While Dr. Winner has worked with a varied group of patients over his career, his current emphasis is in perfectionism, anxiety, obsessive compulsive disorder, depression, anxious depression, rumination, attention problems, and obsessive doubt.
Dr. Winner's approach combines evidence based 'talk' therapies (CBT, ACT, ERP, behavioral activation etc.) with judicious medication management. Combining medication with 'talk' therapy allows for an integrated, centralized treatment approach between the patient and Dr. Winner.
Dr. Winner had a unique experience working as the medical director for a biotech startup company that scaled from him being the 7th person hired at the company to >500 people when he left. This experience has been invaluable when doing executive coaching and performance enhancement coaching for many IT professionals.
A few examples of different presenting problems include:
Some patients have difficulty due to their intense, 'overfocus' on their health condition(s) or body sensations.
Some patients have difficulty making decisions to such a degree that it affects their ability to engage in their career or socialize.
Some patients have a very loud negative internal dialogue that stops them from appropriately socializing due to fear of appearing 'dumb' or 'inept'.
Many patients are constantly plagued with the concern that someone will 'figure out' that they are not as good as advertised.
Some patients suffer from recurrent, negative thoughts, images, or impulses such as fears of contamination or compulsions such as checking/rechecking.
Many patients have difficulty dealing with managers who micromanage them or generally lack emotional intelligence.
Perfect is the enemy of good. Perfectionism is related to many of these problems.
Things don't always go according to plan. When stressors add up some patients feel 'on edge' all the time.
Thinking one's way out of a problem can be akin to digging harder to get out of a hole. Many patients believe, "if I just think about this harder I will figure out."
Many patients have difficulty maintaining attention because they are either 1) too focused on the wrong thing or 2) don't have enough 'anxiety' to hone in their focus.
It is very difficult to sleep if your brain is telling you that it needs to figure everything out RIGHT NOW.
Social dynamics combine elements of many of these problems. Tolerating the emotional discomfort of setting boundaries can be very difficult for some people.
Many patients have difficulty knowing how to navigate politics and work dynamics to move their career to the next level.
The transition to college can be very difficult. The autonomy combined with the rigors of coursework create a pivotal time for students to create personal structure and discipline.
Many patients feel that they are in a 'fog' and have aren't able to tap into the joy in their lives.
As a communal species the pandemic has exacerbated anxiety and depression in many patients' lives.
Avoidance is the currency of anxiety. Many patients avoid people or situations to help 'manage' their anxiety. Unfortunately, this often makes things worse.
Starting school, changing jobs, retirement, moving to the area-- these are a few examples of transitions in life. These transitions can be fraught with 'overthinking', anxiety, and insomnia.