Portrait of Dr. Rachael St. Claire

Psychotherapy for Adults in Colorado: Working Together, Getting to the Heart of the Matter

I provide psychotherapy for adults across Colorado by secure video. Stress, loss, illness, or a major life transition can leave any of us stuck in worry, sadness, or overwhelm. Often, though, the trouble is older than the circumstances: the same difficulties keep returning in how we treat ourselves—shame, self-criticism, perfectionism, feeling unseen—and in how we relate to others, in love, family, or work.

These patterns may show up as depression or mood swings, chronic worry, intrusive thoughts and compulsions, insomnia, or the lasting marks of hurtful relationships. Feeling better matters. So does understanding why these patterns continue, which is what allows change to last.

How I Work

Symptoms arise from how we learned to feel, think, and relate to others, usually to protect ourselves. Over time these become enduring patterns we are mostly unaware of. My work is grounded in psychodynamic psychotherapy: within an honest, trusting relationship that develops over time, we look at these patterns as they show up in your life and in our sessions, and understanding deepens. A diagnosis describes symptoms but rarely explains them. Understanding what drives them is what allows real change.

I am also trained in Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), exposure and response prevention for OCD, Dialectical Behavior Therapy (DBT), and mindfulness-based approaches. When practical skills would help with problem thoughts, emotions, or behaviors, I teach them. Insight and skills work together.

I have practiced as a licensed psychologist in Colorado since 1991 and continue to advance my work as a current trainee in the Columbia University Adult Psychodynamic Psychotherapy program. For people who want to go deeper, I also offer twice-weekly psychodynamic psychotherapy at a reduced self-pay fee; see the Appointments page for details.

What I Help With

Most people come to me because something has become hard to live with: worry that will not settle, low mood that keeps returning, thoughts and rituals that take up more of the day than they should, sleep that has stopped being restful. Often the difficulty has a longer history than the current trouble, in how a person has learned to treat themselves and to be with others, and that history is part of what we look at together.

  • Anxiety, chronic worry, and rumination

  • OCD, intrusive thoughts, and compulsive behaviors

  • Depression and mood disorders across adulthood

  • Relationships, self-worth, and longstanding patterns

  • Chronic illness, identity, and emotional well-being

  • Insomnia and sleep problems related to anxiety or mood

I also see couples when the relationship itself is the concern.

As Tsong Khapa wrote more than six centuries ago:

The human body at peace with itself,
is more precious than the rarest gem.
Cherish your body, it is yours for this one time only.
The human form is won with difficulty, it is easy to lose.
All worldly things are brief, like lightning in the sky;
this life you must know, as the splash of a raindrop;
a thing of beauty that disappears, even as it comes into being.
Therefore, set your goal,
make use of every day and night to achieve it.

— Tsong Khapa (1357–1419)