I am a physician. My clinical work is focused on addiction and related conditions — chronic pain, withdrawal, the psychological dimensions of dependence, and the problems of self-regulation that run through all of them. This site is where I write.

The essays here grow out of that work, but they are not confined to it. Clinical practice in addiction medicine opens onto larger questions: how people experience themselves, how they manage what is difficult to bear, what psychoanalytic thinking can illuminate about suffering and its treatment, and what medicine, at its best, is actually trying to do. Some essays address specific conditions or substances. Others move into theory, into the nature of the clinical relationship, or into questions that the work raises without fully answering. What they share is an effort to think carefully about people and the problems they bring.

Featured Essays

What Addiction Actually Is

A starting point for how addiction is being understood on this site.

The Structure of Addiction

On the simultaneous psychological and biological organization that addiction imposes on a person’s inner life.

The Neurobiology of Withdrawal

On withdrawal as a real and often prolonged state of nervous system dysregulation, and what that means for treatment.

Psychotherapy in Addiction Treatment

On what psychotherapy in this context actually involves, and what it asks of both patient and clinician.

Why Addiction Treatment Often Fails

On what treatment leaves untouched when it addresses only part of the problem.

[View All Essays]

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For information about my clinical practice, please visit NYC Private Addiction Medicine.