Portrait of Dr. Rachael St. Claire

Psychotherapy for Adults in Colorado: Anxiety, OCD, Depression, and What Drives Them

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.

What I Help With

Relationships, Self-Worth, and Longstanding Patterns

  • Repeating relationship patterns and interpersonal difficulties

  • Boundaries, assertiveness, and fear of rejection

  • Shame, low self-worth, and chronic self-criticism

  • Feeling misunderstood, unseen, or emotionally alone

  • Longstanding patterns that affect mood, relationships, and sense of self

OCD, Intrusive Thoughts, and Compulsive Behaviors

  • Intrusive, unwanted thoughts that feel distressing, stuck, or difficult to dismiss

  • Compulsions, rituals, or avoidance aimed at reducing anxiety or gaining certainty

  • Reassurance-seeking, checking, and repeated mental review

  • Scrupulosity, moral OCD, and fears of being irresponsible or a bad person

  • Harm OCD, taboo thoughts, and other upsetting obsessional themes

Chronic Illness, Identity, and Emotional Well-Being

  • Distress related to changes in health, functioning, or daily life

  • Grief, fatigue, exhaustion, and the emotional toll of chronic illness

  • Shifts in identity, roles, independence, and sense of self

  • Living with uncertainty, ongoing symptoms, and medical stress

Anxiety, Worry, Fears, Phobias

  • Persistent worry, overthinking, rumination

  • Avoidant behavior to manage anxiety

  • Panic anxiety and panic attacks

  • Perfectionism, pressure, and fear of making mistakes

  • Reassurance-seeking and difficulty tolerating uncertainty

  • Social or performance anxiety

Depression and Mood Disorders

  • Mood disorders across the adult lifespan, from younger adults to seniors

  • Acute, chronic, persistent, or recurrent depression and related mood difficulties

  • Persistent low mood, emptiness, loss of interest, or difficulty getting started in the day

  • Mood swings or periods of elevated, accelerated, or unusually energized mood

  • Late-life depression related to loss, medical stress, role changes, or isolation

Insomnia, Nighttime Worry, and Early Morning Waking

  • Difficulty falling or staying asleep

  • Waking during the night with worry, rumination, or emotional distress

  • Early morning waking with heaviness, dread, or low mood

  • Sleep disruption connected to stress, anxiety, or mood changes

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.

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)