Narrative Therapy for women — telehealth across Virginia.
The story has always been
the diagnosis.
Psychiatric care that goes beneath the symptom list — to the patterns you inherited, the roles you were handed, and the stories that have been running quietly underneath everything you feel.
Or because the anxiety had returned.
Or because the medication stopped working
and no one could explain why.
But underneath that —
there has been a story running.
A story about what strength means.
About what you owe.
About what happens when you need something.
That story is not separate from your symptoms.
It is often the source of them.
Not what you feel.
Why it makes sense.
- The role you were assigned that became your identity
- The beliefs you carry about strength, need, and rest
- The cost of competence — what it has hidden from others and from you
- The survival strategies that protected you and now constrain you
- The gap between who you perform and who you actually are
- The grief of realizing how long you have been carrying this
- What you are allowed to become that your old role did not permit
- The high-achiever whose symptoms don't match her life on paper
- The woman who has been in therapy before but felt she was circling the same ground
- The one who has always been the strong one — and is exhausted by it
- The woman whose symptoms worsen under role pressure — at work, at home, in community
- The first-generation professional navigating split cultural expectations
- Anyone who feels that something deeper is driving their anxiety or depression
- The patient whose medication is working — but whose life hasn't changed
How the narrative work unfolds
Origin — when did this become necessary?
We identify the role you stepped into — and when. Not to assign blame, but to understand the context in which a particular way of being became necessary. The strong one. The responsible one. The one who held it together. These are not character traits. They are adaptations. And they have a beginning.
Cost — what has this role taken from you?
We name the cost — to your body, your relationships, your sense of self. What has competence hidden from other people about your actual state? What have you been unable to ask for? What have you never allowed yourself to receive? This phase often surfaces grief that has been postponed for years.
Meaning — what does the symptom protect?
Symptoms are rarely random. They often protect something — a belief, a relationship, a version of self that still feels necessary. We ask: what does this pattern seem to help you avoid, manage, or maintain? What is at stake in letting it shift? This is the clinical work underneath the clinical work.
Re-authoring — what are you allowed to become?
This is the forward work. Not replacing the old story with a forced positive one — but widening it. What would strength look like if it included support? What part of you is asking for a new way now? What becomes possible when you author your own story rather than live inside the one that was handed to you?
The questions we actually ask
These are not hypothetical. They are the questions that appear in the narrative work at DepthWorks — in the sessions, in the reflections, in the spaces between what you came in with and what you actually need to say.
I am more interested in understanding
why it makes sense.
That is a different kind of care —
and it changes everything about what comes next."
I am Patria Alexander, PMHNP-BC. I am Caribbean-rooted, Army-trained, and have spent two decades in clinical settings where the story underneath the symptom was the thing most providers never had time to ask about. I built DepthWorks because that story is not separate from the psychiatry. It is the psychiatry. The narrative work is not an add-on to the medication. It is the clinical work that determines whether the medication is enough.
What the narrative work looks like in practice
Integrated into every visit
Narrative work is not reserved for a separate therapy appointment. It is woven into every session at DepthWorks — including medication management visits. Your story does not leave the room when we talk about your prescription.
No retelling required
You do not have to recount every chapter of your past to do this work. Narrative therapy at DepthWorks works with what the story has left behind — in your patterns, your body, your relationships, and your sense of what is possible for you.
Culturally attuned
The stories carried by Caribbean-rooted women, first-generation professionals, and bicultural women are specific. The expectations around strength, silence, and sacrifice are not universal. This practice does not ask you to explain your culture away in order to receive good care.
Paced to your nervous system
Narrative work does not require you to be destabilized to be effective. We work within your window of tolerance. Meaning-making comes after safety — not as a precondition for it.
Tied to measurable change
The narrative work is not navel-gazing. It is tied to specific functional goals — the ones you named when you first came in. We track whether the story work is moving those targets. If something is not shifting, we adjust.
Alongside medication, not instead of it
Where medication is clinically indicated, it remains part of the plan. The narrative work and the pharmacology are not in competition. One creates the neurological ground. The other addresses what lives on that ground.
Frequently asked
If something here named
what you have been
carrying quietly —
That recognition is the beginning. The next step is simply a conversation. Not a commitment. Not a diagnosis. Just a conversation with a clinician who already understands something of where you come from.
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