Approach of Douglas Berger Psychiatrist Tokyo


The Tokyo Meguro Counseling Center cares for persons with a wide variety of psycho-social problems. The 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. Douglas Berger, the  psychiatrist of Tokyo, takes a measured approach to psychiatry.  You can find  information about that here and at the Meguro Counseling Center.

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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.

Related Counseling Approach Links

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). See the Tokyo Meguro Counseling Center’s web site for more details.

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.

Contact Douglas Berger psychiatrist Tokyo, Japan

Does everything need a medication on the formulary? Some things do, some don’t. Natural remedies sound “corny” and don’t make much money for medical stakeholders.

Halving or stopping meds often leads to…nothing, but that doesn’t mean there won’t be some withdrawal or recurrence. Each step of the way in medication management requires patience.

New expensive meds gets lots of praise, old cheap meds commonly get a bad rap. How should we think? Carefully. Look at data with a discerning eye, see what entities stand to benefit or loose, that usually is the best hint.

How to evaluate research? Just read the abstract? Don’t look at the funding or who can gain profit? Don’t read related papers? Don’t see the methods? Don’t see if the authors are related to the publication? If you said yes to these then take a course in evaluating research.

What medications are the "best"? Efficacy, safety, metabolism, dose, social & physical environment, medical illness, family history...besides a few to avoid at all costs, at the end of the day it's largely trial and error.

When mood is up people tend to stop mood medications, when down they restart. Life can be a continual cycle of mild misery, worse misery, and improvement. The number of total years in bad shape can be debilitating.

Drugs need time to work, too many persons aren't patient enough to wait and give up. Sometimes persons will even run into getting treatments that are un- or poorly proven, leading to a disaster. Proper degree of patience is the answer!

Many psychiatric patients are on a cycle of taking and stopping their meds, why? They don't want to accept being sick so they try to stop, the med is still in them they feel better so they conclude they are better...until they crash, and repeat the cycle.

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It is common for persons to wait until their symptoms become bad before getting help then get desperate for care once things snowball. The solution is to be sure when one is going downhill. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

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Many patients dislike medication, they will decline increasing current medication even if they got good help from the current dose but are still have symptoms, it’s easy to forget that a little more is probably the answer. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

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“Many patients have depression”, True? Low moods are common but who is “ill” with depression, just has stress, or has something else? We can only "guess” & treat because psychiatric diagnoses are actually unprovable. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

“Interminable” that’s the only way to describe the way certain couples fight. Each side magically thinks the other will agree with them someday The answer is: how do you want to spend your short time on the earth? Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

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Friends change, w/kids or w/o becomes a big distance, afraid or not to go out becomes a big distance. What to do? Change your expectation and take a crisis as an opportunity, this is called “crisitunity”. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

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