Today we’d like to introduce you to Larry Shapiro, Ph.D..
Hi Larry, please kick things off for us with an introduction to yourself and your story.
I started as a political science major in college, but found that what I was learning was not terribly challenging. I was challenged in my first psychology class after I got my first “C” on an exam. After that I changed my major and didn’t look back. While in college, I had the opportunity to study abroad and travel, which was an eye opener at a young age. I grew up in New York and thought it was the center of the universe. In hindsight, spending time out of the country and navigating relationships and language was probably a better education than the time I spent in class. I understood, at that time, that there was a limit to what I could do with an undergraduate degree in psychology, so I decided to pursue a Ph.D. in clinical psychology. My wife (who I met while I was abroad), and I moved out to the Bay Area for graduate school. Again, another eye opener. The Bay Area seemed to be a different type of culturally diverse setting than New York City. There was an openness to different ideas and lifestyles. Plus the weather, terrain, and food were something completely different than I was used to. It was also in the mid-1980’s at the height of the AIDS epidemic, before we even knew what it was. So besides meeting some great people and having wonderful experiences, we lost a lot of good people, quickly. Seeing both the fear and the compassion demonstrated by people I knew well, and those on the periphery was also an invaluable lesson in psychology. Frankly, I did not like graduate school very much. I found that the prevailing wisdom that therapy must take years and that people need to figure out their problems and solutions with our guidance seemed inefficient and unappealing. So, after I finished my coursework, we moved again, this time to Connecticut for a year of additional training before ending up in St. Louis at the St. Louis Behavioral Medicine Institute. Back in the early 90’s when I trained there it was a unique set up. We had an inpatient unit run by psychologists and nurses. We were able to see some of the most severe cases of obsessive-compulsive disorder (OCD), agoraphobia, eating disorders, social anxiety disorder, and other anxiety disorders at a time when insurance would pay for 90 days of inpatient care. Which meant we could use cognitive-behavioral principles and techniques in a very controlled environment and actually get people better. I took those experiences to the Department of Psychiatry at Washington University School of Medicine to focus on the cognitive-behavioral treatment of anxiety disorders. From there, I spent a few years in a group mental health practice. As the insurance industry changed, how I had to practice also needed to change. Whereas before, I was not questioned about how much time I would need to help someone, I was now given 10 sessions to fix some pretty complex problems. My frustration grew to the point that I left practice for a few years to pursue a different career. However, I started to find that I was not satisfied personally with the work I was doing. It got progressively harder to go to work, and I found excuses to leave early. Until my brother came for a visit after a tour in Afghanistan. After that brief visit I decided that I wanted to do something larger than myself and as a result of that brief visit, I got my psychology license back, took specialized training in military psychology and traumatic stress disorder, and returned to practice psychology with a specialty in combat-related PTSD. In the early 2010’s returning veterans were more likely to die of suicide than combat injuries. I heard from multiple veterans and their spouses about the trouble they had getting good care at the VA and developed my own approach to treating combat trauma which has been very successful. I know when a veteran calls me “brother” or “Dr. Shapiro is the shit”, I was doing something right. Then, in March 2020 we all went into lockdown due to the COVID-19 outbreak and so my practice, as well as all of my colleagues, moved to virtual. At that time I don’t think any of us thought virtual therapy would work, but that is now 5 years ago. During the middle of the quarantine period, in 2021 I suffered a cardiac arrest–twice. This was at a time when my wife could not come to the hospital with me so neither of us really understood the gravity of my situation. I tell people now it was far worse for my family than for me. After I recovered I realized I needed a change. I was working too many hours, seeing far more patient than many of my peers, and was paying a price. Three months later, by chance, I attended a virtual trauma conference and the keynote speaker talked about the use of psychedelics to treat trauma. This was new. He wasn’t just talking about the possibility, he presented actual brain scans and outcome studies on psychedelic-assisted psychotherapy. I remember thinking first “What rock have I been under that I did not know this was happening”, then, “I can get people better, fast, and easier?”. So I set off on another round of training; this time in psychedelic-assisted psychotherapy. In 2021-2022 there were very few programs for training and we still had to do it virtually. Again, my experience learning about psychedelic-assisted psychotherapy was an eye opener. The training really pushed me to recognize human experiences that I dismissed as unnecessary for improvement. Issues of spirituality, relationship, and environment were presented in ways not only taught me how to work therapeutically with psychedelic medicines, but made me a better therapist overall. This is a tricky area, though, because psychedelics are illegal, so I always have to preface anything I say by letting people know that I cannot recommend, condone, or endorse illegal activity. Most people seek me out, having already decided that traditional approaches to their mental health struggles have not works and want an alternative. So I focus on safety, preparing for psychedelic experience, helping people integrate those new experiences, as well as work with people who have had prior negative experience and need to make sense out of those experiences and use them therapeutically. Now, in my practice, I still specialize in treating combat trauma, but that has expanded to first-responders, and adults with a history of abuse or neglect. Most of my patients are still seeking help with medication-resistant depression and anxiety. Many come to me after 2. 3, or 4 unsatisfying experiences with counseling or therapy. I love what I do, so, to paraphrase the saying, I don’t ever feel like I’m working.
We all face challenges, but looking back would you describe it as a relatively smooth road?
I had to move to private practice to work with psychedelics. Getting credentialed with different insurance companies was labor intensive and frustrating. Working with insurance companies even more so. So about 2 years ago I stopped taking insurance and am all private pay. The telehealth avenue made it easy, but not working in a clinic is isolating and at some point people forget I’m still here, so I have to remind them every once in a while. The basics of running a business, paying taxes, bookkeeping, is more stressful than I would like it to be.
Thanks – so what else should our readers know about Quantum Behavioral, LLC?
I’ve been in private practice now since 2022. I named my practice Quantum Behavioral, LLC because I’ve seen and believe that sometimes a small change in thought or behavior can make a big difference. My practice is online only. Having done virtual therapy now since 2020 I’ve come to appreciate the benefits of online therapy. There are fewer missed appointments due to weather or children’s days off from school. Patients have mentioned that doing therapy from the comfort of their home or office makes them feel more comfortable than being in a waiting room and the tension of time to get to therapy and from therapy to their next obligation. Especially when discussing traumatic events, being able to be emotional from the comfort of your own home allows people to open up more. Something I did not anticipate is the information I get from virtual therapy. I can see how people live, how they show up to therapy, literally, how they dress or do their hair or makeup, I get introduced to spouses and children and can observe some interactions I would not get in traditional office work. Rather than being a detractor, I just get different information. Another aspect of my practice that I think is a differentiator is my ability to practice telehealth in 43 states across the country. This means people have access to me from rural Missouri to deserts in Arizona and coastal Maine. People seek me out for my expertise rather than convenience. I think something else that distiguishes me and my work is that rather than focusing on developing coping skills, I focus on eliminating the problem. To me coping implies that the problem never gets better and sets the bar for success far too low. Psychotherapy is not supposed to be easy, and in my practice I remind people that in order to make gains, they must be willing to tolerate a certain degree of discomfort and uncertainty. I believe my experience and comfort with cannabis medicine and psychedelic medicine is a clear differentiator in my field. To that end, I am also know for taking a very direct approach to change. I’ve never been accused of being warm and fuzzy. Another other aspect of my practice that set me apart from others, I believe that being a doctoral-level clinician with over 30 years of experience, and a male, sets me apart from the current clinical landscape. I also have found that an over-reliance on antidepressant medications can hinder progress towards peace of mind or finding contentment. I tell people it’s really hard to help them experience happiness when their medication is making them feel flat and impairing their ability to have a healthy sex life. Brand wise I am most proud of the successes I’ve had helping people who have been on the verge of giving up on improving their mental health. Since my cardiac arrest, having had the privilage of dying twice and coming back, I have more recently started working with people who have end-of-life anxiety. I’ve spent a career helping people live better. Now I can also help people die better. I feel really good when someone says “thank you’. Before people work with me, they need to know that I am just virtual. They should also know that I don’t take insurance and that my fees are at the higher end of local professionals. There’s a saying that goes, “In the absence of value, price becomes and issue”. When people consider the value of lost earnings, lost potential, divorce, and years of unhelpful therapy, many people see the value of goal-directed, assertive, psychotherapy.
Who else deserves credit in your story?
I’ve had some wonderful supervisors in my past. One of my first supervisors in graduate school, an older psychiatrist, gave me a piece of advice or wisdom that I still reference. When I first started seeing patients in San Francisco and I told him I was afraid I was going to make a mistake and make someone worse, he told me that if I think about a problem, work out a rationale for how to approach it, and it doesn’t work, that is not a mistake. If, however, I fail to think about the problem and have no rationale for how to approach it and it doesn’t work, that is a mistake. Gib Henderson, Ph.D., who has since passed, was a supervisor when I was a post-doc. He also shared a piece of professional wisdom that I still refer to. He said, “Larry, if you find yourself on fire, do you really want to sit around and figure out how you got on fire, or do you want to put it out”. That piece of wisdom has driven some of my approach to therapy when people start off by saying, “I want to find out why I’m like this”. Sometimes we have to focus on more practical, immediate issues to decrease the pain and discomfort before trying to figure out why someone is “like that”. Certainly, my wife has been a cheerleader and a constant support of my career, training, moving around the country, and going into private practice. I’m not sure I would have been as comfortable making that move without her encouragement and support. Her trust that I could pull it off often exceeded my own trust in myself.
Pricing:
- Initial Evaluation $350
- Follow up sessions $225
- Veteran PTSD assessment $800 for 4 meetings and communication with the VA
- In-person ketamine assisted psychotherapy $325
Contact Info:
- Website: https://quantumbehavioral.com
- Other: https://PsychologyToday.com
