Staying in the Work

Psychiatry is often framed in terms of diagnoses, medications, and outcomes. Much of the work, though, happens elsewhere—in presence, relationship, and the decision to remain when things are uncertain.

In this collection, psychiatrist Brandon Gimbel reflects on clinical work as it unfolds over time: holding structure without control, staying connected through rupture, and making repairs when things go wrong.

The chapters loosely follow the arc of care, from the first contact to the end of treatment. This is not a manual or a promise of change. It is an account of what can happen when both patient and clinician stay with the work long enough for something real to take shape.

Written for clinicians and for those who have received care, Staying in the Work offers a clear, unsentimental look at what it means to remain engaged when the work does not resolve quickly—or cleanly.