Are You a Mom or Dad Who Has Had Thoughts About Hurting Your Baby?

“What is Postpartum Obsessive-Compulsive Disorder (OCD), and What does it Mean about how I’ll Treat my Baby?”

Postpartum depression has, for good reason, garnered more attention in the media and more resources in communities of late. However, postpartum OCD is not often discussed and, unfortunately, misunderstood by many. So what is postpartum OCD, and what does it mean to suffer from it?


Brain Sleuth: How Neuropsychology Helps Solve Mysteries of The Brain

Neuropsychologist, Brain Detective

As a neuropsychologist, I’m often asked, “What is it you do, exactly?” or more commonly, “What IS neuropsychology?”

One way to think about it is like detective work – a neuropsychologist is like a sleuth solving cases. Cases of the brain, that is.

When something goes wrong in the brain, it can cause quite baffling or bewildering symptoms. Simply put, the brain is complex!  To me, figuring out those complexities is endlessly fascinating, which is one of the reasons I became a neuropsychologist.

The Remarkable Brain

I’ve always been intrigued by the brain and how it works. Did you know…

  • The brain is the control center for all our actions and thoughts, from basic movements to advanced skills.
  • It is estimated that each brain contains 86 billion neurons, or brain cells.
  • The human brain doesn’t reach maturity until approximately age 25.
  • It is our only organ packed in layers of protective cushioning and bony armor.

Many mysteries about the brain remain unanswered, though researchers are discovering more each day. As a neuropsychologist, each patient I assess presents me with an opportunity to discover new insights into the brain.

Brain Changes

Despite our bodies’ best-laid brain protection plans – meninges, protective fluid, the skull – our brains are still susceptible to injury and disease.

An injury or disease involving the brain can hinder its ability to function properly. More often than not, symptoms occur spanning multiple areas of functioning, such as:

  • Cognition
  • Emotion
  • Sensation
  • Motor/movement

Symptoms can massively vary from person to person. They aren’t always apparent on the outside, unlike other physical injuries (e.g., a broken arm). Nonetheless, “invisible” symptoms are very much felt by the individual experiencing them.

What Can Be Done?

Neuropsychology is concerned with how the brain is functioning and how it influences a person’s cognition and behavior. We are psychologists with extensive training in functional neuroanatomy, neurological disorders, and other conditions that involve the brain and the rest of the nervous system.

A neuropsychologist can help identify:

  • If there’s brain dysfunction
  • What may be causing an individual’s cognitive symptoms
  • The degree to which cognition is affected
  • What can be done about it
  • Response to interventions

Diagnosing the cause and extent of problems in the brain is a complex process. It can be difficult to accurately pinpoint a specific disease process, predict someone’s recovery from an injury, or choose the most appropriate interventions to treat brain-based conditions.

Solving The Mystery

Back to the concept of neuropsychology as detective work- it’s true in many ways. Each case presents a unique mystery to be explicated.

A neuropsychologist works through proven steps to address each unique case.

  • Gathering evidence:
    • A neuropsychologist begins to collect evidence from the time of referral. What are the patient’s symptoms, relevant medical history, observations, etc?
  • Identifying Leads:
    • The neuropsychologist uses all the collected information to make hypotheses about what might be going on inside the patient’s brain.
  • Testing hypotheses:
    • The neuropsychologist explores hypotheses through the neuropsychological evaluation, administering a set of cognitive tests.
    • The patient’s performance across these tests reveals more clues.
  • Interpreting results:
    • The neuropsychologist can detect what disease or combination of factors best account for the patient’s symptom by interpreting test performance in view of normative samples and/or expected abilities, as well as the patient’s unique history.

 The Conclusions

Neuropsychologists are detectives in a way, but they’re also psychologists. That means their deductive process doesn’t end once a diagnosis is reached or ruled out!

After integrating all the clues, the neuropsychologist helps guide what to do next. This may include referrals to other specialists, treatments, and other recommendations to help resolve, reduce, or compensate for their difficulties.

Neuropsychologists help treat individuals who have suffered a brain injury, whatever the cause. They also help the individual and loved ones navigate the unpredictable, often uncertain journey that follows. This is done by coordinating their care, collaborating with other providers, and following up to ensure treatment recommendations are meeting the patient’s needs.

Who Should See A Neuropsychologist?

When individuals experience cognitive changes- such as significant forgetfulness, decline in communication, disorientation- without obvious explanation, a neuropsychological evaluation can help identify the problem.

Neuropsychological evaluations can also track cognition over time, such as in recovery from injury, assessing effects of a medical treatment, or if there’s concern about a neurodegenerative disease.

As a neuropsychologist, I typically evaluate:

  • Neurologic conditions
    • Hydrocephalus, multiple sclerosis, epilepsy (seizures), brain tumors, encephalitis, cerebrovascular disease, stroke, known or suspected dementia
  • Neurodevelopmental disorders
    • Learning disorders, ADHD
  • Effects & recovery after brain injury
    • Traumatic brain injury (TBI)
    • Acquired injury due to anoxia, toxin exposure, electrical injury
  • Cognitive symptoms in the context of complex medical problems
    • Autoimmune disease, certain genetic disorders, sleep-related problems, chronic heart or respiratory problems
  • Individuals who had prior neuropsychological testing and are seeking a second opinion after unsuccessful interventions

If you have a case for me, I’m here to help you solve it. Call (212) 335-2100 to chat with me or schedule an appointment.

Dr. Amanda Hahn-Ketter

Dr. Amanda Hahn-Ketter is a licensed psychologist with specialized training in neuropsychology. She has expertise in assessment, diagnosis, and treatment planning for individuals with known or suspected brain dysfunction. She also provides cognitive rehabilitation to help individuals compensate for and cope with cognitive difficulties.

Have A Better Holiday Season As Part Of A Couple

I see couples every day who are trying to figure out how to enjoy the holidays. For some there is a feeling of sadness, as holiday time is an annual reminder of what’s been lost or changed over time. For others, there is a sense of hope and excitement in coming together with family and friends.

In this blog, I’ll share:

  • Specific challenges couples can face during the holidays.
  • Strategies to use to improve the state of your union.
  • Holiday stories from couples.


“What Makes Therapy Work?”: Dr. Michael Dulchin

As the opening part of an ongoing series, we thought it would be interesting to ask the different providers at Union Square Practice for their thoughts on the simple question: “What makes therapy work?”, starting with our co-founders Dr. Jonathan Fader and Dr. Michael Dulchin. Here is Dr. Dulchin’s reflections:

Michael Dulchin, MD:dulchin-bio-img

What makes therapy work? It’s a very interesting question.

Most studies cite the relationship between patient and therapist as one of the biggest components of success. Some of the older studies even say that you can predict whether or not therapy will work by measuring how much you like your therapists.

That being said, it’s also certainly possible that people just happen to like therapists who are using a particular form of therapy which is helpful to them. There are dozens of therapy styles, but in general, you can organize them into three schools of thought. There are the psychodynamic therapies, the cognitive therapies, and the behavioral therapies. (more…)

Afraid of Flying?

Learn How Cognitive Behavioral Therapy Can Help You Manage Those Flying Phobias.

As a clinical psychologist, I help people manage fears, or phobias, that interfere with life.  Many people are afraid of flying but are able to overcome these fears with help.  Below are fictional “dear diary” stories to illustrate how many people feel when facing a Boeing 747 followed by specific ways that therapy can help you get your feet off the ground.


Dear Diary,

I must be coming down with something…my stomach has been upset for the past two days, and I keep breaking out in sweats. I hope it’s not a stomach virus.

Or maybe it’s a respiratory thing? I notice I can’t catch my breath lately. And my heart is beating so fast! Maybe I should see a cardiologist.

Or maybe I hit my head? I’ve been getting sort of dizzy and noticed some tingling in my hands and feet. Which doctor helps with that? A neurologist? I don’t know.

I can’t figure out why this is all happening now. And just before Thanksgiving! I’m supposed to go visit the family, and my flight leaves on Wednesday.…You don’t think that this has anything to do with the terror I feel at the thought of getting on an airplane…right?

Yours truly,

Ms. Jittery


Sound familiar?  

For many of the 45+ million Americans who fly at Thanksgiving, the anxiety of flying sets in days in advance. For some, it might ruin their whole week. Whether the fear began after a particularly rough flight or has been around as long as a person can remember, the physical symptoms that come along with a fear of flying can be very uncomfortable, and often scary.

Some people experience full-blown panic attacks while in flight, and others feel little waves of anxiety every time they think about flying. Whether the feelings come on intensely all at once or build up slowly over a period of time, physical symptoms are a core experience for those with a fear of flying.



The car is almost packed. I have 23 hours of new podcast material to listen to, which should last me the entire drive. I’ll need another 23 for the ride back at the end of the week, but I’ll deal with that later.  Sure, flying would get me there more quickly. And yes, the rest of the family will be catching up for a day and a half before I even arrive. And yeah—I am missing a bit more work than I should (not to mention that huge meeting I won’t make it back for on Monday) but that’s okay. Everybody—from my family to my coworkers—knows that I don’t fly. I mean, I never have before—why start now?


Mr. Evader


How about this?

Most of us know at least one person who will go to great lengths (in a car…) to avoid flying. Avoidance can seem to help with a fear of flying in that you don’t have to experience the anxiety of getting on a plane.  However, avoidance can actually make things worse in the long run. By continuing to avoid airplanes, a person never gives himself the chance to learn that he actually can manage his anxiety and that flying actually is relatively safe. But, as any avid evader knows, avoidance can be addictive!


For my memoire –

That’s it! I just landed, and I swear I will NEVER fly again—and this time I mean it! These airlines nowadays don’t seem to care about passenger safety. With all of the noises that plane made, I was certain that something was wrong. But the worst was when the noise stopped! I swear heard the engine stop working entirely. And the turbulence! I’m telling you—that plane dropped 500 feet in 5 seconds. It’s a miracle that we didn’t fall right out of the sky. I just know that one of these days, my plane will crash. Or even if it doesn’t, I’ll feel so uncomfortable that it might as well crash.

Until next time,

Mrs. Uninformed X. Thinking-Traps


And finally, this?

For lots of people, their fear of flying is perpetuated not only by misinformation, but also by “thinking traps” that work against them when it comes time for a flight. Erroneous concepts such as the existence of “air pockets” and airplanes “dropping” in the sky contribute to people’s experience of fear when it comes to flying.

Furthermore, fearful flyers often overestimate the likelihood of risk on a flight.  They also imagine unpleasant flying experiences to be much more intolerable than they actually are. Both of these common “thinking traps” keep people stuck in the experience of fear when it comes time to travel.

How can Cognitive Behavior Therapy help?

So—are fearful flyers doomed to lives limited by the distance one can reasonably drive in a car? Definitely not!

Cognitive Behavioral Therapy (CBT) is a therapeutic approach that shows great success in managing fears, or phobias, such as the fear of flying.

But how? Through a combination of:

  • Education
  • Breathing skills
  • Thinking skills
  • Graduated exposure to flying-related scenarios
  • Mindfulness

CBT can help people conquer their fear of flying and expand their experiences and lives. Information about flying itself as well as information about the body’s response to fear can go a long way in managing anxiety. Slowed, deep breathing skills quiet the physical reactions of fear, and learning to think from an evidence-based and measured perspective helps to bring big fears down to size.

As with any phobia, exposure to the feared situation itself is key. The creative use of videos and virtual reality exposure therapy (VRET) help familiarize a person with the airplane environment, and, as we all learned during 4th grade piano lessons: practice makes perfect! Finally, from a mindfulness-based perspective, practicing observing one’s own experience of fear without feeling totally consumed by it can help a person navigate the very uncomfortable experience that is fear of flying.

Whether you’ve avoided flying your whole life or just started avoiding it last year, you don’t need to go through another holiday season with the same level of dread that you have in years past.

To learn more about how CBT for fear of flying can work for you, contact us here.


Julia Vigna Bosson, PhDBosson Rounded
Clinical Psychologist
Julia Vigna Bosson, Ph.D. is a licensed clinical psychologist. She has worked in various medical centers, including multiple VA hospitals, in private practice, and for the NYU Posttraumatic Stress (PTSD) Research Program. Dr. Bosson has a specialty in treatment of anxiety and trauma disorders, ranging from the effects of daily stressors on physiology and immunity to PTSD and other post-trauma reactions. Dr. Bosson is a Certified Provider of Cognitive Processing Therapy (CPT) for PTSD.