Work with Patrick and Charlie
Your Charleston and Mount Pleasant Therapist and Therapy Dog
Trauma & Self Esteem
Trauma is something many of us face. It makes us feel trapped, misunderstood, and stuck. Many of us feel we aren’t sure where to go next. Let’s walk on this journey together to help you explore your trauma and help you rebuild your self-worth in therapy together.
Anxiety
Anxiety is what I like to call “the annoying porcupine in our lives.” When it’s quills hit, it hits hard, just like how anxiety does. However, what if we learned how to give this porcupine a hug? I know, it sounds like the impossible, but let’s discover your anxiety and learn how to make it our friend, not our enemy in your therapy journey.
LGBTQ+
As someone who identifies as part of this community and grew up in the south, my heart goes out to those who might be struggling with their sexual identity. If you’re someone trying to discover your sexual identity or expression, let’s take this journey together. I would love nothing more than to be your therapist.
Pornography Addiction
Many individuals, especially males, feel deeply ashamed to address this with loved ones, making them suffer in silence. It can feel as if they were holding a deep, dark secret, and if they’re exposed, their world would crumble. If you are someone who feels this way, let’s talk. Disclosure: I do not offer services for court-mandated treatment or work with individuals involved in the legal system for sexual offenses, including sex offender treatment. If in need for a clinician that can provide these services, I am happy to provide a referral in the Charleston and Mount Pleasant community. I’m also not a certified sex-therapist.
Pet Grief
Losing a pet can be one of the worst experiences one faces. If you recently lost a furry friend that felt like family, please reach out and let me support you during this time for therapy support. I would love to help you process this grief, and guide you to finding your inner peace.
College Students
Whether it’s starting out your first year, transferring from a past institution, or getting ready to graduate, these life transitions can be overwhelming for someone. So let’s talk about it in therapy, and let me serve you as your therapist.I have almost a decade of experience working with college students from my experience in higher education while living in the Charleston community.
50-minute individual counseling session: $125
50-minute couple’s counseling session: $150
Cost of Services:
Meet the Team
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![Mount Pleasant Male Counselor]()
Patrick W. Ramsay
THERAPIST + FOUNDER
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![Certified Therapy Dog in Mount Pleasant]()
Charlie
CERTIFIED THERAPY DOG
The Burrow Blog
Monday, November 17th, 2025
From the Gray Havens to Charleston Oaks: Heartbreak, Hope, and Charlotte York
Dearest Gentle Readers,
Did you miss me? A Lady Whistledown-style entrance seemed appropriate, given the pause in updates. Don’t worry — this is a ghost-free space… though you have full permission to ghost if you like. After all, we all have free will, right?
Let’s take a stroll down Colonial Lake and reflect on some journeys — both fantastical and all too human. And yes, there may be brunch, overpriced lattes, and existential musings involved. All from your Charleston/Mount Pleasant gay male therapist.
FYI… full trigger warning: this one is vulnerable. The kind of vulnerability that hits where it counts — the ache of longing, uncertainty, and hope. There’s a good chance you might feel like that random girl in Mean Girls who didn’t even go to the damn high school but still wanted everyone to know she has a lot of feelings. Lastly, don’t forget to click on the hyperlinks (underlined) for references.
Wood Elves: The Journey to the Gray Havens
The Wood Elves: elegance to the core. Reminder: Legolas was one of these elves: the one who sparked a thousand millennial crushes and a very gay awakening (for me at least...don't believe me, look here).
If Middle Earth were Charleston, these would be the folks who make brunch under the oak trees look like a Gucci fragrance campaign — leaving the rest of us questioning our skincare routines, our fashion choices, and why we just paid $10 for an iced coffee. Yes, $10. And yes, it’s worth it sometimes, but let’s not pretend it’s painless.
The complexity of the elves’ journey mirrors the paths we all walk. Some are heartbreakingly clear — like loss or death, a beloved pet, a person, or a dream that dies. Other paths are twisty, unpredictable, and full of detours. Sometimes what we think is gone may return unexpectedly, in a new form. And in between are the messy moments: walking away from something once beautiful that became toxic, letting go of something that lingers too long, stepping forward into the unknown while carrying the weight of our experiences.
Then there’s the moment that hits the heart: Sam watching the elves on the trail with Frodo, saying, “I don’t know why… but it makes me sad.” The bittersweet ache of beauty in motion, the longing mixed with awe — something exquisite passing through life, leaving an imprint that lingers.
It’s a reminder: the journey isn’t always linear. And sometimes the simplest, clearest path is the one that leads to growth, joy, and emotional survival. Even when the path feels messy or uncertain, there is beauty in the journey — even if it’s Instagram-unapproved brunch vibes kind of beauty. And yes, a few perfectly placed filters won’t hurt either.
Our Fears: Big, Dad Speeches, and the Unknown
Fear is a tricky companion — kind of like Big when it comes to Carrie. Elusive, confusing, a little heartbreaking, and always showing up at the most inconvenient moments. Carrie obsessing over him, wondering if he’ll commit, and Big — well, he’s busy being Big, avoiding the leap, and feeding Carrie's behaviors that made us all want to say, Carrie, please shut up. Fear works in much the same way: it lurks, it whispers, and convinces that the hardest path is always the bravest.
Elrond’s warning to Arwen captures this tension perfectly:
"You will linger on, in darkness and in doubt, as nightfall in winter that comes without a star."
The weight of fear can feel overwhelming: loneliness, uncertainty, longing — the raw sense of being lost. Elrond’s speech is dramatic, full of warnings, slightly terrifying, and yet somewhere hits us in our souls — like those speeches dads give their daughters on prom night, only with slightly more muggle energy. Arwen feared leaving her immortal life behind and stepping into the unknown...making her go off with her people at first. And yet, she glimpsed hope: love, family, and joy that weren’t guaranteed but were possible if she dared to choose life. Choosing Aragorn wasn’t surrender; it was courage in disguise. But hey, I think we can all agree on both ends, it was the happier choice. I mean, look here if you don't believe me.
It’s worth wondering: how often do we endure unnecessary pain, believing suffering proves strength, when the simpler, clearer choice — stepping toward hope, love, and joy — is actually braver? And maybe — just maybe — sometimes courage looks like smiling while sipping on a cup of coffee in Charleston that is worth the cost you paid (Brown Fox Coffee...you guys are fire) and saying, “I’ve got this.”
Charlotte York: Choosing Herself (and Doing It in Burberry)
Charlotte York: the sunshine of Sex and the City and the emotional icon we all need. She wanted happiness, love, and the perfect life. And yet (spoiler alert for anyone who hasn’t watched Sex and the City yet — yes, she leaves Trey, and yes, I just ruined your binge-watch surprise. Don’t hate me), perfection doesn’t always look like we imagine.
Leaving Trey wasn’t easy. It hurt. It scared her. And yet… it was the bravest act she could take. Charlotte stepped away from what looked “right” on paper and toward the life she actually wanted — a life that required trusting herself, not hoping someone else would change. Walking away, honoring herself, following her heart — that was the boldest, most powerful move.
It’s a reminder: how often do we stay in situations hoping someone else will change, or we’ll magically become stronger by enduring more, when the simplest, clearest path — stepping away, honoring ourselves, following our hearts — is actually the bravest choice? And yes, sometimes doing it in a perfect Burberry trench doesn’t hurt either (because have you seen her in Burberry? Girl rocks that. Period). Because if you’re going to walk away, darling, there's no rule saying we can't look fabulous doing it…just realized that sounded very Wendy Williams “post faint” interview-esque.
Conclusions: And Just Like That…because that's how I always end these.
1.) Sometimes the easy way out is actually the best way out. Simple as that.
2.) Admitting fear is one of the bravest acts of self-honesty.
3.) Not everything that leaves is gone forever — some things return when the timing is right. Some things are uncertain, but some things are in fact certain.
4.) Even the coldest, darkest nights pass. Stars return. Daylight comes. And brunch is always a good idea.
And just like that…
Sam learned that sadness can coexist with curiosity, and it doesn’t have to last forever.
Arwen learned that even the scariest choices can lead to joy, love, and light.
Charlotte learned that stepping away from what no longer serves you can bring hope, freedom, and the life you truly deserve.
And just like that, the dark days, the tears, and the fear — they pass. Light returns. Hope returns. And somehow, so do we.