Psychotherapy and the Power of Being “Good Enough”

When the Past Knocks

In the past few weeks, a couple of people from my earlier life reached out—an old friend and a former colleague—each message arriving within days of the other. It made me pause. This time of year often brings a natural turning inward. We take stock of our lives, wonder how we’ve changed, and remember who stood beside us during difficult periods. Sometimes the relationship was brief or imperfect, but meaningful all the same.

As I sit with this, I’m aware of how grateful I am for the life I have today. It isn’t perfect; no life is. But it is good enough. And lately, that phrase has felt especially true to me.

The Power of “Good Enough”

In my work, especially with patients who lean toward perfectionism, I often remind them that perfection isn’t the goal—nor is it even possible. What matters is being good enough: good enough parents, good enough partners, good enough employees, good enough friends.

This idea comes from British pediatrician and psychoanalyst Donald Winnicott, who introduced the concept of the “good enough mother.” He observed that when mothers respond consistently—but not instantly or flawlessly—they actually help children develop resilience. Those slight, tolerable delays teach a child that frustration can be survived. They learn that imperfection does not equal abandonment, and that they can manage difficulty without falling apart.

Letting Ourselves Be Human

I think that principle applies long after childhood. We can allow ourselves to live lives that are real instead of polished, grounded instead of perfect. We can show up with presence rather than performance. We can let our connections be meaningful even when they’re not seamless.

And maybe, in the end, that is more than enough.

 

 

 

The Hidden Life Within: What Cells Can Teach Us About Therapy

When we look at a diagram or image of a cell, it seems simple on the surface — a neat circle with some faint shapes inside. But scientists know there’s much more hidden within. Inside every cell are organelles: the nucleus, mitochondria, and many other structures, each performing essential work to keep us alive.

Therapy is a lot like this. On the outside, a person’s life may look orderly, stable, or even “perfect.” But inside, there may be a world of thoughts, feelings, and experiences that others cannot see.

The Depth Beneath the Surface

Just as the nucleus holds our genetic code, each of us carries inner material that defines us — our history, relationships, fears, and hopes. The mitochondria power the cell, much like our emotions and motivations fuel our daily actions. These inner elements are not always visible, yet they affect everything we do.

In therapy, the work often involves moving beyond what’s visible on the surface. Symptoms like anxiety, depression, or relationship conflict may appear in everyday life, but the roots of those symptoms lie deep inside — just like organelles hidden within the cell.

What It Means to “Go Deep”

Sometimes when I encourage a patient to “look inside,” they are unsure what that means. In practice, it involves slowing down, paying attention to the inner world, and being willing to notice feelings or memories that may not be obvious at first.

It can be uncomfortable — just as examining a cell under a microscope requires magnification and patience, exploring the self requires courage and openness. Yet, this process often brings clarity and healing.

Therapy as an Inner Exploration

When we examine the hidden structures of a cell, we gain a deeper understanding of life itself. Similarly, when we examine the hidden structures of our inner world, we begin to understand ourselves. Therapy offers a safe, structured way to explore these depths, so we can bring what is hidden into the light and use that awareness for growth.

Final Thoughts

A cell is more than its surface appearance — and so are we. Just as science reveals the complex world inside a single cell, therapy helps us uncover and understand the complex world within ourselves. Through this process, healing and transformation become possible.

Psychotherapy Can Help Open the Door to Life Decisions

When people think about therapy, they often picture it as a place to go in a crisis. But therapy is not just about surviving hard times—it’s also about making space to reflect on the major life changes we consider, the ones that shape who we are and who we want to become.

Therapy Beyond Crisis

Therapy is a place where we can process the questions and uncertainties that come with life’s turning points. These moments aren’t always dramatic or visible to others, but they carry enormous weight inside of us.

Some examples might include:

  • Deciding whether to stay in or leave a marriage
  • Considering weight loss surgery
  • Exploring gender-affirming care
  • Thinking about a career change or a move

Even when no clear crisis is present, these choices stir up complex emotions that deserve attention.  I have also witnessed that they can cause significant anxiety, depression and grief.  Rarely have I seen it cause psychosis, but that does happen too, particularly around major life-changing events.

Sometimes making a major decision feels like standing before a closed door. A blue door, in particular, can symbolize calm and hope, yet also the unknown. Therapy allows us to pause at that threshold, to explore our fears, and to imagine what stepping through might mean. Even when it feels scary, choosing to walk through the door—whether toward change or toward deeper self-understanding—can be the beginning of real growth.

The Power of Talking It Through

It’s not always the outcome that matters most—it’s the process of giving voice to our feelings. For example, if I feel uncertain about leaving my marriage, simply talking about my doubts in therapy can bring clarity. Even if I ultimately choose to stay, the act of exploring my emotions openly helps me understand myself better.

The talking part matters more than rushing to a decision. When we honor our feelings by bringing them into the light, we give ourselves the opportunity to make thoughtful, intentional choices about what we want in our lives.

Honoring Feelings Without Judgment

One mistake people sometimes make is believing that talking about a difficult possibility will automatically force an outcome. For instance, discussing gender-affirming care in therapy does not mean someone will be pressured into it—or pressured not to pursue it. Therapy should never be about rubber stamping treatment.   But to say that it’s not necessary to discuss it, ahead of time would be a disservice to our patients.  Instead, it should be a supportive space where feelings, identities, and questions are respected and explored without fear of judgment. By talking openly, people can make informed, authentic decisions about their lives—whether or not they choose to pursue medical steps.

Therapy as a Place of Possibility

Life is full of transitions. Therapy offers a safe environment where we don’t have to have all the answers right away. Instead, we can explore our questions, feel our feelings, and consider our options with compassion.

The point isn’t always to change—it’s to discover what truly matters to us. By talking it through, we make space for self-knowledge, healing, and growth.

Why Choosing a Local Psychiatrist in Maine Matters: I Live Here, I Work Here, I Care

With so many out-of-state providers offering virtual psychiatric care in Maine, it’s more important than ever to choose someone who truly knows the community. Dr. Madeline Goodman, D.O., has lived in Maine since childhood and is deeply invested in the people and values of this state.

I’m Not Just Licensed in Maine — I’m Rooted Here

With the rise of large telehealth companies, it’s become increasingly easy to find a psychiatrist online. But that convenience often comes at a cost — especially when the provider has no real ties to Maine. Many of these companies are run by out-of-state professionals who get licensed here just to expand their business footprint. They don’t live here. They don’t know our communities. And they’re not truly invested.

I’m Dr. Madeline Goodman, a board-certified psychiatrist, and while I wasn’t born in Maine, I’ve called it home since the fifth grade. I know this state not as a visitor or a business opportunity, but as someone who grew up here, raised a family here, and made a lifelong commitment to staying here.

A Psychiatrist Who Understands Maine Life

I understand what it means to grow up in Maine — the rhythm of the seasons, the challenges of rural healthcare access, and the strength and independence of the people who live here. I also understand what resources exist locally and where the gaps are — and that matters when it comes to getting effective, meaningful care.

When you work with me, you’re not getting a stranger from across the country. You’re getting a neighbor. A fellow Mainer. A psychiatrist who genuinely cares about your wellbeing and who brings both professional expertise and lived experience to the table.

I Support the Community Because I’m Part of It

I live in Maine year-round. I support local businesses, pay taxes here, vote in local elections, and advocate for better mental health services in our state. My commitment to this community isn’t just professional — it’s personal.

That’s what sets my practice apart from national telehealth platforms that treat care as a transaction. I treat each patient with the respect, continuity, and local understanding they deserve.

Looking for a Local Psychiatrist You Can Trust?

I offer personalized telepsychiatry services to adults throughout Maine — from Portland to Bangor, Lewiston to remote coastal towns. You’ll receive compassionate, one-on-one care rooted in evidence-based treatment and tailored to your unique needs.

📞 Ready to Get Started?
Reach out today to schedule a consultation or learn more about how I can help.

When Food Is No Longer Your Friend: The Emotional Side of GLP-1 Medications

By Madeline Goodman, D.O., Diplomate, American Board of Psychiatry and Neurology

GLP-1 medications have been a game changer for many—especially individuals with conditions like cardiac disease, where weight loss is not just helpful but medically urgent. Patients taking certain psychotropic medications  who have experienced significant weight gain have also benefited from these medications, offering a much-needed option for weight management that doesn’t require stopping effective psychiatric treatment. The ability to reduce appetite and promote steady weight loss can significantly improve cardiovascular outcomes and reduce long-term health risks. This makes these medications a potentially life-saving option for some patients, and their medical impact should not be underestimated.

GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have been truly transformative for many people—helping with weight loss, blood sugar control, and overall metabolic health.

As a psychiatrist, I’m not against these medications—in fact, I’m very much in favor of them for the right patients. But they’re not for everyone, and like any powerful tool, they come with layers that extend beyond the physical.

This post explores some of the mental health implications I’ve seen in patients using GLP-1s—not to deter, but to add depth to the conversation. Because while appetite may go away, the emotional reasons we eat often don’t—and those deserve just as much attention.

1. When Food Was a Friend—and Suddenly Isn’t

Many of us develop a long-standing emotional relationship with food. It’s comfort, company, celebration, or stress relief. So when GLP-1 medications reduce appetite so drastically that meals feel like a chore, it can stir up feelings of loss, disorientation, or even grief.

I’ve had patients describe it as “losing their best friend,” or “feeling like they don’t know themselves anymore.” This is a valid emotional response—and one that deserves support, not shame.

For some, the grief can be profound. If a tough day used to end with a comforting meal or favorite snack, and that ritual suddenly disappears, it can feel as though a reliable coping mechanism is gone. That loss can feel overwhelming at times—not unmanageable, but difficult at best. Acknowledging this grief is the first step toward replacing it with healthier, more sustainable sources of comfort.

2. Nutrition Still Matters—Even If You’re Not Hungry

One of the most common issues I’ve seen is inadequate nutrition, especially protein. When appetite drops, it’s easy to eat very little—but without enough protein and hydration, people can feel weak, irritable, or even depressed.

In fact, when nutrition suffers, depression can re-emerge, often presenting with psychomotor slowing, low energy, and even brain fogginess. These symptoms may not always be immediately linked to food intake, but they are critical to address.

These medications are tools—not magic—and the body still needs fuel to function well. I often encourage patients to work with a registered dietitian or nutritionist, even if weight loss isn’t their only goal.

3. Emotional Eating Doesn’t Magically Go Away

Even when hunger signals disappear, emotional eating patterns remain. You might not feel hungry, but you may still feel lonely, bored, or anxious. That drive to soothe through food can come back suddenly, especially if the medication is paused or stopped.

This is why therapy, self-awareness, and building alternative coping strategies are still crucial. GLP-1s can remove the cue (hunger), but they don’t erase the conditioning or emotional patterns. The groundwork still needs to be done.

4. It’s a Personal Choice—Not a Shortcut

I never tell someone whether GLP-1s are “right” or “wrong” for them. It’s a deeply personal decision—influenced by medical needs, emotional history, lifestyle, and goals.

What I do encourage is informed use: knowing what you’re signing up for, not just physically but emotionally. Support from your medical provider, therapist, or support group can make the difference between feeling isolated versus empowered.

Closing Thoughts:

GLP-1 medications can be incredibly helpful, and I’ve seen many patients benefit greatly. But for long-term success—emotionally and physically—it’s important to do the inner work, too. Understanding why we overeat, how we soothe ourselves, and what role food plays in our lives is essential, whether or not we’re on medication.

You deserve more than weight loss—you deserve peace with your body, your mind, and your relationship with food.

About Dr. Goodman: Dr. Madeline Goodman, is a board-certified psychiatrist offering compassionate, personalized Telepsychiatry to adults across Maine. She specializes in treating anxiety, depression, trauma, and emotional eating. Learn more at www.drmadelinegoodman.com

Why Telehealth Etiquette Matters: Creating a Safe and Stable Space for Therapy

online counseling session

Telehealth is Convenient — But It Still Deserves Respect

One of the great advantages of telehealth is flexibility: you can receive care from virtually anywhere. But just because you can take a session from your car, your workplace, or the corner of a grocery store parking lot doesn’t mean that you should.

As a psychiatrist and psychotherapist, I show up at the same time every week from a private, quiet, and professional space—because that’s what good care requires. And for therapy to really work, patients need to do the same.

What Good Telehealth Etiquette Looks Like

  • Be in a stationary location. If you’re in your car, that’s fine—but please don’t be driving. Pull over and park so you can give your full attention to the session.
  • Find a private space. Therapy often involves talking about personal and emotional topics. It’s hard to feel safe and open if you’re worried about being overheard or interrupted.
  • Be on time. Just like an in-person appointment, punctuality matters. It honors the therapeutic process and allows us to use the full time we’ve set aside.
  • Try to use the same place each week. Predictability creates a sense of safety, and therapy works best when we’re grounded—not scrambling to find a quiet corner at the last minute.

Why It Matters

When patients show up in a distracted, chaotic, or rushed way, therapy simply can’t unfold the way it’s meant to. Insight, reflection, and emotional growth require presence. When sessions feel disorganized or squeezed between other obligations, the space we need to do meaningful work gets lost.

Therapy is a commitment—not just to the appointment time, but to yourself.

Setting the Frame Is Part of My Job

Part of my responsibility as a provider is to help set the frame for therapy. That includes creating consistency, offering structure, and communicating expectations clearly.

If at any point something doesn’t feel clear, or if you’re unsure why a certain aspect of etiquette matters, I want you to know that it’s okay to ask. And if I haven’t said it directly—I’ll own that. I don’t expect patients to automatically know how therapy works. That’s part of what I’m here for.

Final Thought

Telehealth has opened up access to care in wonderful ways. But it’s still real therapy. The more seriously you take the setting, the more you get out of it.

As your provider, I’m here—every week, in a consistent and grounded space. I invite you to meet me there, in every sense of the word.

 

Therapy isn’t just for bad weather

Therapy Isn’t Just for Bad Weather

When spring arrives and the long Maine winters give way to sunshine and warmth, it’s tempting to step back from routines that feel “heavy” — like therapy. Life feels lighter, moods lift, and we find ourselves outdoors more. It’s understandable. But therapy isn’t just for stormy seasons.

In fact, some of the most meaningful work in therapy happens when we’re not in crisis.

Why Summer Can Be an Ideal Time for Growth

When we’re not in survival mode, we can reflect more deeply. We can ask:

  • Who am I becoming?
  • What habits do I want to reinforce?
  • How do I build on the progress I’ve made?

Without the emotional urgency that comes with winter blues or life stressors, summer gives us space to explore.

Skipping Sessions Can Disrupt Momentum

Taking a break may feel harmless, but therapy often builds on itself. Each session adds to the last, and gaps in treatment can slow or even reverse progress. If you’ve worked hard to get where you are, summer might be the time to solidify that progress — not pause it.

Therapy Isn’t Seasonal — It’s Foundational

Think of therapy like tending a garden. You don’t just water it when it’s wilting — you care for it consistently to see it bloom. Our mental health is similar. Sunny days don’t always mean we’re done healing. Sometimes they offer the best light to see things clearly.

Final Thought

Enjoy the sunshine, take the beach days — but don’t lose sight of the steady work you’ve been doing in therapy. Emotional health isn’t a seasonal project. It’s a lifelong investment in yourself.

Telepsychiatry in Maine — Serving Portland, Bangor, and Southern Maine

Psychiatric Care Across Maine — From Anywhere You Are

Whether you live in Portland, Bangor, Lewiston, or a small town in between, accessing personalized psychiatric care can be challenging. Long waitlists, long drives, and a shortage of providers often get in the way of people getting the support they need.

As a board-certified psychiatrist practicing exclusively via telehealth, I provide accessible, compassionate psychiatric care across the entire state of Maine. All sessions are conducted securely and privately via video, from the comfort of your home.

I work with adults facing a range of concerns, including:

  • Depression and anxiety
  • Trauma and stress-related disorders
  • Midlife transitions
  • Sleep difficulties
  • Medication management and psychotherapy combined

Why choose telepsychiatry in Maine?

Same high level of care you’d receive in person

No commute or wait times

Flexible scheduling

Available statewide — from Aroostook County to York

About Me:

Serving Patients in Bangor and Throughout Maine

Although my practice is fully virtual, I work with many patients in the Bangor area — as well as those in surrounding towns like Brewer, Orono, Old Town, and Hermon. Whether you’re a student at UMaine, a professional balancing a busy schedule, or someone living outside the city with limited access to care, telepsychiatry makes it easy to receive high-quality, private psychiatric care without the need to travel.

I also provide psychiatric care to residents across Maine — including Portland, Augusta, Lewiston, and rural communities that often lack local psychiatric resources.

Whether you’re in a rural area with limited access or just prefer the convenience of remote care, I’m here to help.

If you’re looking for a psychiatrist in Maine who offers both medication and therapy and truly listens, I invite you to learn more or contact me through my website:
👉 www.madelinegoodman.com

Madeline Goodman, D.O., Diplomate, American Board of Psychiatry and Neurology
Psychiatrist for Adults – Licensed in Maine
100% Telepsychiatry | Accepting New Patients
www.madelinegoodman.com

How AI Is Changing Psychiatry – And What It Can’t Replace

By Dr. Madeline Goodman, Psychiatrist & Psychotherapist

In the past few years, artificial intelligence (AI) has moved from a buzzword to a powerful presence in healthcare—and psychiatry is no exception. From chatbots offering mental health support to algorithms screening for depression, AI tools are being hailed as the future. But as someone who practices both psychiatry and psychotherapy, I see both the potential and the limits of AI in mental health care.

What AI Can Do in Psychiatry

AI can be remarkably helpful in specific ways:

  • Screening and early detection: Algorithms can flag symptoms of anxiety, depression, or even psychosis by analyzing speech patterns, facial expressions, or written language.
  • Support tools: Chatbots and apps like Woebot offer basic cognitive behavioral techniques, which some people find helpful between therapy sessions.
  • Administrative support: AI can assist clinicians by summarizing notes, organizing data, and predicting medication responses—reducing our time spent on paperwork.
  • Access expansion: In underserved areas, AI-powered platforms can provide some mental health support where human clinicians are scarce.

These are all meaningful contributions, especially in a system where access and time are limited. But psychiatry is more than pattern recognition.

What AI Can’t Replace

While AI might be efficient, it lacks emotional depth. Psychiatry is not just about diagnosing and prescribing—it’s about understanding the human story:

  • The therapeutic relationship: Healing often happens in the relationship itself—through being seen, heard, and understood by another person. This is something no algorithm can replicate.
  • Complex emotions and nuance: Human distress is rarely neat. A person may present with anxiety that is also grief, that is also trauma, that is also existential. Understanding that layering takes attunement, not coding.
  • Unconscious processes: As someone trained in psychodynamic therapy and dream work, I believe that unconscious patterns shape behavior in ways AI can’t access. Therapy often means sitting with uncertainty and ambiguity—territory machines aren’t built for.

How I Use (and Don’t Use) Technology in My Practice

I value useful tools. I offer telehealth, I keep up with emerging technologies, and I understand the appeal of convenience. But I’ve also seen what’s lost when care becomes too transactional.

My practice offers something different: personalized, attentive, and deeply human care. Whether you’re navigating midlife transitions, relationship changes, or long-standing patterns, I create a space for exploration that goes beyond symptoms.

The Future: Human + AI, Not Human vs. AI

I’m not anti-AI—I think it has a role. But I believe the future of psychiatry is not about replacing clinicians. It’s about supporting them, so we can focus on what machines can’t do: build relationships, tolerate uncertainty, and sit with pain compassionately.

If you’re looking for mental health care that combines depth, professionalism, and a human touch, you’re in the right place.

 

Why Personalized Psychiatry Still Matters in a Telehealth World

🧠 Why Personalized Psychiatry Still Matters in a Telehealth World

Telehealth has transformed the way people access mental health care. With a few clicks, it’s now possible to schedule an appointment, consult with a provider, and even receive prescriptions — all without leaving home.

But not all telehealth is the same. And while large platforms have helped expand access, many people are finding that what they truly need is personalized, consistent, and thoughtful care — the kind that can sometimes be hard to find in fast-paced, high-volume systems.

 

🏥 When Convenience Comes at a Cost

Many online platforms offer quick access to care, including features like brief check-ins, medication consults, or even therapy through text. While this convenience works well for some, others find that something gets lost in translation — especially when sessions feel rushed or when they rarely see the same provider twice.

I’ve worked with many people who started with these services and later realized they were craving more depth, more consistency, and a stronger therapeutic relationship.

“It felt like no one really knew me,” is something I often hear.

For a deeper look at best practices in telepsychiatry, you can visit the  American Psychiatric Association’s Telepsychiatry Toolkit.

🤝 The Power of Personalized Psychiatry

In my practice, whether we meet in person or through telehealth, you are not just a time slot or a diagnosis. You’re a full human being — and your care should reflect that.

Because I work independently, I’m not part of a larger corporate structure. That means your care is guided by your needs — not quotas or time limits.

What to expect:

  • Consistent care with the same provider
  • Integrated therapy and medication insight
  • Sessions that allow time to reflect and explore
  • A relationship built on trust, not turnover

🌿 Telehealth With a Human Touch

Yes, I offer telehealth. But it’s grounded in relationship, respect, and care. Whether you’re navigating anxiety, life transitions, depression, or trauma — you deserve a space where you feel truly seen and heard, not just evaluated.

💬 If You’ve Tried Other Options and Still Feel Unseen…

You’re not alone — and there are alternatives.

If you’re looking for a more personal and consistent experience with a psychiatrist who takes the time to understand your whole story, I’d be honored to talk with you.

online counseling session