Therapy for
High-Stakes Lives
In person in Union Square and across New York by telehealth.
You are prepared. You have done this a hundred times. And still, at the moment it matters, your mind can go blank.
I work with people who live high-stakes lives. Some are performers, founders, and public figures. Others are executives, physicians, attorneys, artists, or simply the person everyone counts on.
Maybe you are raising a round with everyone watching, or the break you spent years earning finally came, or you are the one holding a company, a production, or a family steady through a hard season.
Whatever seat you sit in, you share one thing. You are the one it all runs through, and the cost of not being well is never only yours. You cannot be swapped out, because the instrument is you. So this work is not only about feeling better. It is about keeping you well enough to keep showing up, on schedule, while the pressure is on.
WHO THIS IS FOR
The people at the top of any field learn the same skill early. How to be on. On a stage, on camera, in a meeting, in front of a company or a following.
You get so good at the public version of yourself that almost no one meets the private one. That is the quiet cost of being the one everyone counts on.
This work may be for you if :
You spend your days being the one others rely on, and there is nowhere to set that down.
You have to be on, and the performance does not fully stop when you go home.
The pressure shows up in the body, in your sleep, your energy, the racing heart before the room.
You are only ever as good as your last performance, your last quarter, or your last headline.
The break you worked years for finally came, and it brought a pressure nobody warned you about.
You are making the work and waiting to be found, and the waiting has its own weight.
You are the founder everyone is counting on, and there is no one you can tell that you are not sure.
The ground under your life is moving, by your choice or not, and everyone expects you to hold steady through it.
Your name or your face is known, and almost no one gets the person behind it.
You are carrying something you have never said out loud, because the role could not afford it.
WHY PEOPLE REACH OUT
Almost nobody books a consult on an ordinary day.
People reach out when two things are true at once: the way you have been handling this alone has stopped working, and some part of you still believes it can be different.
That second part is the one that got you here. It is enough to start.
You are not alone.
I believe everyone who sits with me deserves a space to bring whatever they need to bring, free of judgment and free of shame.
No topic is off-limits.
No topic is taboo.
There is nothing you could say in this room that would be met with anything but acceptance and understanding, whatever you have done, or not done, wanted, or not wanted.
Because we do not heal what we will not say out loud. You do not need a diagnosis, the perfect words, or a clean version of the story to begin. You can bring the real thing, the whole thing, even the part you have never told anyone. You are not alone in it, and you do not have to carry it alone anymore.
HOW I WORK
You will not sit in silence waiting for me to speak. I am active, and I am in it with you. I follow what matters, I ask the direct question, and I will challenge the story you have told a hundred times, because people who live these lives do not need to be handled with tweezers. They need someone who can handle them.
When the moment calls for it, I lead. When you start taking care of the room, I hand you back to yourself. And I build the work around you, customized to your concerns, your wiring, the way you actually move through the world.
Cognitive Behavioral Therapy and exposure
For the thoughts and behaviors that keep a problem running, including exposure-based work when avoidance is part of it.
Acceptance and Commitment therapy
For making room for hard feelings while you keep moving toward what matters to you
AEDP, Accelerated Experiential Dynamic Psychotherapy
For the feelings you have learned to keep at a distance. We work with emotion directly, in the room, at your pace, in a relationship safe enough to go there. The experiential heart of how I work.
Psychodynamic work
For the patterns that run deeper than the moment, the ones that repeat until they are understood.
I pay attention to the whole of you, the body and its sleep and energy, the mind, and the relationships around you, including the one between us, because that relationship is what makes the work land.
My work is grounded in AEDP, an experiential, relationship based approach that works with emotion directly in the room rather than only talking about it. Around it I bring cognitive and behavioral tools and exposure, and I match the method to what is actually in your way.
Clients tend to describe my style as active, warm, direct, and fully present. My aim is for you to need me less over time, not more.
MY METHOD
I believe in a whole person approach to therapy. You are one connected person, not a stack of separate problems. Your body, your mind, and your relationships are always talking to each other, so we pay attention to all three. None of them comes first. They come together:
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What you are struggling with often lives partly in the body. If your sleep is wrecked, caffeine is running the show, or something physical is feeding how you feel, talk alone will not fix it. I am not a physician, and I do not diagnose or treat medical conditions. I make sure you have had a recent physical, and I work alongside your doctor and other trusted practitioners, so the body is part of the picture, not an afterthought.
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New behaviors are not created through new insights. They are created through new experiences. We aim to identify your patterns outside of the therapy space and how you can create new, empowering patterns that will lead to more positive experiences in your day-to-day life aligned with who you are and where you want to go as a human.
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The quality of your life tracks the quality of your relationships. We do the work so you can show up the way you want to, at home, in love, at work and at play. We do the work so you can show up the way you want to, at home, in love, at work, and in the rooms where the stakes are highest.
HOW IT WORKS - Starting is simple, and purposeful.
01.
A free 15-minute video consult. I hear a little about what is bringing you in, you get to hear how I work and ask me anything you need to.
02.
One first session. We spend a full session together and see how it feels.
03.
If it feels right, we move forward with weekly sessions.
WHAT CHANGES
In the course of this work, clients tend to find that they freeze less and trust themselves more. The dread before the big moment eases. The body settles, the sleep comes back, and the people close to you start getting more of the real you.
And there is finally one place where you do not have to be on. One room where the whole thing can be set down, said out loud, and worked with, so you can go back out and do what you came here to do.
USING INSURANCE
You may be able to use your health insurance to help pay for therapy.
The steps below show you what your plan covers, in about a minute.
HOW TO CHECK YOUR BENEFITS
1. Open the benefits checker: calculator.meetnirvana.com
2. Enter your insurance information.
3. When it asks for your provider, enter the name Samuel Guzzardi. Sam is the licensed clinician who supervises my work, and your benefits are checked under his name.
4. The checker shows your out-of-network mental health benefits right away.
WHAT YOU WILL LEARN
Whether your plan covers out-of-network therapy.
How much of your yearly deductible you still have to meet.
How much of each session your plan pays back.
How many sessions your plan allows each year.
HOW IT WORKS WITH ME
If your plan has out-of-network benefits, you may be able to use them toward our work together. In simple terms, you pay for your sessions, and your plan may pay part of that back to you, based on your coverage.
The practice helps with the paperwork, and we will check your benefits together on the free consult call, so you know the real numbers before you decide anything.
If insurance is not the right fit, I also see clients on a sliding scale.
WHO AM I? HOW DID I GET HERE?
I am drawn to the people everything is built around. The performer a production depends on. The founder a company depends on. The person a family or a following runs through. And the many who will never call themselves any of those things, and carry the same weight anyway. I also sit with people in the middle of a big transition, a divorce, a career change, the ground moving under a life. I know that weight, and I know the particular loneliness of being the one at the center with nobody to tell.
I want you to be able to do the work you came here to do and still have a life around it.
My purpose and my hope are the same; that anyone who comes into contact with me, or with my work, will feel at least a little less alone. Less alone in who they are, what they're feeling, what they're not feeling, what they've done, and what they didn't do.
Coupled with that is the belief that new behaviors are not created through new insights. They are created through new experiences.
Before I trained as a therapist, I lived several different lives. I never planned on such a twisting and turning path, but I'm ever grateful for it.
I served as a United States Navy rescue swimmer. I trained as an actor, with an MFA from Rutgers, where I studied under William Esper in the Meisner technique, and I have worked for years as a portrait photographer, with work in The New York Times and on Comedy Central. I am still an artist. I still act, and I still photograph.
For a decade I worked inside a community of Fortune 70 chief information officers. It put me in the room with founders and senior leaders, up close, when the pressure was real and someone had to stand up and speak.
I have also taught communication as an adjunct professor at the University of New Hampshire's Paul College of Business and Economics.
The arts, business, the military, and the classroom: four very different worlds, and the same human questions run underneath all of them.
I am completing my Master's in Clinical Mental Health Counseling at Northwestern University, and I have trained in AEDP, the experiential, relationship based approach at the center of how I work. I see clients under the clinical supervision of a New York State licensed clinical social worker.
REACH ME
Reach out for a private 15-minute consult to see how we might work together.
In person in Union Square and by telehealth across New York State.
You do not have to keep carrying this alone.
You will hear back within twenty-four hours.
YOUR QUESTIONS, ANSWERED
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Anxiety, stress and burnout, performance pressure, stage fright and the mind that goes blank, low mood, self-doubt, relationship strain, and big transitions like a divorce or a career change. Because I work with the whole person, I also pay attention to sleep, energy, and anything physical that might be feeding how you feel, and I will point you toward the right medical or specialized care when that is what you need.
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Because your body and your mind are not separate. Sleep, blood sugar, hormones, caffeine, and stress all shape how you feel, and talk alone cannot fix a problem that is partly physical. I am not a physician and I do not diagnose or treat medical conditions, but I ask health questions at the start, I make sure you have had a recent physical, and I coordinate with your doctor and other trusted practitioners so the whole picture is covered.
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I lead with AEDP, accelerated experiential dynamic psychotherapy: experiential, relationship based work that goes to the feeling itself, not only the story about it. Around it I draw on cognitive behavioral therapy and exposure, acceptance and commitment therapy, and psychodynamic work for deeper patterns. I match the method to what is in your way rather than forcing you into one school, and underneath all of it, the relationship between us is what makes the work land.
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Adults across New York State who live high-stakes lives, and the many people who simply carry more than their share: anxiety, stress, low mood, relationship strain, big transitions. I have a soft spot for people who have to stay well while they keep showing up, on a stage, on set, in the boardroom, or running something they built. You do not need to be in crisis to come, and some people simply prefer to work with a man, which is reason enough.
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Yes. Stage fright, fear of public speaking, audition nerves, pitch and boardroom pressure, and the freeze that shows up right when you need to deliver. We work on it in a way that lasts, and if something physical is part of it, like sleep, caffeine, or blood sugar, we take that seriously too.
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I am a pre-licensed therapist. I am completing my Master's in Clinical Mental Health Counseling at Northwestern University, and I practice under the clinical supervision of a New York State licensed clinical social worker.
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As long as the work takes, and no longer. We always keep some kind of goal in view, even when the goal is simply for you to need me less. I am not trying to keep you forever.
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Sessions are out of network, with an income-based sliding scale. Many clients use out-of-network benefits, and the benefits checker on this page shows what your plan may pay back. We go over the real numbers together on the free 15-minute consult, so nothing is a surprise.
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Yes. In person in Union Square, and by secure telehealth anywhere in New York State.
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The difference is the structure around you. When you are the one a production, a company, or a family is built on, a bad week is not private, and there is no understudy who can stand in. Staying well stops being self-care and becomes the thing that protects everyone who depends on you. So the work is built to keep you steady while the pressure is on, not to wait for a collapse that no one has a plan for.
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No. Many of the people I work with are not public at all. They are simply the one everyone leans on, at work or at home, and the cost of their not being well lands on other people. If that is you, you are in the right place.