quality of our relationships."

Through Psychodynamic interventions and empathic listening, I empower clients to understand their emotions, communicate effectively, and build healthier, more fulfilling connections.

For those navigating the end of a relationship—whether through breakup, divorce, or separation—I offer dedicated support tailored to this unique and often painful journey. I also provide specialized support for individuals recovering from emotional and narcissistic abuse, helping them process complex emotions, rebuild self-esteem, and reclaim their sense of self in a compassionate, judgment-free space.

Get in touch

If you have any questions or would like to schedule a free 15-minute phone consultation or therapy appointment, please fill out the form and Marielle will get back to you as soon as possible.

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