Psychoanalytic Psychotherapy, Psychoanalysis & Psychiatry

for Adults Seeking Depth in Pasadena, San Gabriel Valley, Greater Los Angeles and California

Psychoanalytic therapy helps you recognize the unconscious repetitions that keep you stuck—so you can stop reliving old struggles and start living differently.

In therapy, we'll work together to spot the invisible patterns from your past that keep causing problems today; understand how these patterns show up in your relationships, emotions, and choices; use our real-time interactions to change these patterns where they matter most—in your actual life. It's about making lasting changes by bringing what's unconscious into awareness, seeing how old relationship templates affect you now, and practicing new ways of being through our therapeutic relationship.

Welcome! I’m Dr. De Guzman. As a psychiatrist trained in psychoanalytic therapy, I help patients uncover and alter the unconscious psychological forces that keep them stuck in repetitive struggles.

I help adults identify and change the unconscious patterns that emerge from their history and perpetuate current difficulties. Effective therapy requires both insight and practical change—understanding where these patterns come from and doing the work to alter them.

I can help with

Comprehensive Initial Consultation—The Consultation Process: Laying the Foundation for Therapy

80-minute initial session to lay the groundwork. Beforehand, I’ll send you intake forms and practice policies to review and sign (any gaps we’ll fill in during our time). We’ll explore your reasons for seeking help, past history, and goals, while I screen for potential psychiatric or medical needs.

The first session—and often the first few sessions—are a “consultation phase,” a time for us to explore whether working together makes sense. This is not yet therapy, but rather a necessary step to determine if there is a foundation for therapy.

My role is to listen carefully, begin to understand your struggles, and assess whether my approach aligns with your needs. Likewise, this is your opportunity to ask questions, get a feel for how I work, and decide if I’m the right therapist for you.

Good therapy requires a “working alliance”—a shared understanding of the purpose of therapy and the methods we’ll use to get there. Reaching this agreement is a collaborative process:

We’ll clarify what’s causing your difficulties (often beyond surface symptoms).
We’ll determine what can realistically change in therapy.
We’ll assess whether you recognize—and want to change—the deeper patterns contributing to your struggles.

This takes skill, honesty, and sometimes multiple sessions. If we can’t establish this shared understanding, therapy won’t proceed—because without it, therapy lacks direction and depth. But if we do, we’ll have a clear path forward, tailored to you.

One-Time Second Opinion Consultation

Navigating complex psychiatric and medical conditions can feel overwhelming, especially when questions remain about your diagnosis or treatment plan. As a fellowship-trained consultation-liaison psychiatrist, I have specialized knowledge in how psychiatric disorders can affect medical illnesses, and vice versa. I provide expert second opinions for individuals seeking clarity, reassurance, or alternative perspectives on their care. My approach integrates deep expertise in the interface of medicine and psychiatry, ensuring a comprehensive evaluation of your unique needs—whether you’re managing medication challenges, unresolved symptoms, or the interplay between physical and mental health.

This service is ideal if you:

Question the accuracy of your current diagnosis or wish to explore other possibilities.
Are considering a medication change but want expert guidance on risks, benefits, or alternatives.
Feel stuck in your treatment progress and wonder if other options exist.
Seek validation (or refinement) of your current care plan from a specialist in complex cases.
Require nuanced insight into psychiatric symptoms complicated by medical conditions, such as autoimmune disorders, cancers, neurological issues, or chronic illness.

A second opinion consultation is a focused, one-time evaluation. Together, we’ll review your history, treatments tried, and unanswered concerns, empowering you to move forward with confidence.

Psychoanalytic Psychotherapy & Psychoanalysis

If we determine that psychoanalytic therapy or psychoanalysis is the right path for you, we’ll meet regularly—typically once or twice weekly, or more intensively if needed—to engage in deep, exploratory work. Unlike shorter-term therapies that focus primarily on symptoms, our sessions will be dedicated to uncovering the unconscious roots of your struggles, which often originate in earlier life experiences and persist outside your awareness.

The frequency of our meetings will depend on your unique needs and goals. More intensive work (3-5 sessions per week) allows for deeper immersion in the process, much like turning up the magnification on a microscope to bring hidden patterns into focus. Through this collaborative exploration, you’ll begin to recognize how past experiences shape your present emotions, relationships, and choices—freeing you to live with greater authenticity, resilience, and purpose.

My approach integrates psychodynamic therapy, psychoanalytic principles, and psychiatric insight, ensuring that both immediate distress and underlying causes are addressed. The ultimate aim is not just relief, but lasting change that continues to unfold long after therapy ends.

Psychiatry

For patients engaged in therapy who may benefit from medication, I approach prescribing with careful thought and restraint. Medications can sometimes provide necessary relief, but they are never a substitute for the deeper work of understanding yourself. If we determine medication could be helpful, we’ll discuss it openly—considering its role in easing symptoms so you can more fully engage in the exploratory work of therapy. My priority is always to help you develop lasting internal strengths, not reliance on external solutions. Any use of medication will remain integrated into our psychodynamic process, ensuring it supports—rather than replaces—your path toward insight, emotional freedom, and genuine change.