How I Work

How I Work
People come to therapy for all kinds of reasons. Anxiety that won't let up. A relationship that keeps hitting the same wall. Depression that doesn't quite explain itself. A sense that something is off, even when nothing is obviously wrong. Sometimes people arrive with a clear presenting problem and discover, over time, that it was really a doorway to something else — something older, more private, more interesting.

My job, as I understand it, is to be genuinely curious about that something else.

I've been doing this work since 2009. My training has been deliberately eclectic — grounded in modern psychoanalysis and classical psychodynamic theory, and expanded over the years to include somatic psychotherapy, relational and intersubjective approaches, ISTDP, mindfulness, DBT, family systems, and CBT. I keep training because the work keeps asking more of me, and because no single framework is adequate to the full range of what people bring into the room.

In practice, what this means is that I don't apply a method to you. I try to understand you — how you're put together, what you're carrying, what has and hasn't worked before, and what kind of support will actually be useful. Some people need something structured and skills-focused alongside the deeper work. Some need room to talk and follow the thread wherever it leads. Most need both, in different proportions at different times.

What happens in sessions
We talk. That's the medium. But it's a particular kind of talking — one that pays attention not just to the content of what you're saying, but to the emotional texture underneath it. The way something lands in the body. The thing you almost said. The pattern you've noticed yourself repeating without quite being able to stop.

I'm an engaged, active presence in sessions. You won't get someone nodding neutrally and waiting for you to arrive at the answer. I ask questions. I share observations. I'll sometimes say something that surprises you, or that you'll need to sit with before you know if it fits. The therapeutic relationship itself is part of the work — what happens between us, the feelings that arise, the moments of being understood and the moments of misunderstanding — all of it carries information about how you move through relationships more broadly.

At the same time, I'm not in a hurry. There's no agenda I'm pushing. The pace of good therapy follows the person, not a protocol, and I've learned to trust that the work finds its own rhythm.

What I specialize in
I work with adults and young adults across a wide range of presentations: anxiety and depression, relationship difficulties, identity and purpose, addiction, trauma, grief, life transitions, and the more diffuse suffering that arrives without a clear name. I also work with clinicians — early and mid-career therapists who want case consultation, a sharper clinical lens, or a place to think through the work that keeps them up at night.

I have particular interest in people who've tried therapy before and found it useful but incomplete — who are ready to go further, or who are looking for something more exploratory than symptom-focused. And I'm drawn to people who are curious about themselves, even when that curiosity is uncomfortable.

A few things worth knowing
I practice via telehealth across Oregon, Maryland, New York, and Idaho, with an office in Ashland, Oregon for in-person sessions. I'm an out-of-network provider — I don't bill insurance directly, but I can provide documentation for reimbursement. Sessions are typically 50 minutes, and I work with people at a range of frequencies depending on what the work calls for.

I offer a free 15-minute consultation before we begin, which gives us each a chance to get a sense of fit. Therapy is a significant investment of time, money, and vulnerability, and it matters that it's with the right person.

On the approach, briefly
The psychoanalytic tradition I work in isn't the one that most people have a caricature of — the silent analyst, the relentless excavation of childhood. The past is always with us but how we carry it and regard it in the here and now is just as important, if not more. It takes seriously the idea that much of what drives us operates outside conscious awareness, and that making those patterns more visible — gradually, carefully, at a pace that's bearable — creates real room for change.

About the Author: Andrew Bertell is a licensed clinical social worker with over 15 years of experience in psychoanalytic psychotherapy. He practices in Ashland, Oregon and works with adults and young adults via telehealth throughout Oregon, Maryland, New York, and Idaho.