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 cis-identified 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. As this is one of my main specializations, I have created a Gender page to describe my approach in more detail.
  • Polyamory & Other Alternative Relationship Configurations
    • Many individuals currently are opting for less traditional relationship models, including consensual non-monogamy, polyamory being perhaps its most well known variation. I have worked with many people in these communities, including people like Dossie Easton, author of the original poly handbook, The Ethical Slut, whom I count as a colleague and a friend.
  • 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.
  • Anxiety
    • Dealing with anxiety and worry about the future can often make life increasingly unbearable, causing you to lose sleep, agonize over decisions, have problems in your relationship(s), and in more extreme circumstances even have panic attacks.  The constant state of stress can often lead to clinical depression and physical health problems.  In counseling I utilize mindfulness, experiential approaches and occasionally CBT to address this potentially crippling state of being.
  • 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 over 20 years, and provide a safe, non-judgmental space to explore issues related (and unrelated) to one's alternative way of self-expression.
  • 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 ways of being.
  • 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.
  • 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.
  • Mindfulness
    • With all of the above my primary approach is one based on Mindfulness (though I use other modalities as well, such as psychodynamic talk therapy, expressive arts, etc.).  My definition of mindfulness is actually pretty simple:  “A non-judgmental observation of in-the-moment experience.”  Increasingly mindfulness is being seen as greatly beneficial for a wide range of concerns and conditions, and can often shift things for you faster than other approaches.
Myles Downes, MFC 48178

3646 24th Street
San Francisco, CA 94110