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.

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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

Some people have so much anxiety that makes them go to the toilet, some “fight” back at their anxiety, and some need to give up and take meds. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

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Persons often say drugs, therapeutics, or VaXs are “effective” but can’t describe what they are effective for. Think, “indication” & “endpoints”. Know what you are told you can treat before leaping into a point of no-return. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

People often consult us about family fights. They're usually caught up with the intense escalation so that we have to guide them to focus on the start of the fight which hints at the underlying cause. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx.

How to deal with difficult co-workers? Keep frustration low, realize the difficulty is a merry-go-round, try to take it as a comedy and keep out of trouble. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

Connecting events from one’s past to current symptoms can be a jump of logic if a long time has passed. We like to have an event to blame. Problem is there is usually no exit from this turmoil once the person is obsessed on it. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

Called an "anchor point", it's the first belief persons have about a situation. Once set, it is very difficult to change that persons' opinion even in the face of glaring evidence. This phenomena can easily be exploited to control people as well.

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People want to get a “divorce” even with small kids because they get into “0 or 1 mode” when heated and don’t realize the problem to come with the stress on children, alienation, and guilt that might ensue. Try to find creative solutions! Us: https://t.co/W6SS4mUflN

Clinical trials need proper power in subject numbers, proper endpoints, placebo control, and an understanding how all these fit together.

Patients on so many medications, what to do? Try to see what is really necessary, start and stop carefully. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

Why are people overwhelmed? Most commonly, they have a lower capacity due to attention and organization. This can lead to depression and anxiety if work or other functioning fails. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

What can happen after abortion? A domino effect: Guilt---depression---break-up with one’s partner---more depression. Think carefully about what may happen ahead of time. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

Common psychopharm mistakes:1. Stopping meds and thinking they are out of your system-no, 2. Thinking you will absolutely recover on restarting meds on cessation-no. Nuanced understanding is key. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

Poor metabolizers and treatment resistance can be confused. Low drug doses are given for fear of toxicity, leading to poor dose response and "seemingly" treatment resistance.

Workplace harassment is common, sometimes it’s sexual. Fear of losing one’s job, fear of physical harm may make the victim frozen & unable to resist. Getting help early is key. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

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