Photo of Anna Lau, Psychiatric Nurse Practitioner in Bronxville, NY
Anna Lau
Psychiatric Nurse Practitioner, MSN, PMHNP, -BC
Verified Verified
Bronxville, NY 10708  (Online Only)
Hello, I look forward to meeting you! My name is Anna and I'm a Board Certified Psychiatric Nurse Practitioner In the state of New York. I specialize in Anxiety, Depression, LGBTQ Care, Relationship Issues, Women's Issue Therapy as well as medication management. I work with an amazing group of colleagues at Lavender, an online psychiatry and therapy office, where we believe psychiatric care shouldn't be expensive nor impossible to access.
Hello, I look forward to meeting you! My name is Anna and I'm a Board Certified Psychiatric Nurse Practitioner In the state of New York. I specialize in Anxiety, Depression, LGBTQ Care, Relationship Issues, Women's Issue Therapy as well as medication management. I work with an amazing group of colleagues at Lavender, an online psychiatry and therapy office, where we believe psychiatric care shouldn't be expensive nor impossible to access.
(332) 378-5857 View (332) 378-5857
Photo of Westchester Consultation and Psychotherapy, Psychiatrist in Bronxville, NY
Westchester Consultation and Psychotherapy
Psychiatrist, MD
Verified Verified
1 Endorsed
Bronxville, NY 10708
Jeffery Smith, MD is an author and leader who specializes in helping individuals and families in their most challenging and difficult times. He offers thoughtful and through evaluation, diagnosis and discussion of options in person and online. He is full clinical professor at New York Medical College, as well as Leader of the Psychotherapy Caucus of the American Psychiatric Association and President Elect of the Society for the Exploration of Psychotherapy Integration. His years of practice and teaching other therapists allow him to give patients confidence in navigating the maze of mental health treatments and choices.
Jeffery Smith, MD is an author and leader who specializes in helping individuals and families in their most challenging and difficult times. He offers thoughtful and through evaluation, diagnosis and discussion of options in person and online. He is full clinical professor at New York Medical College, as well as Leader of the Psychotherapy Caucus of the American Psychiatric Association and President Elect of the Society for the Exploration of Psychotherapy Integration. His years of practice and teaching other therapists allow him to give patients confidence in navigating the maze of mental health treatments and choices.
(914) 401-4472 View (914) 401-4472

More Psychiatrists Nearby

Photo of Telepsychiatry: Rave Psychiatry, PC, Psychiatric Nurse Practitioner in Bronxville, NY
Telepsychiatry: Rave Psychiatry, PC
Psychiatric Nurse Practitioner, PMHNP, LCSW-R, LMSW, LMHC
Verified Verified
Bronx, NY 10465
At Rave Psychiatry, We offer exceptional and convenient care utilizing tele-psychiatry, tele-therapy and traditional in-office visits; thereby giving client’s the option to choose on which method to see a psychiatric provider. Our team of 10+ Psychiatric providers are experienced, licensed and nationally certified, professional mental health providers that pride on working with each client in order to provide team oriented and consistent care at all times. We serve clients from NY via a secure Telepsychiatry platform through a HIPPA compliant platform that is approved by American Telemedicine Association.
At Rave Psychiatry, We offer exceptional and convenient care utilizing tele-psychiatry, tele-therapy and traditional in-office visits; thereby giving client’s the option to choose on which method to see a psychiatric provider. Our team of 10+ Psychiatric providers are experienced, licensed and nationally certified, professional mental health providers that pride on working with each client in order to provide team oriented and consistent care at all times. We serve clients from NY via a secure Telepsychiatry platform through a HIPPA compliant platform that is approved by American Telemedicine Association.
(347) 835-5963 View (347) 835-5963
Photo of John S Tamerin, Psychiatrist in Bronxville, NY
John S Tamerin
Psychiatrist, MD
Verified Verified
Westchester, NY 10461
My ideal client is someone who wants more out of life than symptom removal. I want to work with people who want to find meaning, purpose and passion in their lives. Certainly, I want to help people diminish suffering but a lasting approach must involve a determined commitment to living a fulfilling life.
My ideal client is someone who wants more out of life than symptom removal. I want to work with people who want to find meaning, purpose and passion in their lives. Certainly, I want to help people diminish suffering but a lasting approach must involve a determined commitment to living a fulfilling life.
(203) 941-6659 View (203) 941-6659
Photo of Tamisha Kelly, Psychiatric Nurse Practitioner in Bronxville, NY
Tamisha Kelly
Psychiatric Nurse Practitioner, MSN, PMHNP, -BC
Verified Verified
1 Endorsed
Rye, NY 10580  (Online Only)
Hello, I look forward to meeting you! My name is Tamisha and I am a Board Certified Psychiatric Nurse Practitioner. I graduated with a Masters of Science from SUNY Stony Brook University. My specializations includes Anxiety, Depression and ADHD. I work with an amazing group of colleagues at Lavender, an online psychiatry and therapy office, where we believe psychiatric care shouldn't be expensive nor impossible to access.
Hello, I look forward to meeting you! My name is Tamisha and I am a Board Certified Psychiatric Nurse Practitioner. I graduated with a Masters of Science from SUNY Stony Brook University. My specializations includes Anxiety, Depression and ADHD. I work with an amazing group of colleagues at Lavender, an online psychiatry and therapy office, where we believe psychiatric care shouldn't be expensive nor impossible to access.
(516) 614-4327 View (516) 614-4327
Photo of Open Hands Psychiatry-TX, NY, CA, AZ, CO, WY, NM, Psychiatric Nurse Practitioner in Bronxville, NY
Open Hands Psychiatry-TX, NY, CA, AZ, CO, WY, NM
Psychiatric Nurse Practitioner, PMHNPBC
Verified Verified
3 Endorsed
Scarsdale, NY 10583  (Online Only)
Hi, my name is Festus. I am a board-certified psychiatric mental health nurse practitioner providing medication and nonmedication management. If you are overwhelmed, dealing with depression, anxiety, panic episodes, PSTD; bipolar or personality disorder or ADHD, I am here to help. Let us work together. I bring a humane and nonjudgmental feeling to my clients as I care for their minds and bodies.
Hi, my name is Festus. I am a board-certified psychiatric mental health nurse practitioner providing medication and nonmedication management. If you are overwhelmed, dealing with depression, anxiety, panic episodes, PSTD; bipolar or personality disorder or ADHD, I am here to help. Let us work together. I bring a humane and nonjudgmental feeling to my clients as I care for their minds and bodies.
(214) 888-3609 View (214) 888-3609
Photo of Emily Leiner, Psychiatric Nurse Practitioner in Bronxville, NY
Emily Leiner
Psychiatric Nurse Practitioner, MSN, PMHNP, -BC
Verified Verified
Bronx, NY 10470  (Online Only)
Hello, I look forward to meeting you! My name is Emily and I'm a Board Certified Psychiatric Nurse Practitioner In the state of New York. I specialize in Anxiety, Bipolar Disorder, Burnout, Chronic Illness, College/Graduate Student Mental Health, Depression, Family Issues, Life Transitions, Relationship Struggles, Seasonal Affective Disorder (SAD), Post-Traumatic Stress Disorder (PTSD), Sleep Problems, Stress Management, OCD and ADHD. I work with an amazing group of colleagues at Lavender, an online psychiatry and therapy office, where we believe psychiatric care shouldn't be expensive nor impossible to access.
Hello, I look forward to meeting you! My name is Emily and I'm a Board Certified Psychiatric Nurse Practitioner In the state of New York. I specialize in Anxiety, Bipolar Disorder, Burnout, Chronic Illness, College/Graduate Student Mental Health, Depression, Family Issues, Life Transitions, Relationship Struggles, Seasonal Affective Disorder (SAD), Post-Traumatic Stress Disorder (PTSD), Sleep Problems, Stress Management, OCD and ADHD. I work with an amazing group of colleagues at Lavender, an online psychiatry and therapy office, where we believe psychiatric care shouldn't be expensive nor impossible to access.
(929) 338-6112 View (929) 338-6112
Photo of Galit Sharon Marcus, Psychiatric Nurse Practitioner in Bronxville, NY
Galit Sharon Marcus
Psychiatric Nurse Practitioner, PMHNP, MPH
Verified Verified
Larchmont, NY 10538
Are personal, school, or business relationships a problem for you? Are you depressed, angry, or anxious? Do you feel different, alone, or like an outsider? Do you have low self esteem? Are there disturbing problems in your life that you struggle to improve? Are you trying to discover who you are? I use a "toolbox" approach using one or more therapeutic techniques based on what you need. I am trained in interpersonal therapy, mindfulness, psychopharmacology, CBT, DBT skills, EMDR, Gottman method, and trauma-informed therapy. I am confident that my combination of skills will help if we have a compatible and good rapport together.
Are personal, school, or business relationships a problem for you? Are you depressed, angry, or anxious? Do you feel different, alone, or like an outsider? Do you have low self esteem? Are there disturbing problems in your life that you struggle to improve? Are you trying to discover who you are? I use a "toolbox" approach using one or more therapeutic techniques based on what you need. I am trained in interpersonal therapy, mindfulness, psychopharmacology, CBT, DBT skills, EMDR, Gottman method, and trauma-informed therapy. I am confident that my combination of skills will help if we have a compatible and good rapport together.
(914) 268-6113 View (914) 268-6113
Photo of Nathalie Avignon, Psychiatric Nurse Practitioner in Bronxville, NY
Nathalie Avignon
Psychiatric Nurse Practitioner, MSN, PMHNP
Verified Verified
2 Endorsed
Elmsford, NY 10523  (Online Only)
I specialize in mood disorders, including depression and anxiety, with a focus on medication management.
Hello! My name is Nathalie Avignon! 'I am a Board Certified Psychiatric Nurse Practitioner with 10+ years of experience in nursing. I'm well-versed in providing psychotherapy and psychoeducation to my clients on mental health, medications, and preventative health measures. I take an approach of enabling my clients, so they can take better care for themselves and their psychiatric and behavioral needs.
I specialize in mood disorders, including depression and anxiety, with a focus on medication management.
Hello! My name is Nathalie Avignon! 'I am a Board Certified Psychiatric Nurse Practitioner with 10+ years of experience in nursing. I'm well-versed in providing psychotherapy and psychoeducation to my clients on mental health, medications, and preventative health measures. I take an approach of enabling my clients, so they can take better care for themselves and their psychiatric and behavioral needs.
(929) 205-5581 View (929) 205-5581
Photo of B.T.M. Psychiatric NP Services, PLLC, Psychiatric Nurse Practitioner in Bronxville, NY
B.T.M. Psychiatric NP Services, PLLC
Psychiatric Nurse Practitioner, FPMHNP, -BC, Psych, NP
Verified Verified
1 Endorsed
Bronx, NY 10466  (Online Only)
Not accepting new clients
Here, is NON-judgmental environment that fosters and focuses on building patient trust/rapport through mutual respect. A Humanistic/Holistic approach is strongly emphasized and practiced. I believe creating a treatment plan that is tailored to each individuals needs. When prescribing, ruling out possible medical conditions and other factors contributing to symptoms is priority. I have expertise in treating child/adolescent disorders, Anxiety, Panic Disorder, PTSD, Major Depression, Bipolar Disorder, Schizophrenia, ADHD, and other mental health issues.
Here, is NON-judgmental environment that fosters and focuses on building patient trust/rapport through mutual respect. A Humanistic/Holistic approach is strongly emphasized and practiced. I believe creating a treatment plan that is tailored to each individuals needs. When prescribing, ruling out possible medical conditions and other factors contributing to symptoms is priority. I have expertise in treating child/adolescent disorders, Anxiety, Panic Disorder, PTSD, Major Depression, Bipolar Disorder, Schizophrenia, ADHD, and other mental health issues.
(914) 350-5265 View (914) 350-5265
Photo of Drew Bianchi, Psychiatrist in Bronxville, NY
Drew Bianchi
Psychiatrist, MD
Verified Verified
1 Endorsed
Scarsdale, NY 10583
I am a therapist first and foremost. I am also a Mt Sinai and NYU-trained psychiatrist, and can prescribe medication when appropriate. I have over 10 years experience working with children (tweens and up) and adults (individuals and couples).
I am a therapist first and foremost. I am also a Mt Sinai and NYU-trained psychiatrist, and can prescribe medication when appropriate. I have over 10 years experience working with children (tweens and up) and adults (individuals and couples).
(646) 759-1265 View (646) 759-1265
Photo of Barbara Fontane, Psychiatrist in Bronxville, NY
Barbara Fontane
Psychiatrist, MD
Verified Verified
Harrison, NY 10528
I provide support for anxiety and depression linked to family or relationship challenges. Whether you opt for medication, therapy, or a combination of both, I'm here to assist. Opening up about deeply personal fears and worries can be daunting, but I'm here to guide you through it. I understand the desire for a more fulfilling life and the complexities of treatment. I offer both in-person and virtual sessions for your convenience. Let's work together to address your concerns and improve your well-being.
I provide support for anxiety and depression linked to family or relationship challenges. Whether you opt for medication, therapy, or a combination of both, I'm here to assist. Opening up about deeply personal fears and worries can be daunting, but I'm here to guide you through it. I understand the desire for a more fulfilling life and the complexities of treatment. I offer both in-person and virtual sessions for your convenience. Let's work together to address your concerns and improve your well-being.
(914) 359-3665 View (914) 359-3665
Photo of Dr. Julia Novikov, Psychiatrist in Bronxville, NY
Dr. Julia Novikov
Psychiatrist, MD
Verified Verified
1 Endorsed
White Plains, NY 10603
Double board-certified psychiatrist with subspecialties in general psychiatry, psychosomatic medicine, and reproductive psychiatry. I am passionate about providing comprehensive mental health care to adult individuals of all ages and backgrounds. Subspecialized expertise allows me to address the unique mental health concerns that arise with various comorbid chronic medical conditions as well as all stages of female reproductive cycle. I believe in a patient-centered approach, each individual's unique needs are taken into consideration in developing a personalized treatment plan.
Double board-certified psychiatrist with subspecialties in general psychiatry, psychosomatic medicine, and reproductive psychiatry. I am passionate about providing comprehensive mental health care to adult individuals of all ages and backgrounds. Subspecialized expertise allows me to address the unique mental health concerns that arise with various comorbid chronic medical conditions as well as all stages of female reproductive cycle. I believe in a patient-centered approach, each individual's unique needs are taken into consideration in developing a personalized treatment plan.
(914) 483-3474 View (914) 483-3474
Photo of Cara Gouldey, Psychiatric Nurse Practitioner in Bronxville, NY
Cara Gouldey
Psychiatric Nurse Practitioner, CRNP, PMHNP
Verified Verified
1 Endorsed
Mamaroneck, NY 10543
My specialties include, but are not limited to treatment of depression, anxiety (generalized anxiety, social anxiety, panic disorder, and obsessive-compulsive disorder), and ADHD.
The best psychiatric care is tailored to an individual's unique needs, understood through the context of their environment, relationships, and lived experience. With this foundation, I work with patients to identify and achieve their mental health and wellness goals. I am a board-certified Psychiatric Nurse Practitioner with over ten years of direct patient care experience in a diversity of roles, including diagnosing and treating mental health disorders in group practice, community settings, and via telehealth. I provide psychiatric evaluations and medication management for adults, adolescents, and school-aged children.
My specialties include, but are not limited to treatment of depression, anxiety (generalized anxiety, social anxiety, panic disorder, and obsessive-compulsive disorder), and ADHD.
The best psychiatric care is tailored to an individual's unique needs, understood through the context of their environment, relationships, and lived experience. With this foundation, I work with patients to identify and achieve their mental health and wellness goals. I am a board-certified Psychiatric Nurse Practitioner with over ten years of direct patient care experience in a diversity of roles, including diagnosing and treating mental health disorders in group practice, community settings, and via telehealth. I provide psychiatric evaluations and medication management for adults, adolescents, and school-aged children.
(267) 358-6157 View (267) 358-6157
Photo of Meghan Kise, Psychiatric Nurse Practitioner in Bronxville, NY
Meghan Kise
Psychiatric Nurse Practitioner, MSN, PMHNP, -BC
Verified Verified
Bronx, NY 10470  (Online Only)
Hello, I look forward to meeting you! My name is Meghan and I'm a Board Certified Psychiatric Nurse Practitioner In the state of New York. I specialize in Depression, Anger Management, Anxiety, Bipolar, Family Issues, Life Coaching, Loss/Grief/Bereavement, Post-Traumatic Stress Disorder, Stress Management and Women's Issues. I work with an amazing group of colleagues at Lavender, an online psychiatry and therapy office, where we believe psychiatric care shouldn't be expensive nor impossible to access.
Hello, I look forward to meeting you! My name is Meghan and I'm a Board Certified Psychiatric Nurse Practitioner In the state of New York. I specialize in Depression, Anger Management, Anxiety, Bipolar, Family Issues, Life Coaching, Loss/Grief/Bereavement, Post-Traumatic Stress Disorder, Stress Management and Women's Issues. I work with an amazing group of colleagues at Lavender, an online psychiatry and therapy office, where we believe psychiatric care shouldn't be expensive nor impossible to access.
(929) 560-2358 View (929) 560-2358
Photo of Dr. Suparna Basu, Psychiatrist in Bronxville, NY
Dr. Suparna Basu
Psychiatrist, MD
Verified Verified
2 Endorsed
Scarsdale, NY 10583  (Online Only)
If you are suffering from anxiety or depression you should know you are not alone. Problems with your emotional health can prevent you from pursuing your dreams and living life to the fullest. Working with you to reach your full potential is my number one goal. My approach can best be described as interpersonal/humanistic, one in which my working relationship is every bit as important as any medication you might decide to use. You can learn more about my practice on my website; http://basupsychiatry.com
If you are suffering from anxiety or depression you should know you are not alone. Problems with your emotional health can prevent you from pursuing your dreams and living life to the fullest. Working with you to reach your full potential is my number one goal. My approach can best be described as interpersonal/humanistic, one in which my working relationship is every bit as important as any medication you might decide to use. You can learn more about my practice on my website; http://basupsychiatry.com
(914) 529-6364 View (914) 529-6364
Photo of Josephine Kuhl, Psychiatrist in Bronxville, NY
Josephine Kuhl
Psychiatrist, MD
Verified Verified
Harrison, NY 10528
I work with people of all ages and from all walks of life. Most come because they have the sense that something in their life isn't working. They want to feel better and I want to help them. During our first visits we will get to know each other and talk about why you came in. We will start to determine your personal goals and the different treatment options available to you. I see patients in my private office, in a nonthreatening environment, with complete confidentiality. I want people to feel comfortable and safe in my office, even if it it their first experience with a psychiatrist.
I work with people of all ages and from all walks of life. Most come because they have the sense that something in their life isn't working. They want to feel better and I want to help them. During our first visits we will get to know each other and talk about why you came in. We will start to determine your personal goals and the different treatment options available to you. I see patients in my private office, in a nonthreatening environment, with complete confidentiality. I want people to feel comfortable and safe in my office, even if it it their first experience with a psychiatrist.
(914) 825-4335 View (914) 825-4335
Photo of Karen G. Gennaro, Psychiatrist in Bronxville, NY
Karen G. Gennaro
Psychiatrist, MD, MBA
Verified Verified
Harrison, NY 10528
AS A PSYCHIATRIST WHO IS ALSO A PSYCHOANALYST, I can help you better understand the root of your issues and develop methods for coping and moving forward. I will offer treatment tailored to your specific needs to help you maximize your unique strengths and shore up any vulnerabilities. Together we will work to enhance your sense of individuality, community and personal freedom. You will gain the strength to finally break out of old habits and release new potentials. Although I am an expert using psychiatric medication, I ONLY OFFER MEDICATION MANAGEMENT TO PEOPLE WILLING TO WORK WITH ME IN AT LEAST ONCE WEEKLY THERAPY.
AS A PSYCHIATRIST WHO IS ALSO A PSYCHOANALYST, I can help you better understand the root of your issues and develop methods for coping and moving forward. I will offer treatment tailored to your specific needs to help you maximize your unique strengths and shore up any vulnerabilities. Together we will work to enhance your sense of individuality, community and personal freedom. You will gain the strength to finally break out of old habits and release new potentials. Although I am an expert using psychiatric medication, I ONLY OFFER MEDICATION MANAGEMENT TO PEOPLE WILLING TO WORK WITH ME IN AT LEAST ONCE WEEKLY THERAPY.
(914) 260-6437 View (914) 260-6437
Photo of Adam Turner, Psychiatrist in Bronxville, NY
Adam Turner
Psychiatrist, MD
Verified Verified
Scarsdale, NY 10583  (Online Only)
My primary goal is to help you or your child heal and be the best version of yourself. Our initial meeting will include psychiatric evaluation and assessment of need for medication. I am well-versed in psychotherapy and natural healing and use various modalities to help individuals regain both emotional and physical health. Our work will help you connect more deeply in your most important relationships and live with purpose.
My primary goal is to help you or your child heal and be the best version of yourself. Our initial meeting will include psychiatric evaluation and assessment of need for medication. I am well-versed in psychotherapy and natural healing and use various modalities to help individuals regain both emotional and physical health. Our work will help you connect more deeply in your most important relationships and live with purpose.
(917) 791-1096 View (917) 791-1096
Photo of Yesie Yoon, Psychiatrist in Bronxville, NY
Yesie Yoon
Psychiatrist, MD
Verified Verified
1 Endorsed
Tarrytown, NY 10591
As a triple board-certified pediatrician, psychiatrist, and child and adolescent psychiatrist, I am driven by a deep passion for providing comprehensive and compassionate care to children, adolescents, and their families. Throughout my training and career, I have been dedicated to advancing my knowledge and skills in all three fields, with the goal of offering the most effective and evidence-based care possible. Throughout my career, I worked with children and families from diverse backgrounds, honing my clinical skills and deepening my commitment to providing holistic care.
As a triple board-certified pediatrician, psychiatrist, and child and adolescent psychiatrist, I am driven by a deep passion for providing comprehensive and compassionate care to children, adolescents, and their families. Throughout my training and career, I have been dedicated to advancing my knowledge and skills in all three fields, with the goal of offering the most effective and evidence-based care possible. Throughout my career, I worked with children and families from diverse backgrounds, honing my clinical skills and deepening my commitment to providing holistic care.
(914) 877-2439 View (914) 877-2439

See more therapy options for Bronxville

Depression Psychiatrists

What is the goal of therapy for depression?

Therapy for depression has several major goals. One is to relieve the mental pain of depression, which distorts feeling and thinking so that sufferers cannot see beyond their current state of mind or envision feeling better. Another is to give people the mental tools to recognize and correct the kinds of distorted thinking that turn a problem into a catastrophe and lead to despair. Therapy also teaches people how to process negative emotions in constructive ways, so they have more control over their own emotional reactivity. And it helps people regain the ability to see themselves positively, the motivation to do things, and the capacity for pleasure.

What happens in therapy for depression?

Perhaps most important, no matter the type of therapy, patients form an alliance with the therapist; that connection is therapeutic in itself, plus it becomes an instrument of change. Patients learn to identify and to challenge their own erroneous beliefs and thoughts that amplify the effects of negative experiences. They learn to identify situations in which they are especially vulnerable. And they learn new patterns of thinking and behaving. They may be given “homework” assignments in which they practice their developing skills. In addition, good therapists regularly monitor patients to assess whether and how much the condition is improving.

What therapy types help with depression?

Several types of short-term therapy have been found effective, each targeting one or more areas of dysfunction. Cognitive behavioral therapy (CBT) helps clients challenge their negative thoughts and beliefs, learn new behavioral strategies, and curb reactivity to distressing situations. Behavioral activation (BA) is a form of therapy often used in conjunction with CBT; it focuses on engagement in rewarding activity as a pathway to changing negative feelings and disturbed mood. Another widely used approach is interpersonal therapy (IPT), which targets the social difficulties that both give rise to and get exacerbated by depression. Therapists may combine approaches as needed.

Can therapy for depression be done online?

Studies have found that online therapy can be highly effective for treating depression, although it may be more challenging to build a good therapist-patient alliance on screen than in person—at least at first. However, online therapy can offer considerable advantages. Accessibility and convenience are tops among them. Some people actually find it easier to talk about problems online than in person. While online therapy typically limits visibility of facial expression and body gestures that give important nonverbal cues to a patient’s state of mind, it can give therapists a glimpse into a patient’s world and life, providing information that can be highly useful in guiding therapy.

How effective is therapy for depression?

Many studies show that therapy is highly effective provided that patients complete the prescribed course of therapy, commonly 16 to 20 sessions. Over the long term, it is more effective than medication and the effects are more enduring. As a result, psychotherapy has the power not just to relieve current suffering but to prevent future episodes of the disorder. Therapy reverses the dysfunction in neural circuitry that disposes individuals to a negative view of themselves, the world, and their future and they acquire coping techniques, problem-solving skills, and understanding of their own vulnerabilities that are useful over the course of a lifetime.