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

Some ADHD persons can’t function even for a few minutes at a time. When deadlines draw near they rush and lose sleep just to catch up. It’s very hard to coach these persons without medical intervention. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

Some people can’t even face a friendly situation, some are tough as nails and can face huge risk like this speech in the Italian parliament this week: https://t.co/DEm6PlO9pi.

If your mood is low you’ll feel bad about yourself. You may be nervous in front of others & you may feel rejected easily. If your mood is high you may be optimistic and confident. Its your mood, not your situation! Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

Some persons with hyperactivity have social stress at the same time they get depression. Do we fix the social stress, the hyperactivity, or the depression? We can’t let depression go ignored as it can lead to bad outcomes. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

Are sleeping pills “addictive”? Yes and no. They don’t cause craving or a “high” but they can cause one’s natural sleep mechanisms to get rusty causing these persons to require a slow taper of their medicines. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

Intense and emotional persons may have impatience, rejection sensitivity, or some minor depression. If we don’t try different interventions we won’t get data on what it is or what to do with it. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

Many persons don’t want to be “dependent” on a medication to help moods. Only when debilitating can they really see it’s out of their control and they will accept medical help. Us: https://t.co/VOm63Hc41r, https://t.co/uaoP3ZvxU7

Losing weight? Only exercise or only diet may work if done correctly. Commonly, persons think that “a bit” of exercise is enough. They don’t realize that they are just using up energy in their blood & muscles, not burning fat. Us: https://t.co/VOm63HtESZ, https://t.co/uaoP3ZdWvx

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Many patients have a myriad of problems and symptoms: smoking, drinking, nail-biting, insomnia. Impatience, burn-out. Looking closely, they are all connected. Guess how! Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

Drs in big public agencies that see autistic kids don’t easily try adjunctive medications for associated symptoms. It’s because these agencies don’t have systems that easily allow out-of-the-box treatments, doctors are risk-averse, and the paperwork increases.

Many persons have been traumatized by being in a cult. Sexual abuse under the guise of “spiritual experience” is commonly reported. The cult was probably started as a cover for sex and pedophilic activity. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

Persons frequently complain about bad grammar, spelling & trouble with making sense in their emails. This can be due inattention and requires looking closely at other signs of trouble with attention, organization, and planning. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

Long history of depression can make persons think depressed mood is normal and only when there are stressors do they dip and feel worse. Therapy is important to help them see the stress-dips over the background of depression. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

What causes bad dreams? Nobody know for sure, but daytime fears and trauma, anxiety or depression disorders, substance and medicine use and withdrawal, sleep and other brain disorders are known to be associated. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

Can anxiety and ADHD be related? If hyperactive people are impatient then that can lead to tension and more anxiety. Both need to be treated. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

We Americans live here in Japan, but does that mean we have the same risk as Japanese for Corona virus? Not really, because Americans didn’t get the BCG Tb vaccine which seems correlated to risk of Corona illness severity. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

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