Patients arrive with a question that sounds simple — “should I be on medication?” — and a story that almost never is. The work begins by slowing down enough to let the story matter, because what we eventually decide together depends on it.
Integrative psychiatry, in my use of the term, is not a separate school of thought. It is a practical commitment: to consider the biology, the psychology, and the texture of a life — sleep, food, relationships, work, meaning — as one continuous field rather than competing departments.
The diagnosis is the beginning, not the end
A diagnosis is useful in the way a map is useful: it orients. But two people with the same diagnosis can be living in entirely different terrain. One is sleeping four hours a night and grieving a parent. The other is in a job that no longer fits a person they have quietly become.
The treatment that helps each of them is not the same, and pretending otherwise produces care that is technically correct and humanly wrong.
Context is not a soft addition to the science. Context is what tells you which science to use.
What this looks like in a session
A first appointment runs 60 to 90 minutes. We do not rush. I take a careful psychiatric history, but I also ask about the parts of life most intake forms skip — what your days tend to revolve around, who you can rely on when things feel heavy, what you have already tried and quietly set aside.
From there, we shape a focused, individualized plan. It might involve medication. It might involve therapy. It often involves changes that are not obviously psychiatric— a more consistent sleep window, a hard conversation, a walk that becomes part of your routine.
Whatever it includes, it is yours. Not a protocol applied to a category, but a conversation that grows over time.