Dr. K Psychiatry

01/30/2026

We have had a few people asking about longer appointments or more frequent appointments. Although I might suggest a time frame in which we might expect to see the impact of medication changes, I don’t mind if you want to make an earlier appointment to talk about something else. If the appointment is only to discuss medication issues or renewal, then usually 15 minutes is enough, but you have the option of booking a longer one if you have more to talk about than that.

As a reminder we still need 24 hours notice of cancellation. Fortunately the ability to do video appointments usually makes it possible to keep your appointment unless you’re deathly ill. Some people do their video visits from their car to get privacy. For that you need the free Zoom app on your phone.

Some folks are still habitually late. I try not to take that personally but ask that you be ready at least 5 minutes before. Sometimes the app wants to update before you can begin.

We are getting busier, so it’s a good idea to arrange your visit at least a week before you want it.
Thanks,
Dr. K

01/12/2026

Worry makes you suffer twice... once in your mind, and again in life.

It drains your energy before anything happens
and steals your peace without changing the outcome.

Save your strength for what is real.
Meet life when it arrives, not before. 🌿

01/10/2026

Here's a little story from a book I'm reading about CBT. Apparently true. A couple were sailing in the Virgin Islands, and sent out a distress signal saying "help, we're trapped in the Bermuda Triangle! We sail 20 yards one direction then are stopped, we sail in another direction 20 yards and we are again stopped, we're trapped!"

A rescue boat came along, sized up the situation and said, "You're not trapped by the Bermuda Triangle, you forgot to lift your own anchor!" This anecdote sometimes applies to people who are stuck in depression. They may not be able to see that it is their own negative thinking patterns that are acting as the anchor preventing them from sailing free.

- Dr. K
PS. The book is called Overcoming Resistance in Cognitive Therapy by Robert Leahy

01/10/2026

Granddaughter Sage sings an old standard 🥰. She’s not yet 2 😍

01/09/2026

Facing a difficult decision? Imagine how you’re going to feel one month after you make it, then six months, one year, 5 years later. Wouldn’t you rather get over that hump starting now?
Dr. K

01/06/2026

I wonder if the process of retraining the mind with CBT is like training a little tree with bonsai wire? It might be uncomfortable at first. Young branches are more flexible, but you might hear them creak as they bend. People are like that too. We can be flexible, but we might complain as we are doing that. But the long term outcome, if you stick with it, can be a thing of beauty, and after a while, you can take off the training wire and the new shape becomes normal. Notice below the old branch, representing an old brain circuit. It's about to be snipped off. That doesn't really happen in CBT and the old circuit can still be used if you let it. Keep focusing on new growth.
- Dr. K

01/03/2026

Here is a fallacy of belief, from Overcoming Resistance in Cognitive Therapy by Robert Leahy.

01/03/2026

Self-condemnation amplifies depression. Don’t do it.
-Dr. K

12/31/2025

I have recently found a questionnaire in the public domain, that's very useful for looking at patterns of unhelpful thinking, called schemas. The questionnaire is called the Young Schema Questionnaire. You can find it here.
https://novopsych.com/wp-content/uploads/2024/10/mss-ysq_template.pdf
Dr. K

12/28/2025

Here are some important words paraphrased and excerpted from today's Stoic Wisdoms email:

You’ve been working on yourself for a long time now. "Reading the books, doing the practices...Some days you feel transformed. Other days you feel like you’re exactly who you’ve always been, just with better vocabulary for your limitations. Are you actually getting anywhere, or are you just moving in circles at a higher altitude?"

"But understanding isn’t the same as transformation. Knowledge isn’t wisdom."

"Most people judge their progress by how they feel. If they feel more confident, they assume they’re progressing. If they feel anxious or uncertain, they assume they’re regressing. But feelings are terrible measures of development because they fluctuate based on sleep, blood sugar, recent events, and a thousand other variables that have nothing to do with actual growth."

"You can be making tremendous progress while feeling terrible because growth often feels like confusion, uncertainty, and the discomfort of outgrowing old patterns. You can be completely stagnant while feeling great because familiar patterns feel comfortable even when they’re limiting you."

Progress can falsely look like stagnation on the inside because your automatic thoughts are still there. Accept that those negative thoughts will never be gone. Otherwise, its more all or nothing thinking. This is a normal part of being human. But by paying attention and practicing, you can reduce the amount of time and the amount of depth in these negative mind states.

Don't give up, keep practicing.
-Dr. K

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12/22/2025

Why do people resist in psychotherapy? Because "I've been wrong about my beliefs all this time" is one of the most difficult things to accept in life. (And can be one of the most unburdening at the same time!)
- Dr. K

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12/17/2025

This was forwarded to me by one of my clients. This might not resonate you right now, and for some people it might even feel invalidating...We may feel that we're entitled to be angry about feeling wronged in the past, or to be damaged by past trauma. But the meme is right, change is our own responsibility regardless of where the problem originated. Therapy can help but it starts with willingness to examine what you're doing that might be maintaining the problem, and being willing to make changes.
- Dr. K