San Francisco Psychotherapy for Anxiety, Depression, Gay, Queer or Transgender Men, Polyamory, BDSM
San Francisco Psychotherapy for Anxiety, Depression, Gay, Queer or Transgender Men, Polyamory, BDSM

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San Francisco Psychotherapy for Anxiety, Depression, Gay, Queer or Transgender Men, Polyamory, BDSM


Therapy Specialties

I count the following as areas in which I am the most skilled, trained and/or proficient. Some of these have been passions of mine for many years, some are relatively new. I provide a brief synopsis of each for clarity, but these are all areas that could take a lifetime to explore or explain.

  • Gender and Transgender Concerns
    • As a Gender Specialist, I have been working with trans clients since the mid-90's, making me one of the longer-running psychotherapists to work with Trans and Gender Nonconforming (TGNC) populations. Since that time, the options and protections for TGNC individuals have increased dramatically, yet there is still much work to be done in terms of education and advocacy. In terms of approach, while I do continue at this point to maintain my WPATH membership, I personally use an Informed Consent model.
  • Experiential / Somatic Approaches
    • Many clinicians today believe that true learning and unlearning of behaviors and ways of being cannot take place without involving the body and the full realm of the senses. I am currently an advanced student in Hakomi, an experiential therapy modality, and plan to become a certified Hakomi therapist.
  • Alternative Sexualities and Lifestyles
    • Sexual variance, fringe communities, alternative living arrangements; all of these are often misunderstood and judged. I have been working with LGBTQ and similar communities for almost 20 years, and provide a safe, non-judgmental space to explore issues related (and unrelated) to one's alternative way of self-expression.
  • Anxiety & Depression
    • Two of the most common ailments of our time, these mood states can make life increasingly unbearable. In counseling I utilize CBT, mindfulness and experiential approaches to address these potentially crippling states of being.
  • Polyamory & Other Alternative Relationship Configurations
    • Many individuals opt for non-traditional relationship models, of which polyamory is one of the more common (and often one of the most hotly debated). I have worked with many people in the polyamory community, including people like Dossie Easton, author of the original polyamory handbook, The Ethical Slut, whom I count as a colleague and a friend.
  • Trauma Exploration and Resolution
    • Utilizing more somatic techniques, such as found in Hakomi trainings and in the work of Peter Levine, I provide therapeutic treatment for both situational and chronic trauma. Many people are unaware that trauma is sometimes at the root of other difficulties that they are experiencing; having the help of someone knowledgeable in this area can be life-saving.
  • Relationship/Couples Counseling
    • Relationship counseling can be used for a variety of relationships, including family, friends, couples, triads, and other alternative configurations. My orientation is based mostly on Emotionally Focused Therapy (EFT) and other experiential approaches.
  • Substance Use / Abuse
    • Addiction can cause a huge roadblock in the road to wellness and happiness. I have 20 years experience in substance abuse treatment modalities, from 12-Step programs to harm-reduction models.

Other Areas of Interest

  • BDSM/Kink
    • I provide non-judgmental counseling that is kink-aware and sensitive to the particular set of needs of people in these communities. Power dynamics, boundaries, and safety are just some of the issues that can be of particular interest to people attracted to these lifestyles.
  • Grief and Loss
    • Grief and loss are part of life, but can sometimes generate a "stuckness" that causes great difficulty. I assist people in experiencing what they need to experience from these life lessons, and then help them integrate these aspects in a way that allows them to move forward with their lives.
  • Spirituality
    • I am open to working with a wide array of spiritual approaches, and often integrate them into the counseling work itself.
Myles Downes, MFC 48178

3646 24th Street
San Francisco, CA 94110