- Cognitive-Behavioral Approaches
- Gestalt/Body Approaches
- Humanistic Inter-Personal Approaches
- Community Therapy / Approaches
- 12-Step Programs
- Holistic Healing
- Relationship The Counseling Approaches
- Jungian Transpersonal Approaches
- Religious Abuse
- Healing Sexual, Emotional, and/or Physical Abuse Survivors
- Healing Abusive Relationships
- Healing Perpetrators and Victims of Abuse
Dr. Karr’s private practice is broad in nature. His work includes individual, couple, and group therapy. Dr. Karr has extensive training in behavioral and cognitive approaches including sex therapy, systematic desensitization, hypnosis, guided visualizations, relaxation methods, as well as Jungian depth approaches, including dream work, archetypal and other analytic processes.
Dr. Karr respects the needs, desires, and wants of his clients. He offers a variety of approaches, but he does not impose anything on anyone. The client has the right to say no to any suggestions. Dr. Karr is comfortable dealing with a traditional talk oriented individual therapy with clients who so choose.
It may appear on the surface that some of the diverse philosophies and methods used by Dr. Karr might be in conflict or incongruent with each other. However, a skilled practitioner, like Dr. Karr, is able to determine which method is appropriate for a particular client, or a particular time or issue in the course of a client’s treatment. There have been many clients that Dr. Karr has seen, where the first several years of therapy have required cognitive behavioral approaches to help a client get their life in order and create a high enough level of a functioning to move on to analytic depth approaches. Other clients in analysis may enter a period of external life crisis where analytic focus must be put aside and cognitive behavioral approaches be utilized on order for them to survive their crisis.
He sees a variety of clients in terms of age, sex, sexual orientation, race and ethnicity. He utilizes a large variety of clinical approaches and methods depending upon the needs and desires of a given client or clients. He has over 28 years of clinical experience in individual, couple, and group therapy approaches. He currently sees individuals and couples, and facilitates ongoing long-term groups.
Dr. Karr had extensive training at the University of Washington, one of the primary centers of cognitive behavioral therapy, in a variety of cognitive behavioral methods of treatment. Cognitive Behavioral methods involve identifying a problem or issue, and developing an intention or goal concerning this issue, and then working out a methodology to achieve this goal.
Cognitive Behavioral approaches demand an active involvement in the process of change outside of the therapy time and relationship. Clients are encouraged to read, study and try new behaviors in their life. Often it is suggested that a client puts in at least four hours of time per week upon homework related to the therapy goal. This homework for an introverted person might include forcing themselves to go to a club meeting, or a bar, or some situation, which is uncomfortable for them. Cognitive behavioral therapy is primarily concerned with changing thought patterns and behavior in the present.
The past is of interest only in terms of identifying the negative behavioral and thought patterns. The present is of the greatest focus for change. The cognitive-behavioral approach discourages the repetitive replaying of the old painful dramas of childhood like a broken record. A cognitive behavioral therapist would encourage a client to develop new ways of thinking about their issues along with new ways of acting or being. Such therapy encourages a focus upon the present and future, which we may change, and downplays the past and our ways of thinking about it, as what is in the past cannot be changed.
Behavioral approaches include such things as sex therapy, systematic desensitization to fear and other negative emotion, positive thinking and visualization, re-scripting negative belief systems, identifying negative and destructive thought and behavioral patterns and changing them, re-parenting oneself, identifying one’s power and gifts and expressing them, goal setting, boundary setting, self-control, improving self-esteem, social skills training to improve one’s relationships with others, and creating a new effective self.
Dr. Karr’s extensive training in sex therapy approaches and in Tantric yoga, meditation and philosophy have exposed him to the effectiveness of various Gestalt and body approaches to healing. He utilizes these methods when appropriate. The Gestalt/Body approach differs greatly from the cognitive-behavioral approach, concerning the issue of the past. It is the primary goal of the Gestalt/Body approach to bring the past body memory into the present, re-experience it, and then release it. Dr. Karr in his groups, for example, uses Gestalt psycho-drama, which involves acting out previous painful experiences, especially past childhood, and thereby releasing it. Group members play out the characters of the participants in the childhood drama enabling the person to work through in the present, as an adult, the experiences that they could not deal with as a child. The methodology of Gestalt/Body work is aimed at a deep fully physical and emotional re-experiencing of wounding events versus a thinking repetitive mechanical replaying of the event.
Humanistic Inter-Personal Approaches
It is the philosophy of various Humanistic/Interpersonal therapy approaches that the real relationship of intimacy, which may develop between the client and the therapist, is of primary importance in the healing process for the client. It is not meant by this personal involvement that the client and therapist have personal contact outside of the standard clinical session. Rather, it is that the therapist steps up to the plate and shares his truth, life and experience. This is very different from a traditional Freudian analytic approach where the therapist does not share anything personal about himself/herself, and rather the emphasis is upon the client’s ability to project on to the blank screen of the analyst.
Dr. Karr over the last 28 years has been very involved in various gay, lesbian, transgender counseling centers which have all emphasized a community interpersonal based approach to therapy for gay, lesbian and transgender people. He believes strongly in this approach and shares his truth, his life, his wisdom, and his experience with clients when appropriate. He shares his pains, his hurts, his successes, and his failures, in order to model the concept that a whole human being is not perfect. He has a caring, personal, sharing relationship with his clients. Some of Dr. Karr’s clients have later in therapy shared that their relationship with him was for them the first place where they became comfortable being intimate and sharing themselves with another person without criticism or judgment. It is the hope that the therapy relationship can become a model for intimacy whereby the client can take, outside of therapy, the skills necessary to build healthy relationships with other people.
Community Therapy / Approaches
Dr. Karr’s extensive experience has contributed to his belief of connecting clients with various community organizations, services and activities. It is Dr. Karr’s extensive experience that individual therapy is greatly facilitated by encouraging and referring clients to various organizations within the community in which the client can develop connectedness with others. These organizations provide extensive resources which Dr. Karr encourages clients to become involved with as members and volunteers.
Dr. Karr especially supports the various 12-step groups as being particularly effective in helping people with issues of addiction and co-dependency. Dr. Karr feels that individual therapy by itself may be helpful for many people, but healing can be speeded up greatly by utilizing the many resources that exist in our SF Bay community.
Dr. Karr refers his clients, if they are open to it, to various holistic healers including naturopaths, doctors, yoga teachers, body workers and others. Dr. Karr believes strongly that healing is greatly facilitated by working with the mind, the body, and the spirit.
Relationship Counseling Approches It is Dr. Karr’s experience in his 28 years of therapy with people that issues of difficulty with intimacy and relationship are core. Many people have felt rejected by their families, friends, and communities and have developed defenses and facades in order to survive in the world. These patterns may help survival, but they sabotage intimacy around issues of trust, honesty, and disclosure. It is a long slow process for these people to develop self-confidence and the necessary intimacy skills in order to risk honest communication with those we become close to. Additionally, we must explore and discover our own models and versions of relationships, which may be very different from the traditional model. Many people who have been rejected by their families of origin must develop their own relationship skills to create families of choice.
Couples/Relationship Therapy Dr. Karr has co-created his own long-term relationship. This relationship, like his analytic relationship with his teacher/analyst has provided a place of exploring and learning about intimacy. His personal relationship is a safe container for them both to grow and develop as individuals as well as partners.
With his clients, Dr. Karr shares the learning, experience, joy and suffering he has undergone in his relationship. He is non-judgmental of relationships and honors people’s choices in diverse sorts of relationships including S&M relationships, mï¿½nage a trois relationships (triads), bisexual relationships, polyamory, polyfidelity, as well as traditional monogamous relationships.
Couples’ therapy tends to be short-term, (six to eight months). Dr. Karr focuses with people creating their goals and intentions. He utilizes a number of cognitive behavioral approaches in couples relationship therapy. Homework is used. Sex therapy may be utilized when appropriate. A major focus is placed upon developing and using communicating skills. It is Dr. Karr’s perception in seeing a large number of relationships that a number of conflicts are related to people speaking different emotional languages. It is important in relationship counseling for clients to learn the emotional language that their partners use, and not assume that their words mean the same thing as if they had used those words themselves. Dr. Karr focuses on helping clients to learn the art of loving. Eric Fromm, in his famous book, The Art of Loving, emphasizes that most Americans conceive of love as a shopping list of their own needs rather than understanding that love is a verb we do. Important core issues in relationship counseling include co-dependency, commitment, trust, honesty, boundaries, communication expectations, acceptance, patience, honoring and listening to the other, and putting a voice to one’s emotion and truths. Dr. Karr focuses a great deal on clients developing the ability to be active listeners.
Dr. Karr feels strongly that relationships need to be honored and supported in the therapeutic relationship. Many relationships may appear very dysfunctional and it would be easy to quickly decide to facilitate their demise. However, Dr. Karr believes that it is important for a therapist to encourage a wounded relationship to become healthy. Relationships should be given a chance. Dr. Karr believes it is not his place to be a party to the ending of a relationship, rather that needs to be the people involved’s decision. It is also his experience that many relationships improve greatly when they are supported and encouraged to develop better communication and relationship skills through therapy.
Many people have difficulty getting into long-term intimate relationships. They may have a pattern of vulnerability and hurt in previous relationships, they may lack relationship kills in order to create a long-term relationship. Group therapy provides an opportunity for people to develop intimacy and relationship skills with others in the context of the group they are then encourage to utilize these skills in developing intimate relationships in the outer world. The same approaches in relationship counseling are utilized to facilitate intimacy and communication between group members. Group members are encouraged in developing skills of active listening and communicating their truth in group. Group members are encouraged to develop the ability of communicating their emotions to other people.
Jungian Transpersonal Approaches
Dr. Karr works with some clients utilizing his extensive experience with Jungian analytic philosophy and process. He completed twenty-two years of analysis with his Jungian analytic teacher/analyst. He utilizes dream work, psychodrama and psycho-play. Work with the archetypes include the shadow, anima and animus, puer aeternis, king, warrior, magician, mother, maiden and crone, etc. He also teaches various methods of meditation, shamanistic journeys, and guided journeys to facilitate the client connecting and becoming aware of the deepest aspects of consciousness. Jungian transpersonal approaches, unlike most other psychotherapy approaches, recognize and honor the spiritual nature of being a human being. The spiritual experience of the client is valued as being an essential aspect of the therapeutic process. It is as real and important as a person’s work life, relationship life, body life, and mind. A person’s spiritual beliefs and history can be an important facilitator of psychological healing. A transpersonal psychologist, such as Dr. Karr, utilizes the wholeness of mind, body and spirit for healing within the sacred alchemical container of the psychotherapy relationship. Dr. Karr does not impose his spiritual beliefs. Neither does he introduce the spiritual dimension upon clients who do not choose to deal with this dimension. Some of Dr. Karr’s groups also incorporate Jungian methods.
Religious Abuse A large number of people have experienced extensive religious abuse and damage. This abuse may have occurred within their own childhood and family of origin, or it may have been experienced culturally in terms of Christianity and/or other major traditional religion’s abuse and oppression. Many people have rejected spirituality and religion because they were rejected themselves. Many individuals who have rejected their religion of origin and think that they have completed their issues with it suffer from self-hate, self-deprecation, and self-rejection unconsciously. Dr. Karr feels that it is an important part of the healing process to explore the ramifications and possibilities of religious abuse and the damage it has caused. A common and major damaging result is that many people have thrown the baby out with the bath water, rejecting their own spiritual and religious nature.