Approach
Some therapy explains your history beautifully and leaves you with nothing to do on Tuesday night. Some therapy hands you skills and never asks why you needed them. I work in the middle, and I move between the two depending on what the week in front of you requires.
How I Work
01
We look at where the pattern started, what it protected you from, and how it shows up in the present, including between the two of us. This is the part that answers the question you probably came in with: why does this keep happening?
02
Distress tolerance, emotion regulation, and interpersonal effectiveness, taught in the situations you actually face rather than in the abstract. Skills without understanding tend not to stick; understanding without skills can leave you articulate and still overwhelmed.
03
When a thought pattern is doing measurable damage, we work on it directly and practically. I use CBT as a tool inside a broader relationship, not as a manual we work through page by page.
04
You will know what I think and why. We set the direction together, check whether it is working, and change it when it is not. If something I do lands badly, telling me is useful data, not a problem.
A Private Check-In
This private self-check is for reflection only. It is not diagnostic and does not replace an assessment.
A reflection, not a verdict
Choose any statements that feel familiar. There is no score to achieve.
Integration
Here is what integration actually looks like on a Wednesday. You arrive having had a bad week with your partner. We spend the first stretch on what happened — the specific exchange, what your body did, what you concluded before anyone said anything. That is psychodynamic and relational work: we are after the meaning and the history sitting underneath a two-minute argument, because that is what makes it repeat.
Then, usually with fifteen minutes left, we get practical. What is the actual sentence you could say next time. Which skill do you use in the ninety seconds before you say the other thing. That is DBT and CBT, and I bring them in not because a protocol says so at week four, but because insight you cannot use on Thursday night is entertainment.
The reverse failure is just as common. Skills-only work produces people who can name every distortion, run a clean thought record, and still repeat the pattern for a decade, because nobody ever asked why the pattern was necessary in the first place. Understanding without tools leaves you articulate and overwhelmed. Tools without understanding leave you competent and stuck. I would rather do both, in the same hour, and let the balance shift as the work changes.
What I think is overrated: technique loyalty, homework for its own sake, and the idea that a therapist should stay neutral. Neutrality is often just withholding. You will know what I think, and you are welcome to disagree with it out loud.
The Arc
A free call. What brings you here, what you have already tried, what you want to be different. If I am not the right fit, I will tell you and suggest where to look.
History, current pressure, and a working picture of the pattern. You leave with something usable early, even while the deeper work is still forming.
Weekly sessions, working on the pattern as it happens in your life and in the room. This is where most of the change lives, and it takes consistency more than intensity.
We check what has shifted and what has not, and adjust. Ending, pausing, or spacing sessions out are all legitimate outcomes we discuss out loud.
Honest Notes
On length. Some of this work is short and focused. Attachment and trauma patterns generally are not, and I would rather say that at the start than imply otherwise. You are never locked in, and we revisit the question openly.
On judgment. If therapy has felt judgmental or disappointing before, that history is welcome material here. Tell me what went wrong last time and we will work to avoid repeating it.
On outcomes. I will not promise you a result. What I can describe is the direction of the work: from feeling controlled by intense emotions and painful relationship patterns toward feeling more grounded, more secure in yourself, and able to build stable, fulfilling relationships.
The Direction Of The Work
I help clients move from feeling controlled by intense emotions and painful relationship patterns to feeling more grounded, secure in themselves, and able to build stable, fulfilling relationships.
Dr. Rebecca Payne, PsyD · Licensed in California
Free Consultation
The first step is a free consultation call. We talk about what brings you here, what you have already tried, and whether working together makes sense. If I am not the right fit, I will say so and point you somewhere better.
Or call the office at (213) 761-8555.
