Outer and inner stresses
———
Getting help

Paul M. Brinich, PhD

Single Office Practice of
Psychoanalysis and Psychotherapy
with
Children, Adolescents, and Adults

Specialty Areas
Adoption
Bereavement
Divorce
Physical Illness / Disability

Some stresses arise in the course of normal development. Others arise from forces outside our control. And some are the result of inner conflict.

Life brings many stresses to us all, whether we are children, adolescents or grown-ups.

Some of these stresses are the result of normal development. When a child goes off to school for the first time, it is hard for the child . . . and for the parents, too. When an adolescent or young adult moves away from home, the excitement is mixed with sadness and worry. Although these developmental stresses are quite normal, they still can be quite painful and sometimes may require outside help.

Other stresses lie outside our control. A hurricane, a serious illness, “down-sizing” . . . each puts us to the test. Most people manage to deal with problems like these pretty effectively, especially if they have family, friends, and neighbors who are willing and able to help. But some people find themselves stuck and need help finding ways to get back on track after such external stresses.

Finally, some stresses arise from within us. Old guilts, problems with authority or competition, feelings of inferiority — these kinds of things can tie many people into knots, whether they are 5 or 95 years old.

When problems arise from external sources, their solutions usually require that we do something about the outside world. A child in an inappropriate school placement needs a change. Someone working in a truly hostile environment needs to change that environment or move on to greener pastures.

Likewise, when problems arise from within us, we need to do something about the internal forces that produce these failures and miseries. These kinds of problems require the assistance of someone who is comfortable and experienced in helping people to overcome such inner worries.

How problems grow

Internal conflicts rarely spring up “out of the blue.” They usually germinate over long periods of time. Not surprisingly, we almost always prefer to not think about them; after all, they remind us of our weaknesses, not our strengths. Often they are tied to things we feel (rightly or wrongly) to be shameful and therefore secret.

Over time such internal conflicts get incorporated into our very personalities, creating a psychological suit of armor that sometimes may be protective but at other times may be very limiting.

Changing well-established but maladaptive patterns of behavior, thought, and feeling usually takes a lot of work. This is especially true when the roots of the patterns run deep and draw from areas that lie outside our everyday awareness.

Children, adolescents, and adults

I have been working with patients who have “inside worries” since the late 1960s. I see children from the toddler years on (often together with their parents, or involving their parents in other ways). Because most adolescents are quite jealous of their privacy, I always spend a good deal of time sorting out how best to work with them  and their parents.

I also work with adults who find themselves repeating patterns of behavior that they know too well, that they have tried to change, but that persist despite their best efforts.

A safe, private space

Patients have taught me that they tend to do best when they are encouraged to take things one step at a time and are allowed to decide for themselves when they are ready for us to take a look at their private troubles together. I see some patients once each week and others every day. My patients and I decide together what is best for them in terms of the frequency and intensity of our work.

My obligations are to my patients, not to outside case managers. I am not on any managed care panels and I never release information about my patients to anyone else unless my patients ask me to do so. Experience has taught me that confidentiality is essential if my patients are to be able to face issues and fears that often have troubled them for years.

My office, located in a residential area of Chapel Hill, is carefully set up to be both quiet and discreet. I set my fees according to individual circumstances and I adjust them (to the extent that I am able) in ways that help preserve my patients’ privacy and independence

Years in Practice

Education

• University of Chicago
  
• Anna Freud Centre, London
  
• UNC-Duke University Psychoanalytic Education Program
  

Professional Affiliations

• North Carolina Psychoanalytic Society
  
• American Psychoanalytic Association
  
• International Psychoanalytic Association
  
• Association for Child Psychoanalysis
  

Gender

Prescribe Medications

Accepting New Clients

Insurance Accepted

Sliding Scale?

Services Provided

Age Specialties

Languages

License Number

License State