Adult Therapy
Therapy for what hurts, what keeps repeating, and what you want to understand more deeply.
Adults come to therapy for many different reasons.
Sometimes something is clearly wrong.
Anxiety has become difficult to manage. Depression has made life smaller. OCD is consuming increasing amounts of time and attention. A painful experience from the past continues to intrude into the present. A relationship has become a source of distress rather than connection.
Other times, life is functioning reasonably well and the problem is harder to name.
You may keep finding yourself in versions of the same relationship.
You may understand intellectually why you behave as you do and remain frustrated that understanding has not changed the pattern.
You may have accomplished many of the things you once hoped to accomplish and feel unexpectedly dissatisfied with the life those accomplishments produced.
You may realize that expectations inherited from family, religion, culture, or earlier versions of yourself no longer fit.
Or you may simply have the sense that something could be different.
Therapy does not require a crisis.
It requires enough curiosity to wonder what is happening and whether another way of living might be possible.
Sometimes the Problem Has a Name
Diagnoses can be useful.
Anxiety, depression, OCD, ADHD, and trauma describe recognizable patterns of psychological experience. Naming what is happening can provide relief, guide treatment, and help people discover that experiences they thought were uniquely theirs are actually well understood.
Both Zach and Alicia work with adults experiencing anxiety, OCD, depression, relationship difficulties, identity concerns, and concerns connected with religious experiences or religious trauma.
They also bring different areas of emphasis to their work.
Zach works particularly with ADHD, emotional regulation, perfectionism, motivation, creativity, and the experience of feeling stuck despite understanding intellectually what needs to change.
Alicia works particularly with trauma, codependency, boundaries, relationship patterns, and the ways painful earlier experiences continue influencing life in the present.
Sometimes identifying the problem is the beginning of treatment.
Sometimes it is only the beginning of understanding it.
Sometimes the Problem Does Not Have a Name
Not every difficult human experience fits neatly into a diagnosis.
You may be successful and unhappy.
Connected to people and lonely.
Capable and exhausted.
In a relationship you love while recognizing patterns within it that you do not understand.
You may be questioning a career, a marriage, a religious tradition, an identity, or assumptions about yourself that once seemed settled.
You may notice that you spend much of your life responding to what other people need and have become less certain what you need yourself.
Or perhaps nothing is obviously wrong, but the life you are living feels increasingly disconnected from the person you are becoming.
These are psychological concerns even when they are not psychiatric disorders.
Therapy provides a place to take them seriously.
Anxiety, Worry & Overthinking
Anxiety often begins as an attempt to protect us.
We anticipate problems.
Think through possibilities.
Prepare.
Avoid unnecessary risks.
Pay attention to what could go wrong.
Those capacities are useful until they become difficult to turn off.
A person may begin replaying conversations, researching decisions far beyond the point of usefulness, seeking reassurance, avoiding unfamiliar situations, or mentally rehearsing possibilities that may never occur.
Sometimes anxiety becomes visible as panic or obvious fear.
Sometimes it hides inside conscientiousness, responsibility, or the determination to make the right decision.
Both Zach and Alicia work extensively with anxiety and the many forms it can take.
The goal is not to become careless.
It is to develop enough flexibility that caution, reflection, and responsibility remain capacities rather than requirements.
OCD & Intrusive Thoughts
OCD is another shared specialty at Neuma.
Both Zach and Alicia work with obsessive-compulsive disorder, including presentations involving intrusive thoughts, checking, reassurance seeking, primarily mental compulsions, relationship OCD, moral and religious scrupulosity, contamination, responsibility fears, and other forms of obsessive doubt.
OCD often takes hold of questions that matter deeply to the person experiencing it.
Am I a good person?
Did I hurt someone?
Do I really love my partner?
What if this thought means something about me?
What if I made the wrong decision?
What if I am not remembering correctly?
The attempt to obtain certainty can become more disruptive than the original question.
Treatment involves learning to recognize that cycle and develop a different relationship with uncertainty, intrusive thoughts, and the compulsions that promise relief but ultimately keep the problem alive.
Both clinicians understand OCD as a condition requiring knowledgeable, evidence-informed treatment while still recognizing that the person experiencing OCD is considerably larger than the disorder.
EXPLORE ANXIETY, OCD & PERFECTIONISM
Depression & Disconnection
Depression can look like sadness.
It can also look like exhaustion, irritability, numbness, withdrawal, diminished motivation, loss of creativity, difficulty experiencing pleasure, or the sense that life has become something to manage rather than inhabit.
Sometimes treatment begins with helping someone function again.
Getting out of bed.
Going to work.
Eating.
Sleeping.
Reconnecting with people.
Doing enough that life begins to acquire momentum.
But depression can also raise larger questions.
What has been lost?
What has become disconnected?
What needs have gone unattended?
What expectations have become impossible to sustain?
What relationships or circumstances are contributing to the way life currently feels?
Both Zach and Alicia work with depression and approach it in the context of the person's history, relationships, circumstances, and larger sense of self.
Feeling better matters.
So does rediscovering what makes feeling better worthwhile.
Trauma & the Continuing Influence of the Past
The past does not remain psychologically important simply because it happened first.
It remains important when it continues shaping the present.
Trauma may involve experiences that are obviously overwhelming: abuse, violence, danger, loss, or catastrophe.
It can also develop through repeated relational experiences that teach someone enduring lessons about themselves and other people.
Do my needs matter?
Are other people safe?
What happens when I disappoint someone?
Can I trust my own perceptions?
What do I have to do to remain loved?
Some of those lessons were adaptations to circumstances that no longer exist.
They can nevertheless continue appearing in relationships, emotional reactions, boundaries, self-concept, and the ways people respond to vulnerability.
Alicia has particular expertise in trauma and is certified in EMDR, which she integrates with a broader relational and psychodynamic understanding of the person.
Trauma treatment is not about endlessly returning to the past.
It is about reducing the extent to which the past must continue organizing the present.
ADHD in Adulthood
Adult ADHD is frequently misunderstood as a simple difficulty paying attention.
Its effects can extend into motivation, time perception, organization, emotional regulation, task initiation, follow-through, relationships, household responsibilities, work, and the ability to translate intentions into action.
This can be particularly confusing for intelligent and capable adults.
Someone may manage complicated professional responsibilities while repeatedly forgetting ordinary tasks at home.
They may perform exceptionally under pressure while being unable to work consistently without a deadline.
They may understand exactly what needs to happen and still experience an enormous gap between intention and action.
Over time, people often develop explanations for these experiences.
Lazy.
Irresponsible.
Undisciplined.
Not living up to my potential.
Zach works particularly with adults with ADHD, including both the practical challenges of executive functioning and the psychological consequences of spending years struggling with tasks that appear as though they should be easy.
The work may involve strategies.
It may also involve reconsidering the story someone has learned to tell about themselves.
Emotional Regulation
Emotional regulation does not mean remaining calm all the time.
Healthy people become angry.
Anxious.
Sad.
Excited.
Overwhelmed.
The question is what happens next.
Some people experience emotion so intensely that it quickly becomes difficult to think, communicate, or choose how to respond.
Others have learned to regulate emotion primarily by disconnecting from it.
They remain composed, functional, and reasonable while gradually losing access to information their emotions might be providing.
Zach has a particular interest in helping people understand their emotional systems: what activates them, what they have learned to do with difficult feelings, and what different emotional responses may be attempting to accomplish.
The goal is neither emotional control nor emotional indulgence.
It is increasing the capacity to experience emotion without automatically being governed by it.
Relationships & Recurring Patterns
Relationships have a remarkable ability to reveal patterns that remain less visible elsewhere.
We may become anxious when someone pulls away.
Withdraw when someone gets too close.
Take responsibility for another person's feelings.
Avoid conflict until resentment accumulates.
Become intensely sensitive to criticism.
Struggle to identify what we need.
Or repeatedly find ourselves in relationships that feel strangely familiar even when we consciously want something different.
Both Zach and Alicia approach therapy relationally and psychodynamically.
That means we are interested not only in what happens between people, but in how those patterns developed and why they remain compelling.
Understanding a relationship pattern does not automatically change it.
But it can create the possibility of recognizing the pattern while it is happening rather than only afterward.
Codependency, Boundaries & Losing Yourself in Relationships
Some people become extraordinarily good at attending to other people.
They anticipate needs.
Manage conflict.
Keep relationships functioning.
Notice subtle changes in mood.
Accommodate.
Help.
Fix.
These capacities may be expressions of genuine generosity.
They can also become ways of maintaining safety and connection.
Over time, a person may become much more skilled at identifying what everyone else needs than identifying what they need themselves.
Boundaries can feel selfish.
Another person's disappointment can feel intolerable.
Saying no can create disproportionate guilt.
Alicia has particular expertise in codependency, boundaries, and relationship patterns in which caring for other people gradually becomes indistinguishable from taking responsibility for them.
The goal is not to become less caring.
It is to develop relationships in which care does not require disappearance of the self.
Identity & the Person You Have Become
Identity development does not end in adolescence.
Adults continue changing.
Sometimes the identities that once organized life stop fitting.
A person who has always understood themselves through achievement may become uncertain after reaching a major professional goal.
A parent may wonder who they are as children become more independent.
A religious identity may change.
A relationship may end.
A career may no longer feel meaningful.
A creative life that once seemed central may have gradually disappeared beneath other responsibilities.
These transitions can be disorienting because identity provides continuity.
It tells us who we are and what we are supposed to do next.
Therapy can create room to examine which parts of an identity remain meaningful, which were inherited, which developed as adaptations, and which may need to change.
The goal is not to discover some perfectly fixed authentic self hidden underneath everything else.
It is to become more capable of participating consciously in the person you continue becoming.
Religion, Spirituality & Religious Trauma
Religion can shape identity, family relationships, morality, sexuality, community, purpose, and a person's understanding of what makes a life meaningful.
For many people, faith remains an important source of connection and meaning.
For others, religious experiences become associated with fear, shame, coercion, exclusion, family conflict, or painful experiences that continue influencing life long after beliefs themselves have changed.
Both Zach and Alicia work with adults exploring religious experiences, religious trauma, changing beliefs, spirituality, or the process of reconsidering ideas that were once treated as unquestionable.
Our role is not to move clients toward faith or away from it.
It is to provide enough psychological room to examine what happened, what remains meaningful, what caused harm, and what a more personally owned relationship with belief—or unbelief—might look like.
Creativity, Creative Blocks & the Psychological Life of Making Things
Creative work can become psychologically complicated precisely because it matters.
Writing, music, visual art, performance, and other forms of creative work require putting something personal into the world without being able to control how it will be received.
That creates vulnerability.
Creative blocks can involve perfectionism, self-criticism, fear of failure, fear of success, comparison, burnout, performance anxiety, or the gradual transformation of something once intrinsically meaningful into another arena for achievement.
Zach has a particular interest in working with artists, writers, musicians, performers, and other creative people.
Sometimes the work belongs in psychotherapy because creativity has become entangled with anxiety, depression, ADHD, trauma, identity, or other psychological concerns.
When the primary concern is growth, creative practice, or discernment rather than treatment of a mental health condition, Creative Coaching may be the better fit.
Feeling Stuck
One of the more frustrating reasons people seek therapy is that they already understand the problem.
You know you are too hard on yourself.
You know you avoid conflict.
You know you procrastinate.
You know you keep seeking reassurance.
You know you should establish a boundary.
You know the relationship pattern is familiar.
You may even know exactly where it came from.
And you continue doing it.
This is where psychological work becomes more interesting than advice.
People rarely maintain painful patterns simply because no one has explained that the pattern is unhealthy.
Usually something about it still feels necessary.
A perfectionistic part may believe criticism is what keeps you successful.
An anxious part may believe worry prevents catastrophe.
A conflict-avoidant part may believe disagreement threatens connection.
A hyper-independent part may have learned that depending on other people is dangerous.
Understanding what a pattern is protecting can make change possible in ways that simply arguing with the pattern often does not.
Two Clinicians, Different Ways of Working
Zach and Alicia share a basic understanding of psychotherapy.
Both approach people relationally and psychodynamically. Both are interested in how earlier experiences and important relationships shape present patterns. Both believe symptoms deserve treatment without reducing the person to the symptoms.
But we are different therapists.
And that matters.
Zach's work frequently incorporates Internal Family Systems and other parts-oriented approaches, Acceptance and Commitment Therapy, Exposure and Response Prevention, narrative work, and psychoeducation. He tends to be interested in internal conflict, protective patterns, identity, meaning, and the experience of knowing intellectually what should change while another part of the person remains unconvinced.
Alicia's work is strongly relational and trauma-informed. She is certified in EMDR and has particular expertise in trauma, codependency, boundaries, couples, and family systems. Her work often attends closely to the ways earlier relationships and painful experiences continue shaping expectations, emotional responses, and relationships in the present.
These differences are not rankings.
They are differences in fit.
Some clients will immediately feel more drawn to one approach, personality, or perspective.
Others may simply know what they want help with and want us to help determine who makes the most sense.
IFS Therapy
Internal Family Systems begins with the observation that people contain different parts of themselves.
We can want change and resist it.
Want intimacy and fear it.
Want rest and feel guilty whenever we stop working.
Know intellectually that something is safe while another part of us remains unconvinced.
IFS approaches those apparent contradictions with curiosity.
Rather than treating difficult parts of ourselves as irrational obstacles that need to be eliminated, we become interested in what they are trying to accomplish and what they fear might happen if they stopped.
Zach is trained in IFS and frequently incorporates parts-oriented work into therapy with adults experiencing anxiety, perfectionism, trauma, self-criticism, limiting beliefs, internal conflict, and the experience of feeling stuck.
EMDR Therapy
Eye Movement Desensitization and Reprocessing is an evidence-based psychotherapy used extensively in the treatment of trauma and distressing experiences.
EMDR can help people process experiences that remain psychologically active long after the event itself has ended.
Alicia is a certified EMDR therapist and integrates EMDR into her broader relational and psychodynamic work.
The aim is not to erase a memory or convince someone that an experience did not matter.
It is to help the experience become more fully processed so that remembering what happened no longer requires reliving the same psychological response.
Therapy, Coaching, or Both?
Not every concern that involves psychology requires psychotherapy.
Questions about vocation, habits, relationships, life transitions, communication, creativity, boundaries, or personal growth may occur without a mental health condition requiring treatment.
For those concerns, coaching may be appropriate.
The distinction is not that therapy is for serious people and coaching is for people with minor problems.
They are different kinds of relationships organized around different purposes.
Therapy is healthcare. It is appropriate when we are treating psychological symptoms, disorders, trauma, or patterns of distress and impairment.
Coaching is oriented toward development, discernment, psychoeducation, growth, and the intentional cultivation of capacities someone wants to strengthen.
Sometimes it is immediately obvious which makes sense.
Sometimes we can figure that out together.
More Than Functioning
Adults become remarkably good at functioning.
We work.
Pay bills.
Care for children.
Maintain relationships.
Answer emails.
Complete tasks.
Keep schedules.
Meet expectations.
Functioning matters.
But it is possible to become extremely competent at maintaining a life without periodically asking whether the life being maintained is one we actually want.
At Neuma, we want therapy to help reduce anxiety, depression, compulsions, trauma responses, relationship distress, and the other forms of suffering that bring people into treatment.
We also want to remain interested in what becomes possible when suffering occupies less space.
Greater self-understanding.
More satisfying relationships.
Healthier boundaries.
Creativity.
Discernment.
Meaning.
The freedom to make decisions without being governed entirely by fear or expectation.
The ability to participate more deliberately in one's own life.
There is no reason for psychological health to stop at functioning.
In-Person & Online Adult Therapy in Wisconsin
Zach and Alicia provide in-person adult psychotherapy from our office in Glendale, Wisconsin, serving Milwaukee and surrounding communities including the North Shore, Mequon and Thiensville, Wauwatosa, Brookfield and Elm Grove, and the greater Milwaukee area.
Online therapy is also available throughout Wisconsin, including Madison and surrounding communities.
Telehealth can make it possible to choose a therapist based more on expertise and fit than on whether their office happens to be within a few miles of home.
Both in-person and virtual therapy can support meaningful psychological work.
Finding the Right Therapist
You do not need to know whether Zach or Alicia is the better fit before contacting us.
You also do not need to know what diagnosis describes what is happening or which therapy modality you need.
Tell us what has been difficult.
Tell us what keeps happening.
Tell us what you hope might be different.
From there, we can help determine which clinician and approach seem most appropriate.
Sometimes finding a therapist begins not with knowing exactly what kind of treatment you need, but with finding someone whose way of thinking about people makes sense to you.