Dr. Joy PiccolinoMy philosophy of counseling starts off with the belief in the wisdom of my clients, both in how you understand yourself as well as your ability to know what you need to get better. The way I see it, my role is to do my best to understand you and then help you find your strengths and resources to get better. In this way I am like a consultant. I may teach you skills or help you view things from a different perspective, but ultimately it is up to you to carry it out. This is true of any therapist you would see. And while you don’t get to bring me home to coach you through every situation, clients often talk about the doctor in their head, as if I was there helping them out.

My approach to helping people is based in cognitive behavioral principles with psychodynamic influences. Eye Movement Desensitization and Reprocessing (EMDR) training has also strongly influenced my work. EMDR is used to change a negative cognition, or belief, to something positive or more realistic. So now, even if I may not be doing EMDR with someone, I am always listening for the negative belief that needs to be shifted to another perspective or viewpoint.

In counseling, specific strategies to help you resolve the issues that brought you in can be recommended. We can also identify and work to change long-standing patterns that have interfered with life satisfaction. Some clients will come in for one course of counseling to resolve the current life stressor, never to return again. Other clients will enter the counseling relationship with the mindset that it is like that of your physician: you go in when you have a concern, deal with that concern, and return for brief help when a new concern arises. Still others will come in with “work to do” and spend a good deal of time resolving whatever issues are present before ending counseling. These clients will return to counseling at different life stages as they face new stressors.

The most exciting work I do is helping a client transform into a truer form of themselves. Many of our dysfunctional negative beliefs, feelings, and behaviors are developed in response to some painful experience, and they are maintained as a protective mechanism against more pain. Unfortunately, this has the unintended consequence of suppressing our full self.


Working with clients who have experienced a trauma is a specialty of mine. Traumas come in various sorts. It may be a single incident, such as a rape or car accident, or repeated over time, such as childhood abuse or domestic violence. It may be something less dramatic, such as being teased by your peers when you were young or rejected by a friend, but these events can also have a lasting impact. Witnessing violence can also be traumatizing. Our brains naturally process difficult situations and disturbing events, but sometimes the processing of traumas gets stuck and your brain believes that you are still back in that situation. These are situations when EMDR can be particularly helpful because it allows these past experiences to become unstuck and processed so you can move on to more fully living in the present.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma. It has also been used to treat a variety of conditions including other anxiety disorders, depression, and personality disorders, though these areas have been less researched.  EMDR is not for everyone. Appropriateness for EMDR must be evaluated by your therapist.

Although EMDR may appear on the surface to be a simple counseling technique, it is actually a complex approach, containing numerous components that are considered to contribute to treatment effects. For this reason, it is important that if you are seeking EMDR, you look for someone who has completed training through the EMDR Institute or an EMDRIA-Approved Trainer. For detailed information about EMDR, please visit the above websites.

Mind-Body Health

I have long been aware of how the body expresses various stresses, and I am incorporating this understanding into my work more and more. Psychological studies show that your mind and your body are strongly linked. When you are stressed, anxious or upset, your body tries to tell you that something isn’t right. Poor emotional health can weaken your body’s immune system, making you more likely to get colds and other infections during emotionally difficult times. So, taking care of your emotional health is important for your physical health, too.

Helping clients become more aware of and more connected with their body can be very helpful in counseling. Awareness of bodily sensations can help you understand your emotions better. Naming emotions facilitates linking those emotions to causative events, which can then be processed in counseling.

Codependency, Boundaries, & Perfectionism

Many clients I work with have issues in the area of codependency, boundaries, and perfectionism. These issues are often interrelated, but may occur independent of one another.

Codependency was first identified in research on families of alcoholics. The term codependence is now used to refer to any unhealthy dependence within a relationship. Common characteristics include placing the wants and needs of others first, perfectionism, insecurity, lack of boundaries, and need for (or relinquishment of) control.

Boundary problems can be encountered in many different ways, too many to list here. Some clues that you may need stronger boundaries are an inability to say no or ask for help, a tendency to absorb others’ feelings as your own, or sharing too much information too quickly or not sharing information at all. Developing healthier boundaries takes time, but it can lead to improved self esteem and increased intimacy in relationships.

Perfectionism is present more and more in our culture due in large part to increasingly high expectations we have for ourselves and our children. It is particularly an issue for mothers in this age of Martha Stewart and parenting experts. Men also often find it hard to live up to societal expectations that demand nothing less than the best. While perfectionists may appear to be strong and capable, many of them are driven by insecurity — and that kind of fuel is mentally draining. Aiming for a 0% margin of error will make achieving your goals extremely difficult, if not impossible. If you find that you are so busy trying to keep up with all the things on your “to do” list and you can’t give yourself a break to enjoy the good things in your life, you may be struggling with perfectionism.

All of these issues invariably affect one’s quality of life. If they sound familiar to you, I can help. With my expertise and your strengths, we can work collaboratively toward improving the quality of your life.