Approach – Douglas Berger Psychiatrist Tokyo


Douglas Berger psychiatrist Tokyo, takes a mixed approach to psychiatry.  You can find more in-depth information about that here on this page as well as the Meguro Counseling Center.

Click here for a QUICK DEPRESSION CHECK.

Cognitive Behavioral Therapy (CBT): CBT is helpful to delineate maladaptive and negative thinking patterns that often torment and distress people. CBT is particularly useful as an adjunctive and rehabilitation treatment for depression and other problems including low self esteem, anxiety, and other issues. Lists of thought distortions, records of dysfunctional thoughts and their rational reappraisal, life planning strategies that can overcome one’s usual negative pattern of behavior etc. are often given in a work-book fashion that can be an effective method toward self-improvement. This is an example of Psychopharmacology-Integrated CBT (Cognitive-Behavioral Therapy), where a medication-illness paradigm is integrated with a psychology-psychotherapy paradigm in order to boost treatment effects from both angles.

Depression & Anxiety: Sometimes an illness like severe depression or anxiety may require medication in order to allow the talk therapy to jump-start. The therapists at the Meguro Counseling Center have considerable experience in using psychiatric medications and keep up to date with the many medications used in Western countries that are not yet available in Japan. Your therapist can provide you with information and recommendations regarding psychiatric medication, and the Meguro Counseling Center works together with a number of physicians licensed in Japan who can provide a prescription as appropriate.

Some of the more common problems that the therapists at the Tokyo Meguro Counseling Center have experience treating includes self-confidence problems, relationship/family problems, depression and manic depression, anxiety/panic, eating disorders, obsessive-compulsive disorder, phobias, substance and alcohol abuse, history of traumatic experiences (PTSD)/child abuse, feelings of unreality, sleep disturbances, psychosomatic (mind/body) disorders, women’s issues, gay and lesbian issues, and child and adolescent disturbances. The Tokyo Meguro Counseling Center has considerable experience in the treatment of depression. Corporate training and conflict resolution is also available, please inquire for details. In addition, Phone or Skype counseling is often provided for persons living in the Kansai area (Kobe, Osaka, and Kyoto).

Charts & Graphs. The Meguro Counseling Center often uses charts and graphs in order to conceptualize clinical issues in visual form. These are some examples of the many files used with clients at the Center (the graphs require individual discussion in order to make sense in context of each unique situation):

  • Core Issues and Defenses; a flow chart of the core psychological issues people have and the adaptive and maladaptive defenses people use.
  • Mood Effects On Psychology; a diagram of how abnormal mood can lead to feelings and behaviors that are not optimal.
  • Self Esteem Needs In Relationships; an illustration of how the mechanics of intimate relationships can lead to crashes in self esteem.
  • Obedience and Defiance Cycle; how a cycle between obedience and defiance can lead to resentment, guilt and fear, and secondary depression, anxiety, conflict, and decreased self-assertion.

Douglas Berger psychiatrist Tokyo - Meguro Counseling Center logoThe Tokyo Meguro Counseling Center strives to create a friendly and compassionate atmosphere in its counseling style. An eclectic counseling approach using a balance of the different major types of therapy (cognitive/behavioral (CBT), psychodynamic, supportive, group psychotherapy and others) is employed to fit with what each individual requires in order to achieve the goals set in the sessions.

Psychodynamic Psychotherapy: Also called insight-oriented psychotherapy. A central theme in therapy is that everyone has certain core issues like feeling inadequate or unloved that one sometimes makes maladaptive defenses against (ie. trying too hard to get noticed by others or getting into unhealthy romantic relations) that can lead to trouble for the individual. Understanding and re-working these defenses and how they lead to trouble, as well as minimizing the effects of one’s core issues is a very useful tool in therapy. A detailed description of this approach can be found here: Core Issue-Defense Paradigm, and this page illustrates some clinical case examples. This is a related paper on how defenses can be used in psychotherapy to help one understand and work-through maladaptive behavioral styles.

The Meguro Counseling Center is also experienced in Alcohol Treatment in Japan, and is happy to help persons with alcohol or substance abuse issues in Tokyo or greater Japan via phone or Skype counseling.

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ADHD is both over- and under-diagnosed, depending on the set of people you look at: https://t.co/wNPdlFMiUd The authors’ title “Are We Overdiagnosing and Overtreating ADHD?”, is somewhat unfair to the cohort of persons who are underdiagnosed. https://t.co/sJUSXfRv1G

Cold water swimming for depression https://t.co/rBHqTJW7bF What % and which depressives might benefit, is there placebo effect, what temp, duration, frequency is best is still unclear, & if this is reducing inflammation or stress response is conjecture. https://t.co/2opApRuwKL

There is confusion in depression with “full-remission” (no-symptoms), “effective” (defined at each use), and "responsive" (50% improvement) https://t.co/8g5BXeBjET Many trials claim efficacy using "responsive" but "responsive" is easy to achieve. Us: https://t.co/uZEIPRxr0J

Is there a list of CBT clinical trials for anxiety or depressive disorders that have had subject blinding or subject+treater blinding, or blind placebo? Rater blinding (often mistakenly called single-blind) is not so valuable as blind raters just record what the subject reports.

Funding longer GP consults seems ineffective for patients who are dead-set to get antibiotics. Funding public ads campaign, removing prescription repeats, and reducing prescription expiry to between 2 weeks and 3 months as noted in the article seems the way to go.

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Some mistakenly think tramadol is a combination drug with both an opioid and an SNRI: https://t.co/kYtNeXyy9x Tramadol has a dual mechanism of action but it is not a combination drug. https://t.co/vhEwPF9JpC

Farah’s book on Hemingway had no interview & he/his estate gave no consent https://t.co/7y5FAs4cvY There's no brain scan/autopsy. Farah does not prove chronic traumatic encephalopathy nor disprove bipolar disorder. The estate may sue after sales grow. https://t.co/1HKbrH9Y6i #li

NIDA instills pot fear in doctors as causing schizophrenia & statements like "use and possession of cannabis is illegal in under federal law" etc: https://t.co/9LKyC7PDrw. Dr. Kosten is NIDA-sponsored & Psychiatric Times known to publish NIDA articles. https://t.co/vhEwPF9JpC #li

Questionable ethics when psychiatrists label persons they did not examine, here deceased poet Robert Lowell: https://t.co/KsJ2H0XRZE Psychiatric conditions are not provable so that (re)labeling Mr. Lowell is concerning even if his doctors did so. https://t.co/RZFx8zOZJO #li

Blue-blocking glasses for mania? https://t.co/vmAOFTUtGb only 11-12 subjects in each group in a single blind (not double-blind) study, only followed for one week. Poorly controlled studies should not have results exaggerated. https://t.co/lABkWI4nXZ

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