286 Madison Avenue, Suite 1602
New York, NY 10017
Tel: 212.684.5377

Barry L. Stern Ph.D. Licensed Clinical Psychologist
Associate Clinical Professor of Medical Psychology
Columbia University College of Physicians and Surgeons

Clinical Services

Consultation / Evaluation

The purpose of a consultation is to provide a comprehensive assessment of the patient's difficulties, a diagnosis and a recommended treatment plan. Consultations generally require my meeting with the patient two or three times, after which I share my understanding of his or her difficulties and recommendations for treatment. It is my practice to precede the start of all psychotherapeutic work with a consultation.  If I have time available for new patients, I will make this clear prior to the first consultation meeting. If the patient is seeking a second opinion, I will, with the patient's consent, share my findings with the referring doctor or the patient's therapist.

Psychoanalysis

Psychoanalysis is a form of intensive psychotherapy based on the belief that factors beyond our conscious awareness have a profound influence on our behavior. Unbeknownst to us as we go about our daily lives, these factors (implicit beliefs about self and others, unconscious wishes and fantasies) are often related to the difficulties for which patients seek treatment.

Psychoanalysis is often indicated for people whose lives are essentially stable, who have achieved some success in work and relationships but for whom an enduring sense of life satisfaction or relief from troubling symptoms has proved elusive. Psychoanalysis can be helpful for people who experience:

  • Chronically poor self-esteem
  • Feelings of ineffectiveness and failures of performance in work
  • Inflexibility, rigidity, and a strong need for control
  • Chronic anxieties
  • Recurrent depression
  • Problems feeling happy and satisfied, even when things are "going well"
  • Problems with anger and irritability
  • Recurring disappointments in love relationships and friendships
  • Problems with intimate and sexual relationships

Patients in psychoanalysis attend four times per week and are encouraged to lie on an analytic couch during sessions. Both the session frequency and the use of the couch are designed to help patients explore the full range and content of their mental and emotional life, without censor, and without attention to what is socially appropriate. The patient's dream life, fantasies, memories, experiences in relationships and work, and reactions to the analyst are frequent subjects of investigation in psychoanalytic treatment. By examining the themes raised by the patient and through learning about repeated patterns of behavior, thought, and feeling in the patient's life outside of treatment, the psychoanalyst is able to generate and share hypotheses about the patient's underlying, unconscious motivations, and how these relate to the patient's present-day difficulties.

Psychoanalysis is frequently caricatured as a treatment that focuses on the patient's past. Although many psychoanalysts would agree that one's experience of early family relationships forms important templates for later experiences, many modes of contemporary psychoanalysis involve an intensive examination of the patient's current life through the lenses of work, love, and interpersonal relationships. This characterizes my approach to psychoanalysis.

Psychoanalysis is a collaborative venture in which learning and growth occur not simply through the intellectual understanding of the patient's difficulties, but through the emergence of problematic behaviors, thoughts, and feelings in and related to the relationship with the psychoanalyst. The emergence of the patient's difficulties in the treatment relationship and their discussion in ‘real-time' with the psychoanalyst promotes an emotion-based learning that is particularly powerful.

Over the course of an analysis, through the enactment time and again of troubling behavioral patterns and their discussion in the treatment, the jointly constructed understanding of the patient's difficulties sharpens. Patients start to feel that they have greater sense of self awareness and control in their lives, resulting in an expanded range of choice in work and relationships. Ultimately, an enduring, more positive experience of oneself, one's relationships and one's activities prevails.

Psychotherapy

Psychotherapy is based on the same principles as psychoanalysis but differs in two key respects: patients are seen less frequently (once or twice, rather than three or four times weekly), and patients are seated rather than supine. A determination of suitability for psychoanalysis versus psychotherapy is made according to several factors, assessed during an initial consultation, including: the nature and extent of the patient's presenting difficulties; the patient's life situation; and logistical considerations such as sessions times and fees.

Couple Therapy

My approach to working with couples draws from contemporary psychoanalytic, systems, and cognitive perspectives to address the problems related to communication, intimacy, sexuality, and partnership with which couples frequently present. With couples, the work is problem- and solution-focused. In the evaluation period I work to clarify the nature of the difficulty and the contributing behaviors of each partner that maintain the presenting problems and mutual sense of impasse. Over the course of treatment couples develop an understanding of why they are drawn in, repeatedly, to conflicts with similar content (money, child-rearing, sharing responsibilities, sex) or form (one approaches, the other withdraws; one asserts, the other submits, but resents). By the conclusion of treatment, each member of the couple develops an improved understanding of their respective fears and anxieties about change and the skills to break the maladaptive cycle of communication or impasse on their own.

In addition to helping couples resolve areas of conflict, I also help couples identify and cultivate areas of interest, passion, and strength. Research has shown that these positive factors provide resilience against the inevitable stresses associated with couplehood, and that couples that understand, appreciate, and actively support and enjoy one another stay together longer and with greater satisfaction.

Pre-marital Consultation

The Pre-marital Consultation Service is designed to assess your relationship and provide the tools and knowledge essential in building a strong, communicative, more balanced partnership. The Pre-marital Consultation Service is designed for couples who are engaged, or seriously considering the future of their current relationship.

The Pre-marital Consultation Services will provide:

  • A rapid assessment of relationship stress and strength
  • Recommendations for enhancing communication and intimacy
  • Strategies for managing specific areas of conflict

The Pre-marital Consultation Services can help you:

  • Identify ineffective patterns of communication
  • Manage engagement and wedding planning stress
  • Establish boundaries with parents and in-laws
  • Understand and resolve difficulties involving sexual intimacy

Fees

I have a standard psychotherapy and consultation fee that is my maximum fee for a 45-minute session. In practice, my fees are often adjusted on an individual basis, depending on the type of treatment, session frequency, and the patient’s financial constraints. Although I am not currently a provider for any insurance plans, I will fill out supporting documentation required for patients who can be reimbursed by their carrier for mental health care. Please note, however, that timely payment is the responsibility of the patient, not the insurance carrier.

 

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