Therapy · Washington State · Telehealth

The problem rarely arrives in one clean category.

Anxiety overlaps with overthinking. Depression can look like shutdown or burnout. Obsessive thoughts generate rituals that create a few minutes of certainty. Grief reactivates losses that seemed settled. A major transition can destabilize a system that looked functional from the outside. Therapy needs to follow the whole pattern.

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You do not need to have the diagnosis figured out

Most people do not arrive with a clean explanation for what is happening. They know they are exhausted, stuck, anxious, disconnected, or caught in something they cannot reason their way out of. Often they have several explanations, each of which accounts for part of the picture and none of which accounts for the whole thing.

You do not need an ADHD or autism diagnosis to work with me. You do not need to know whether the shutdown is depression, burnout, grief, or some combination. That is part of the work: slowing the system down enough to see what belongs to the nervous system, what belongs to the environment, and what protective strategies formed around both.

What people bring into therapy

Anxiety that never quite turns off

The mind keeps scanning, rehearsing, forecasting, and trying to close every open loop. Sometimes the anxiety is obvious. Sometimes it hides inside preparation, perfectionism, irritability, overwork, or the inability to rest without feeling that something is being neglected.

Depression, shutdown, and disconnection

Depression can feel like sadness, but it can also look like numbness, withdrawal, lost momentum, or a nervous system that has simply stopped volunteering energy. For people who have spent years overcompensating, collapse may arrive after a long period of looking unusually capable.

OCD and compulsive patterns

Intrusive thoughts create doubt. Checking, reassurance, reviewing, avoidance, or mental rituals create temporary relief. Then the doubt returns, usually with a slightly stronger case. The cycle can consume enormous amounts of time while remaining almost invisible to everyone else.

Trauma and protective responses

Hypervigilance, emotional flashbacks, dissociation, relational threat, and avoidance are not random defects. They are adaptations that continued doing their jobs after the original conditions changed. Therapy helps the protective system recognize what is happening now without forcing it to surrender before it is ready.

Grief and loss

Grief includes death and bereavement. It also includes relationship endings, lost identities, missed developmental experiences, family estrangement, and the life someone realizes they might have had after a late diagnosis. Some losses are public. Others barely get acknowledged, which does not make them smaller.

Life transitions and identity changes

Career changes, divorce, fatherhood, relocation, midlife, changing relationships, and late identification can disturb the assumptions that held a life together. The old arrangement no longer works. The new one has not taken shape yet. That in-between period is often where symptoms get louder.

These are not always separate problems

Anxiety, depression, compulsivity, grief, and trauma often form a system.

Anxious parts scan for danger. Perfectionistic parts try to prevent it. A compulsive behavior creates temporary certainty. Other parts shut the whole operation down when the effort becomes unsustainable. Each response makes sense on its own; together they can lock a person into a pattern that insight alone does not move.

Treating one symptom may bring relief. Sometimes that is exactly what is needed. But when the same structure keeps rebuilding itself around a new symptom, the work has to go underneath it.

Neurodivergence changes the clinical picture

Neurodivergence is not the explanation for every difficulty. It is also not background information.

ADHD, autism, AuDHD, sensory differences, masking, delayed processing, and executive-function variability can change how anxiety, depression, trauma, and compulsive behavior present. Avoidance may include demand sensitivity. What appears to be depression may partly be autistic burnout. Apparent resistance may be overload. Intense focus may be monotropic attention, an OCD process, a protective strategy, or some combination.

The distinctions matter because the interventions can point in opposite directions. Depression may respond to gradually increasing activity. Autistic burnout usually requires reducing load first. Pushing activation inside burnout can deepen the collapse. Treating every intense interest as obsession can pathologize the nervous system; treating every obsession as neurodivergence can miss OCD.

Good therapy does not force all of this into one model.

A direct note about OCD

I work with clients who experience intrusive thoughts, checking, reassurance-seeking, mental rituals, avoidance, shame, and the exhaustion of trying to achieve certainty. I am informed by Exposure and Response Prevention (ERP) and Inference-Based Cognitive Behavioral Therapy (I-CBT). I am not a specialist-trained or certified ERP or I-CBT provider.

My approach integrates relevant principles from those models with IFS and neurodivergent-informed therapy. That combination can be useful when OCD overlaps with ADHD, autism, trauma, shame, or a protective system that experiences treatment itself as a threat.

This is not an intensive OCD program. When specialized ERP, a higher level of care, or a clinician whose primary practice is OCD treatment would be a better fit, I will say so directly.

How I work

IFS and parts work

IFS helps identify what the protective responses are trying to prevent, manage, or keep out of awareness. The goal is not to argue a part out of its fear. It is to understand the fear well enough that the system no longer needs the same level of protection.

Neurodivergent-informed formulation

Neurological needs, environmental mismatch, shame, and trauma can produce similar-looking behavior for different reasons. We distinguish what needs accommodation from what needs clinical attention. Confusing those two creates a great deal of unnecessary suffering.

Evidence-informed tools

Therapy may draw from ERP and I-CBT principles, behavioral activation, motivational work, nervous-system regulation, and practical scaffolding. The method serves the problem. The problem does not get squeezed into the therapist's favorite method.

Direct clinical judgment

I track whether the work is producing movement. If something is not working, we examine it. If a specialist or a different level of care would serve you better, I will name that rather than allowing therapy to become something you endure indefinitely.

Who this tends to fit

This work may fit if you:

Have one primary concern or several that overlap
Understand your patterns but remain caught in them
Suspect ADHD or autism may be part of the picture
Have been given advice that ignored how your nervous system operates
Want depth without abandoning practical change
Prefer a therapist who has a point of view and will tell you what he sees

A formal neurodivergent diagnosis is not required.

Scope

Therapy is available by telehealth to adults located in Washington State at the time of the session.

This practice is not an intensive OCD or ERP program. I do not treat active psychotic disorders or eating disorders as primary presenting concerns. At this time, I am not accepting new clients with active suicidal ideation or recurrent self-harm. When a concern requires specialty treatment, medical management, or a higher level of care, I will recommend adding or transferring to the appropriate provider.

Frequently asked questions

Do I need ADHD or autism to work with you?

No. ADHD and neurodivergence are central areas of my practice, but they are not entry requirements. Many clients are undiagnosed, self-identified, questioning, or simply dealing with concerns that require thoughtful therapy rather than a neurodivergent specialty label.

Do you treat OCD?

Yes, within the scope described on this page. I work with intrusive thoughts, checking, reassurance-seeking, mental rituals, avoidance, shame, OCD-related magical thinking, and compulsive patterns. I also help clients with hoarding behavior, including the attachment, avoidance, difficulty discarding, and distress that can organize around possessions. Hoarding is not always an OCD presentation, so the formulation matters. I assess whether the concern fits my scope or calls for a clinician or program specializing primarily in OCD or hoarding disorder.

Do you provide ERP?

I am informed by ERP and use relevant exposure and response-prevention principles when appropriate. I am not specialist-trained or certified in ERP, and I do not operate an intensive ERP program. I am also informed by I-CBT and integrate both approaches with IFS and neurodivergent-informed treatment.

How do you distinguish depression from autistic burnout?

There can be overlap, and a person can experience both. Depression often includes persistent low mood, loss of interest, hopelessness, and withdrawal across contexts. Autistic burnout is more specifically associated with sustained load, masking, loss of functioning, and reduced tolerance for stimulation. The distinction matters because increasing activity may help depression while worsening burnout when load reduction is what the nervous system needs first.

Can I work on trauma and executive-function problems together?

Yes. They often interact. A calendar cannot resolve a threat response, but trauma work that ignores working memory, time perception, or initiation problems can remain disconnected from daily life. Therapy can address both layers without pretending they are the same thing.

How is this different from coaching?

Coaching focuses on implementation, systems, accountability, and execution. Therapy can work directly with anxiety, depression, OCD, trauma, grief, addiction, and the deeper protective patterns underneath daily functioning. I also run High Signal Coaching for people seeking non-clinical executive-function support.

When would you refer me to a specialist?

I refer when another clinician has training or a level of care that better matches the problem: intensive ERP, eating-disorder treatment, detoxification, residential care, medication management, active safety needs, or another specialty outside my scope. Referral is not a failure of therapy. It is clinical judgment doing its job.

You do not need to know which diagnosis explains everything before reaching out.

The first conversation is about what is happening, how the pieces connect, and whether this is the right place to work on it.