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

Depression studies have subjective endpoints so that double blind/blind placebo are needed for efficacy: https://t.co/4XySe7dNmt Hope makes all improve on non-inferiority. "Blind assessments" are deceptive as all the subjects and treaters are UNblind. https://t.co/K6iHnNBhQ1

This study https://t.co/1mfQHq3VWs quoted the parents of a 6 year-old who heard their child's voice. They concluded “The voice and image kept him alive" though It could also be a neurological echo of an emotional memory. Psychodynamics are conjecture. https://t.co/RZFx8zOZJO

Genetic tests are expensive: https://t.co/P4nDSdXfE9. Whether “adverse effects” are due to slow metabolism vs. illness are easily studied: crushed Pills can be blindly put in juice. Do this on and off and see which days correspond to symptoms. Us: https://t.co/1HKbrH9Y6i

Pts given 2-mos of CBT-ib (insomnia/bipolar): https://t.co/Gp5qCz4P7h. Dr. Aiken states to give the “expectation..they..deserve a full remission.” But giving expectations to an unblinded cohort w/no placebo control is the exact thing to avoid. https://t.co/UKcXpxJdqE

This article does not conclude that vaping is more dangerous than tobacco https://t.co/wk8SS8Ohz7 The endpoint should be health effects of tobacco vs vaping not the use frequency or the daily use of e-cigs vs quit attempts or number of cigs smoked. https://t.co/hWt1mTxCDw

Insurance cos & med boards want Drs. to check-off boxes. Douglas Berger, Psychiatrist in Tokyo: https://t.co/TwDAxa3nrV https://t.co/q17evG5VDK

In 2016 firearms were the most common method used in suicide deaths: Douglas Berger Psychiatrist in Tokyo. https://t.co/hAWtWRC9AF https://t.co/AFmNPkWY4p

Insurance cos & medical boards want to check-off admin boxes. Douglas Berger, Psychiatrist in Tokyo: https://t.co/AC6iM82xAS https://t.co/E021GS2RK8

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S Hollon trying to wriggle-out of the need for double blinding and blind placebo control in psychiatric studies with SUBJECTIVE endpoints https://t.co/DkJ7w4TPhN. Quoting Churchill on democracy has nothing to do with treatment of a human condition. See https://t.co/pCdesvYiey

Dr. Byatt makes the point to continue bupropion in this 14wk pregnant patient as she is already exposed for the first trimester: https://t.co/krUSUTsP8t Why Dr. Byatt does not recommend trying to find the lowest effective dose though is baffling. https://t.co/4EE55E1tzZ #li

The open-label GeneSight and unblined/no-blind placebo Genomind studies are at high-risk for researcher bias and should be suspect to extreme caution: https://t.co/y0WTC42zXm Us: https://t.co/f7ZtKavHEq

An elderly patient refuses oral meds & gets injections. Douglas Berger, Psychiatrist in Tokyo: https://t.co/fZvIDnPlcs https://t.co/Z6yI4R8VEB

Rats were exposed for only 12 days in a fear extinction model-not a traumatic event in humans. Therapeutic effect was seen in the startle test. We need to be modest about extrapolating this data to long-term use of cannabis in humans. https://t.co/5aZe9SJbH4

This article exaggerates cannabis causing psychosis https://t.co/NO5NCR7uE6. Includes ER visits for medical reasons, doesn’t consider other drugs nor recent inc in the US population > 10 mil in data. Author is NIDA sponsored- suggests NIDA article. https://t.co/NWy4CcQJ1Y

75% of HOARDING DISORDER patients are said to have other disorders (ADHD MDD OCD), all w/many symptoms while HD is a one-symptom disorder https://t.co/E1d83giZVB. Ergo, HD is a symptom labeled as a disorder in order to bill insurance companies: www.counseling-in-tokyo.html

Dr. Pies states “all treatments have meaningful effects on brain function and structure”: https://t.co/5LhJgWxviX. However, the brain is also known to change on -running, Juggling, etc. There's no way to prove subjective reports in unblinded studies. https://t.co/AUoZmka5Bb

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