Archive for Anxiety

Positive Outlook Is Good For Your Health

CBT Skills and Your Health

In A Positive Outlook May Be Good for Your Health, the New York Times reports that actively enhancing positive emotions can boost your immune system and reduce depression. Studies have shown a link between having a positive outlook and health benefits like lower blood pressure and heart disease, better weight control and healthier blood sugar levels.

CBT Skills that Work

In a research study, participants were encouraged to learn at least three of eight skills and practice one or more each day. The eight skills were:

  • Recognize a positive event each day.
  • Savor that event and log it in a journal or tell someone about it.
  • Start a daily gratitude journal.
  • List a personal strength and note how you used it.
  • Set an attainable goal and note your progress.
  • Report a relatively minor stress and list ways to reappraise the event positively.
  • Recognize and practice small acts of kindness daily.
  • Practice mindfulness, focusing on the here and now rather than the past or future.

How to Get Help for in San Jose/Saratoga and Sacramento/Roseville

The Cognitive Behavior Therapy Center in Silicon Valley (San Jose/Saratoga) and Sacramento Valley (Roseville) specializes in therapy and counseling with adults, children and teenagers. Call us in Saratoga at (408) 384-8404 or in Roseville at (916) 778-0771 or Click to send an email for more information on how we can help you or your family members improve your outlook.

Silicon Valley and Sacramento Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder and Eating Disorders near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

Cognitive Behavior Therapy Center of Sacramento Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder (OCD) and Eating Disorders near the following Sacramento Valley and Sierra communities:

Sacramento Therapy CounselingRoseville Therapy Counseling • Rocklin Therapy Counseling • Granite Bay Therapy Counseling • Lincoln Therapy CounselingFolsom Therapy Counseling • Citrus Heights Therapy Counseling •  El Dorado Hills Therapy Counseling • Loomis Therapy CounselingGrass Valley Therapy Counseling  • Auburn Therapy Counseling

CONTACT US
Saratoga: (408) 384-8404
Roseville: (916) 778-0771
Click to send an email

Using CBT Skills to Become Mindful: The Future of Mindfulness!

Cognitive Behavior Therapy Skills to Become More Mindful and Manage Anxiety

cbt-future-of-mindfulnessMindfulness meditation has become equated with being mindful. But there are alternate ways to build your mindfulness skills. Here’s a way to use CBT skills to become more mindful and manage worry. Read the New York Times article Achieving Mindfulness at Work, No Meditation Cushion Required on a new approach. Some of the main ideas in the article include:

  1. Self-Distancing: Talking to yourself as an objective adviser would.
  2. Reasons Why Bad Thing Won’t Happen: Realize that you’ve already made two unrealistic assumptions: that something will happen, and it will be bad. Next, give yourself three reasons the issue you’re worried about might not happen. Notice that it immediately becomes less stressful, because you just went from “it’s going to happen” to “maybe it will happen, maybe it won’t.”
  3. Reasons If Bad Thing Happens That It Could be Good: Now give yourself three reasons that, if the situation does turn out bad, good things will happen. Now you’ve gone from thinking “there’s this terrible thing that’s going to happen” to thinking “there’s this thing that may or may not happen, but if it does, it could have both good and bad outcomes.”

How to Get Help for Anxiety in San Jose/Saratoga and Sacramento/Roseville

The Cognitive Behavior Therapy Center in Silicon Valley (San Jose/Saratoga) and Sacramento Valley (Roseville) specializes in anxiety therapy and counseling with adults, children and teenagers. Call us in Saratoga at (408) 384-8404 or in Roseville at (916) 778-0771 or Click to send an email for more information on how we can help you or your family members overcome anxiety.

Silicon Valley and Sacramento Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder and Eating Disorders near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

Cognitive Behavior Therapy Center of Sacramento Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder (OCD) and Eating Disorders near the following Sacramento Valley and Sierra communities:

Sacramento Therapy CounselingRoseville Therapy Counseling • Rocklin Therapy Counseling • Granite Bay Therapy Counseling • Lincoln Therapy CounselingFolsom Therapy Counseling • Citrus Heights Therapy Counseling •  El Dorado Hills Therapy Counseling • Loomis Therapy CounselingGrass Valley Therapy Counseling  • Auburn Therapy Counseling

CONTACT US
Saratoga: (408) 384-8404
Roseville: (916) 778-0771
Click to send an email

The Boy Whose Dreams Came True

Here’s a letter one of male teen clients wrote after successful completion of cognitive behavior therapy. It’s a very motivating letter for all ages even adults!

Dear Self,

The engine of my car rumbled when I came here, but the funny thing was that I didn’t even know where I was going. Then my parents said “Remember those scary pictures the kids showed you and you were very scared about that?” and I said “Yeah…” Then they said “we’re going to do something about that so we’re going to take you to a therapist to deal with that and not be scared about them anymore.”

I had a lot of fears about looking at the pictures because if my parents said I was scared, I knew at some point I’d see those pictures again. I thought Saryna would be very mean, and I didn’t want to have to be one of those people lying down on the couch just talking. I was totally unready at first. I just didn’t want to be here when we started talking. Once we came up with the hierarchy list, I was completely not ready for doing anything on that list. For the first few times we did the hierarchy, I thought I could do them, but I knew I couldn’t do anything above a level 5. Especially with a level 10, I would have run away. But the third time I was here, we already started and I said “It was no big deal” afterwards. After that, I knew I could definitely get through all of these. If I were to do the highest thing on the hierarchy list then, I would have never came back here again. Currently, I am 11 years old and I can look at one of the scariest pictures in the world.

“Just do it. Don’t let your dreams be dreams. Just do it.”
This is the quote you should think about when something that you have great anxiety around happens.

The practices here were like the practices I did for the multiplication test I had in 3rd grade. I was practicing my multiplication tables with my mom every day. The day I took the test, I got a really good score – almost 100%. This reminds me of now and the whole year I was here. At the beginning, I was so scared to see the pictures. Now, it’s like the day I took the test. I may have a little anxiety when I see the pictures, but I can do it easily.

I learned that sometimes I go turtle speed and sometimes I go rabbit speed. Just like a band aid, if you go really slow to take it off, it’s really painful. But if you go really fast, it hurts too. If you go at the right speed, it doesn’t hurt as much. I realized this is my own speed. It’s my speed that helps me do things and doesn’t make me scared.

My fear was that I couldn’t handle myself in the dark, and I was constantly waking up and going to my parents’ bed. It has probably been a year and when I compare my new self with my old self, you can see a huge difference in my levels of anxiety.

There were two ways I realized my brain was tricking me. Recently, I have had many bloody noses in the middle of the night and whenever I had them I would usually depend on my parents to stop the bleeding and take care of it, and then I would go to their bed because I was awake and scared. But the latest one I’ve had was a very surprising experience because I handled the bleeding and my nose all by myself, and once I was done, I realized I didn’t need my parents to do it.
My brain was tricking me about that. I was really proud of myself after that happened because my brain would trick me all the time. Another reason why I learned my brain was tricking me, each time we looked at a cut up picture of the characters I was scared of, I realized I was willing to bring it closer to me. From that, I realized my brain was tricking me to be constantly cautious without being willing to try anything uncertain.

So that’s why I have created a character of my own called Mr. Muntz. Mr. Muntz helped me realize every time my brain kept saying “no you can’t do this!” That’s what Mr. Muntz would be saying. So to prevent that from happening, I created another character called Homeyeggagetasaurous Rex. Homeyeggagetasaurous Rex was a combined character of all of my favorite people and fantasy and real life. When I thought of Homeyeggagetasaurous Rex, it helped me realize that I can conquer whatever Mr. Muntz told me because the reckless dinosaur I created helped me think of a silly, cool, and strong personality of myself and I wouldn’t need to worry about anything that I’ve done or will be doing that would make me feel scared and have a really high anxiety level.

So as you can see, you can always try even if you’re scared of doing it. As I said, you should listen to the quote “Just do it. Don’t let your dreams be dreams. Just do it.” so that you can focus on the happy time and not let your worries control you.

Sincerely,
The Boy Whose Dreams Came True

Does Halloween Make You Want to Hide?

Halloween’s Growing Popularity Can Lead to Social Anxiety

Halloween Yorkie Social AnxietyHalloween used to be primarily a kid’s holiday. In recent years, Halloween has transformed from a kid-centric holiday into an $8 billion a year industry for everyone. Two in three adults believe Halloween is a holiday for them and not just kids. Many companies allow, and even encourage employees to wear costumes. Halloween’s creep also extends to pets. Americans will spend $370 million on pet costumes this year, with pumpkin (13%), devil (7%), and hot dog (6%) among the most popular. Halloween is now the second-biggest decorating holiday of the year — right behind Christmas.

Common Worries About Halloween

All this pressure to celebrate Halloween can make some folks downright anxious, especially if you suffer from social anxiety. Besides the fear of ghosts, witches and goblins, adults with social anxiety may suffer from other fears such as:

  • Worry and indecision about whether to wear a costume and, if so, what to dress up as
  • Fear of being judged for the type of costume you choose
  • Depression about not being invited to a Halloween party and thinking that everyone else is having fun except you
  • Social awkwardness if you do go to a Halloween party, such as not knowing what to say, being uncomfortable with small talk or comparing your costume to others
  • Anxiety about opening the door for trick-r-treaters and having to interact with neighbors and strangers

Easing Your Social Anxiety About Halloween

Halloween Ghosts Social AnxietySo what can you do this year to help ease the Halloween jitters?

First, remember Halloween is about fun. No one really cares what you dress up as. Most people are more focused on showing off their own costume than what you are wearing. Since everyone is so focused on their own costumes and being spooky and silly, they are less likely to care whether you talk or what you say anyway.

Second, remember many people enjoy staying home and watching scary movies on Halloween or just doing nothing and relaxing. Take the pressure off yourself if you do end up spending the evening alone. Plan some fun and enjoyable activities for yourself.

Third, if you stay home and don’t feel like opening the door, you can leave a bowl of Halloween candy on your doorstep with a friendly message so your neighbors know you care. Or you can push yourself to face your anxiety, open the door, and hand out candy. You can say “trick-r-treat” and smile. Or just make a pleasant comment about the kids’ and adults’ costumes.

How to Get Help for Social Anxiety in San Jose/Saratoga and Sacramento/Roseville

The Cognitive Behavior Therapy Center in Silicon Valley and Sacramento Valley specializes in social anxiety therapy and counseling with adults, children and teenagers. Call us in Saratoga at (408) 384-8404 or in Roseville at (916) 778-0771 or Click to send an email for more information on how we can help you or your family members overcome your social anxiety.

Silicon Valley and Sacramento Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder and Eating Disorders near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

Cognitive Behavior Therapy Center of Sacramento Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder (OCD) and Eating Disorders near the following Sacramento Valley and Sierra communities:

Sacramento Therapy CounselingRoseville Therapy Counseling • Rocklin Therapy Counseling • Granite Bay Therapy Counseling • Lincoln Therapy CounselingFolsom Therapy Counseling • Citrus Heights Therapy Counseling •  El Dorado Hills Therapy Counseling • Loomis Therapy CounselingGrass Valley Therapy Counseling  • Auburn Therapy Counseling

CONTACT US
Saratoga: (408) 384-8404
Roseville: (916) 778-0771
Click to send an email

Introversion: Quiet Revolutionaries

What is Introversion?

Gentle GandhiIntroversion is “the state of or tendency toward being wholly or predominantly concerned with and interested in one’s own mental life.” According to the Myers-Briggs inventory, introverts are more likely to think, “I like getting my energy from dealing with the ideas, pictures, memories, and reactions that are inside my head, in my inner world. I often prefer doing things alone or with one or two people I feel comfortable with. I take time to reflect so that I have a clear idea of what I’ll be doing when I decide to act. Ideas are almost solid things for me. Sometimes I like the idea of something better than the real thing.”

Introversion vs. Shyness and Social Anxiety

While studies have estimated that introverts are one-third to one-half of the U.S. population, being social and outgoing is prized in our culture so it can be difficult, even shameful, to be an introvert. Mistaking introversion for shyness is a common error. Introversion is different from shyness and social anxiety. Introverts don’t necessarily feel shy or anxious in social situation, although some do. Introverts need downtime to recharge but many introverts function quite well in social situations and leadership roles.

Bias Against Introversion is Slowly Improving

Quiet RevolutionAccording to Susan Cain, author of Quiet: The Power of Introverts in a World That Can’t Stop Talking, “Our schools, workplaces, and religious institutions are designed for extroverts, and many introverts believe that there is something wrong with them and that they should try to “pass” as extroverts. The bias against introversion leads to a colossal waste of talent, energy, and, ultimately, happiness.”

Due to the popularity of Cain’s book, “Now people think it’s cool to be an introvert,” said Amy J. C. Cuddy, a social psychologist and associate professor at Harvard Business School quoted in a recent New York Times article about Cain’s Quiet Revolution. She added that at least half her students tell her they have read Ms. Cain’s book. “I love that the students are no longer ashamed,” Cuddy said. It seems Brian R. Little, a professor of psychology at Cambridge University, quoted in a New York Times Op Talk column, agrees, “You could almost say that introversion has become the new cool…there has been a recognition of the quiet strengths of introversion.”

Famous Introverts Who Have Changed The World

Many highly influential engineers and scientists, politicians, business people, actresses, actors and comedians, athletes, singers and musicians, movie producers and directors, writers and others in all fields are introverts. Here are some highly successful introverts who have changed the world with their gifts, to name just a few:

  • Albert Einstein
  • Mahatma Gandhi
  • Bill Gates
  • Michael Jordan
  • Audrey Hepburn
  • David Letterman
  • Abraham Lincoln
  • Larry Page (co-founder of Google)
  • Eleanor Roosevelt
  • J.K. Rowling
  • Steven Spielberg
  • Steve Wozniak (co-founder of Apple)
How Can I Be A Proud Introvert?

On the Quiet Revolution website, you can take an introversion test as well as find stories written by Quiet Revolutionaries, individuals who “embody the spirit of Quiet Revolution: strong yet gentle, firm but kind, they are as indomitable as they are unassuming.” Introverts are careful, reflective thinkers who can tolerate the solitude that idea-generation requires. Introverts form the majority of gifted people. Moreover, it appears that introversion increases with intelligence so that more than 75% of people with an IQ above 160 are introverted. In Susan Cain’s TED Talk, one of the most watched of all time with almost 12 million views, she argues that introverts bring extraordinary talents and abilities to the world and should be encouraged and celebrated.

How To Learn to Thrive as an Introvert

The Cognitive Behavior Therapy Center in Silicon Valley (San Jose/Saratoga) and Sacramento Valley (Roseville) specializes in therapy and counseling with adults, children and teenagers with introverted personality styles. Call us in Saratoga at (408) 384-8404 or in Roseville at (916) 778-0771 or Click to send an email for more information on how we can help you or your family members succeed in life as a quiet revolutionary.

Silicon Valley and Sacramento Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder and Eating Disorders near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

Cognitive Behavior Therapy Center of Sacramento Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder (OCD) and Eating Disorders near the following Sacramento Valley and Sierra communities:

Sacramento Therapy CounselingRoseville Therapy Counseling • Rocklin Therapy Counseling • Granite Bay Therapy Counseling • Lincoln Therapy CounselingFolsom Therapy Counseling • Citrus Heights Therapy Counseling •  El Dorado Hills Therapy Counseling • Loomis Therapy CounselingGrass Valley Therapy Counseling  • Auburn Therapy Counseling

CONTACT US
Saratoga: (408) 384-8404
Roseville: (916) 778-0771
Click to send an email

OCD Specialty Outpatient Clinic for the OCD Foundation

Cognitive Behavior Therapy Center Designated a Specialty Outpatient Clinic by International OCD Foundation

OCD Foundation LogoThe Cognitive Behavior Therapy Center of Silicon Valley and Sacramento Valley has been designated as a Specialty Outpatient Clinic by the International OCD Foundation. A Specialty Outpatient Clinic is defined as:
1) A minimum of three, licensed clinicians who maintain a professional membership in the IOCDF working in the same outpatient clinic.
2) These clinicians should have 10 combined years experience treating OCD and related disorders.
3) The identified clinic advertises itself as a facility where the primary focus is on the treatment of OCD and/or related disorders.

https://iocdf.org/clinics/cognitive-behavior-therapy-center-of-silicon-valley/
https://iocdf.org/clinics/cognitive-behavior-therapy-center-of-sacramento-valley/

How to Get Help for OCD in San Jose/Saratoga and Sacramento/Roseville

The Cognitive Behavior Therapy Center in Silicon Valley (San Jose/Saratoga) and Sacramento Valley (Roseville) specializes in Obsessive Compulsive Disorder (OCD) therapy and counseling with adults, children and teenagers. Call us in Saratoga at (408) 384-8404 or in Roseville at (916) 778-0771 or Click to send an email for more information on how we can help you or your family members overcome OCD.

Silicon Valley and Sacramento Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder and Eating Disorders near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

Cognitive Behavior Therapy Center of Sacramento Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder (OCD) and Eating Disorders near the following Sacramento Valley and Sierra communities:

Sacramento Therapy CounselingRoseville Therapy Counseling • Rocklin Therapy Counseling • Granite Bay Therapy Counseling • Lincoln Therapy CounselingFolsom Therapy Counseling • Citrus Heights Therapy Counseling •  El Dorado Hills Therapy Counseling • Loomis Therapy CounselingGrass Valley Therapy Counseling  • Auburn Therapy Counseling

CONTACT US
Saratoga: (408) 384-8404
Roseville: (916) 778-0771
Click to send an email

Book Review: Same Time Next Week

Stories of Hope and Resilience in Mental Health

Read Laura Johnson’s book review of “Same Time Next Week” on Positive Psychology New Daily:

http://positivepsychologynews.com/news/laura-lc-johnson/2015060331717

How to Get Help for Anxiety, OCD and Anxiety-Related Problems

The Cognitive Behavior Therapy Center of Silicon Valley and Sacramento Valley specializes in Anxiety, OCD and Anxiety-Related Problems in adults, children and teenagers. We have two convenient locations to serve you.

The Silicon Valley office in Saratoga serves the Santa Clara County communities of San Jose, Saratoga, Mountain View, Santa Clara, Sunnyvale, Los Gatos, Los Altos, Palo Alto, Cupertino, Campbell and surrounding areas.

The Sacramento Valley office in Roseville serves the Placer County and Sacramento County communities of Sacramento, Roseville, Rocklin, Granite Bay, Lincoln, Folsom, Citrus Heights, El Dorado Hills, Loomis, Auburn, Penryn, Grass Valley, Colfax and surrounding areas.

Contact us at (408) 384-8404 or email us for more information on how we can help you overcome your anxiety-related problems.

Anxiety Mental Game: Paradoxical Strategies Win

An Important Twist on the Mindful Moment by Reid Wilson, Ph.D.

ParadoxAnxious clients enter treatment in the position of resistance. If they are diagnosed with an anxiety disorder, they’ve got to be resisting. They want that discomfort to go away, which is totally understandable. But the stance of ‘I don’t want this to be happening’ gives Anxiety the upper hand, because the mind & body will move into battle mode. If we teach them permissive skills, like brief relaxation or mindfulness, they are more likely to say, ‘Let me take a mindful stance in this situation. And I hope this works, because I’ve got to get rid of this feeling.’ These skills associated with permitting & accepting the symptoms often allow the client to slide right back into resisting.

Say “Yes” to Anxiety

If clients can truly say ‘yes’ to the encounter, & accept exactly what they are experiencing in that moment, then they will be back in control. This is manifested in the supportive message of ‘It’s OK that I’m anxious, I can handle these feelings, & I can manage this situation.’

It’s a Paradoxical Approach to Anxiety

This approach has a paradoxical flair to it that people often miss. You take actions to manipulate the symptoms while simultaneously permitting the symptoms to exist. With physical symptoms, you are saying, ‘It’s OK that I am anxious right now. I’m going to take some Calming Breaths & see if I settle down. If I do, then great. But if I stay anxious, that’s OK with me, too.’We attempt to modify the symptoms without becoming attached to the need to accomplish the task. This is a critical juncture in the work, & the therapist must track closely the client’s expected move of, ‘I’m going to apply these relaxation skills because I need to relax in this situation.’ No! While it is fine to relax in an anxiety-provoking situation, it is not OK to insist that you relax. That’s how anxiety wins.

Vist http://www.anxieties.com for more self-help strategies on the Anxiety Mental Game.

How to Get Help for Anxiety in San Jose/Saratoga and Sacramento/Roseville

The Cognitive Behavior Therapy Center of Silicon Valley (San Jose/Saratoga) and Sacramento Valley (Roseville) specializes in anxiety therapy and counseling with adults, children and teenagers. Call (408) 384-8404 or Click to send an email for more information on how we can help you or your family members overcome your anxiety-related disorders.

 

Silicon Valley and Sacramento Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety, OCD and Eating Disorders near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

Cognitive Behavior Therapy Center of Sacramento Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder (OCD) and Eating Disorders near the following Sacramento Valley and Sierra communities:

Sacramento Therapy CounselingRoseville Therapy Counseling • Rocklin Therapy Counseling • Granite Bay Therapy Counseling • Lincoln Therapy CounselingFolsom Therapy Counseling • Citrus Heights Therapy Counseling •  El Dorado Hills Therapy Counseling • Loomis Therapy CounselingGrass Valley Therapy Counseling  • Auburn Therapy Counseling

CONTACT US
Call (408) 384-8404 or Click to send an email

Cognitive Behavior Therapy Center of Sacramento Valley Opens in Roseville

New CBT Center of Anxiety and OCD Opening in Roseville, CA

Douglas Blvd Sacramento RegionOn June 1st, the Cognitive Behavior Therapy Center is expanding to the Sacramento Valley with a new branch office in Roseville, CA. The name of the new office is Cognitive Behavior Therapy Center of Sacramento Valley. With our convenient location on Douglas Boulevard in Roseville just minutes from I-80, the new CBT Center will serve the communities of Sacramento, Roseville, Rocklin, Granite Bay, Lincoln, Folsom, Citrus Heights, El Dorado Hills, Loomis, Penryn, Grass Valley, Colfax, Auburn and surrounding areas.

Anxiety and OCD Therapy for Adults, Children and Teens in Roseville/Sacramento Valley

At the Cognitive Behavior Therapy Center of Sacramento Valley in Roseville, we will continue to offer high quality and compassionate evidence-based therapy for adults, children and teenagers with anxiety and OCD. The Roseville office will provide therapy for all of the various anxiety disorders including generalized anxiety (GAD), panic disorder, agoraphobia, specific phobias, social anxiety, selective mutism, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), trichotillomania/hair pulling, skin picking, Tourette Syndrome/tic disorders, eating disorders, and other anxiety-related problems.

Our Current CBT Center in Silicon Valley

The Cognitive Behavior Therapy Center of Silicon Valley currently has a successful anxiety and OCD center in Saratoga, CA, with six therapists and a center assistant serving the San Jose region. We will replicate the high quality of evidence-based services for Anxiety and OCD offered in the Silicon Valley in the Sacramento Valley. The Cognitive Behavior Therapy Centers of Silicon Valley and Sacramento Valley are divisions of Cognitive Behavior Therapy Center, Adult & Child Counseling, Inc. The CBT Center of Sacramento Valley in Roseville will be our second major location.

Contact the Cognitive Behavior Therapy Center of Sacramento Valley

From our office in Roseville just minutes from I-80, we are conveniently located to serve all of Placer County, Sacramento County and surrounding communities. Call (408) 384-8404 or Click to send an email for more information on how we can help you or your family members overcome your anxiety-related issues.

 

Cognitive Behavior Therapy Center of Sacramento Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder (OCD) and Eating Disorders near the following Sacramento Valley and Sierra communities:

Sacramento Therapy CounselingRoseville Therapy Counseling • Rocklin Therapy Counseling • Granite Bay Therapy Counseling • Lincoln Therapy CounselingFolsom Therapy Counseling • Citrus Heights Therapy Counseling •  El Dorado Hills Therapy Counseling • Loomis Therapy CounselingGrass Valley Therapy Counseling  • Auburn Therapy Counseling

CONTACT US
(916) 778-0771 or Click to send an email

Impostor Syndrome: Are You Discounting Yourself and Your Successes?

In the Boston Globe, I read that four smart and talented students at MIT committed suicide within the past year. Among its efforts to help students cope with stress, MIT is encouraging students to talk about the psychological phenomenon called “impostor syndrome,” the feeling of being a failure despite a record of accomplishment.

What is Impostor Syndrome?

Imposter Syndrome MouseImpostor syndrome is common among high achievers, many of whom discount their successes. As a result, they do not feel confident or deserving inside of themselves even though they are objectively successful and perceived as such by other people. Psychological research done in the early 1980s estimated that two out of five successful people consider themselves impostors and other studies have found that 70 percent of all people feel like impostors at one time or another.

The impostor’s thoughts and feelings can be divided into several categories:

1. Feeling like a fake: You may believe that you do not deserve your success, academic standing or professional position. This is accompanied by a fear of being “found out”, “discovered” or “unmasked.” If you feel this way, you might identify with statements such as: “I have tricked other people into thinking that I am more competent than I really am” or “I am often afraid that others will discover I don’t really know what I am doing.”

2. Attributing success to luck: Another aspect of the impostor syndrome is the tendency to attribute success to luck or to other external reasons and not to your own internal abilities. You may refer to an achievement by saying, “I just got lucky this time” or “it was a fluke” and worry you will not be able to succeed next time. You may think you are just lucky, in the right place at the right time, and that’s why you were chosen for a particular job or role.

3. Discounting Success: The third aspect is a tendency to downplay success and discount it. You may discount an achievement by saying “it is not a big deal” or “it was not important.” For example, a student attending a prestigious university may discount the fact that they were accepted or feel like it was a mistake that they were accepted and that they don’t belong or they aren’t as smart as the other students. Or you may say “I did well because it is an easy class” or “I was promoted because my manager left” instead of attributing it to hard work or intelligence. You may also discount your accomplishments and have a hard time accepting compliments.

4. Dwelling on the Negative: You may notice every time where you think you should have done better or where you made a mistake. On the other hand, you overemphasize minor flaws in your performance. You fail to notice, or fail to put enough importance, on what you did well.

5. Unfair Comparisons: You compare yourself unfavorably to others. Frequently you pick out the most outstanding people in your school, company or field and judge your own performance as inadequate and inferior.

Women and Impostor Syndrome

Imposter Syndrome MaskThe term “impostor syndrome” first appeared in an article written by Pauline R. Clance and Suzanne A. Imes in the 1970s. They observed that many high-achieving women tended to believe they were not intelligent, and that they neither internalized nor accepted their own accomplishments. These individuals attributed their successes to luck rather than skill or talent, and were afraid others would realize they’d been deceived by a fraud.

While both men and women experience impostor syndrome, studies show that women are more often affected. According to Valerie Young, author of The Secret Thoughts of Successful Women, boys are raised to bluff and exaggerate. Girls, on the other hand, learn early to distrust their opinions and stifle their voices. Young women learn that they tend to be judged by the highest physical, behavioral and intellectual standards. Perfection becomes the goal, and every flaw, mistake or criticism is internalized—slowly reducing self-confidence.

“A real bias against female competence persists,” says Young. “Being female means you and your work automatically stand a greater chance of being ignored, discounted, trivialized, devalued or otherwise taken less seriously than a man’s.”

Sheryl Sandberg, COO of Facebook, spoke of her own feelings of insecurity in her best-selling book, Lean In: Women, Work, and the Will to Lead. When Sandberg attended her Phi Beta Kappa induction at Harvard, a woman gave a speech called “Feeling Like a Fraud.” During the talk, Sandberg looked around the room and saw people nodding. “I thought it was the best speech I’d ever heard,” she recalls. “I felt like that (an impostor) my whole life.” At school, Sandberg thought, “I really fooled them.”

Sandberg says, “Many people, but especially women, feel fraudulent when they are praised for their accomplishments. Instead of feeling worthy of recognition, they feel undeserving and guilty, as if a mistake has been made. Despite being high achievers, even experts in their fields, women can’t seem to shake the sense that it is only a matter of time until they are found out for who they really are – impostors with limited skills or abilities.”

Originally thought to be more common among women, men, too, can be victims of the imposter style of thinking. Even Albert Einstein suffered from impostor syndrome near the end of his life. A month before his death, he reportedly confided in a friend: “the exaggerated esteem in which my lifework is held makes me very ill at ease. I feel compelled to think of myself as an involuntary swindler.”

Do I have Impostor Syndrome?

Imposter Syndrome DogDr. Valerie Young developed the Impostor Syndrome Quiz (reprinted below). If you answer yes to many of these questions, you may have impostor syndrome:

  • Do you secretly worry that others will find out that you’re not as bright and capable as they think you are?
  • Do you sometimes shy away from challenges because of nagging self-doubt?
  • Do you tend to chalk your accomplishments up to being a “fluke,” “no big deal” or the fact that people just “like” you?
  • Do you hate making a mistake, being less than fully prepared or not doing things perfectly?
  • Do you tend to feel crushed by even constructive criticism, seeing it as evidence of your “ineptness?”
  • When you do succeed, do you think, “Phew, I fooled ‘em this time but I may not be so lucky next time.”
  • Do you believe that other people (students, colleagues, competitors) are smarter and more capable than you are?
  • Do you live in fear of being found out, discovered, unmasked?

Strategies for Overcoming Impostor Syndrome

1) Become aware of your thoughts. Automatic thoughts can be defined as underlying, unquestioned thoughts, which affect how you perceive an event or situation. Realize them for what they are: negative self-talk that has become a habit. Be aware when you engage in thoughts and feelings of an impostor. Awareness is the first step to change and many times we are not aware of our automatic thoughts.

2) Do a reality check. Question your automatic “impostor” thoughts and feelings and try to come up with more balanced thoughts. Understand the difference between your negative thoughts and reality. Identify the critical voice that is doubting your authenticity. It’s not You. Separate yourself from the critical and self-limiting “impostor” voice.

3) Understand the difference between feelings and reality. Some people believe that if they feel something strongly it must be right. “If I feel so stupid, it must mean that I really am stupid.” When you catch yourself thinking in this way, change it to a coping statement of “the fact that I feel stupid does not mean that I really am. It’s a feeling and not reality.”

4) Write down the steps you took to earn the success you achieved. In one column, make a list of what you accomplished on a particular task or project, and in a second column, write the names of people who helped contribute to the success. Come up with realistic responses that give you credit, but also share praise with others who contributed. For example, you could say to yourself, “I’m proud of what I did on that job, and I had the help of a great team.”

4) Replace your negative “impostor” thinking habit by practicing more realistic and helpful self-talk. Remind yourself of how you contributed to your success with thoughts like “I have proven I am capable by…” or “I prepared for this by…” Give yourself credit throughout the day for both major and minor successes. Notice and reframe “yes, but” statement such as “I brought in accounts but she brought in more” to “Even though she brought in more accounts, I brought in many myself.” Focus on your strengths. When you finish a task, you can ask yourself, “What positive qualities do I have that allowed me to do accomplish this?”

5) Be on the lookout for unhelpful coping strategies you engage in to prevent others from evaluating you negatively. For example, if you tend to hold back from sharing your opinions in meetings, take a risk and speak up in a calm and confident way.

6) Celebrate! Give yourself permission to be proud. Let your friends and family praise you. Take some of it in. Let it touch your heart. Being proud of an accomplishment is not the same as being self-centered. After you celebrate, you will probably remember that no matter what you achieved, chances are there is more to do. This can be humbling and healthy, and important to distinguish from the unhealthy internal put-downs.

7) Give yourself a little time to grow into your success, especially if success seemed to come rather easily or quickly. Sometimes you just need time for a new promotion or status to settle in so you can feel like you deserved it and earned it. However, if you think impostor syndrome is keeping you from getting the most out of your life, then you might want to find a therapist to help you work through your thoughts and feelings.

How To Get Help for Impostor Syndrome

The Cognitive Behavior Therapy Center of Silicon Valley offers counseling and therapy for women and men suffering from Impostor Syndrome. We are located in Saratoga on the border of San Jose and Saratoga just 1/2 mile from Highway 85. With our convenient location near highway 85, we serve the Silicon Valley communities of San Jose, Saratoga, Mountain View, Santa Clara, Sunnyvale, Los Gatos, Los Altos, Cupertino and Campbell, CA. Contact us at (408) 384-8404 for more information on how we can help you savor your accomplishments and reduce your feelings of being an impostor at school or work.

Radically-Open Dialectical Behavior Therapy (RO-DBT)

RO-DBT: Your Path to a More Flexible Life and Joyful Experiences

Flexible ThinkingLaura Johnson, LMFT, LPCC, Center Director, attended a two-day workshop on Radically-Open Dialectical Behavior Therapy (RO-DBT) led by its founder, Thomas Lynch, PhD, Professor of Clinical Psychology at the University of Southampton, UK. RO-DBT is an evidence-based approach to help individuals become more flexible in their thinking and responding, more open to life experiences that create joy and happiness, and build intimacy and social connections. RO-DBT can be particularly helpful for individuals with inflexible, rigid personality styles who are susceptible to certain types of anxiety disorders, depression, OCD, perfectionism, anorexia and autism. RO-DBT includes many of the skills taught in traditional DBT but also teaches an entirely new set of skills to increase flexibility and reduce rigidity.

RO-DBT Theory

The theory behind RO-DBT is that children with an “over controlled” temperament are more likely to develop internalizing disorders such as anxiety and depression and become socially isolated as adults. “Overcontrol” is defined as an emotionally constricted, shy and risk averse temperament. In appropriate amounts, overcontrol is a positive trait. You may desire to exceed expectations and perform well, value rules and fairness, delay gratification to achieve goals, and have a high sense of duty, obligation and self-sacrifice.

On the other hand, individuals who develop a excessively overcontrolled style may have a need to appear perfect (planning ahead, being right, stressing orderliness and structure), follow rules (always doing the right thing, being prepared, smiling even when unhappy) and have high pain tolerance (able to work really hard and delay or minimize joy and fun).

Goals of RO-DBT

The goal in RO-DBT is to help individuals develop optimal control that is neither over- or under-controlled.

RO-DBT starts with defining what’s healthy and what’s not. Its interventions strive to build these positive traits including:

  • Receptivity and Openness to new experiences (as opposed to high risk aversion, hypervigilance for threat, avoidance of novelty and discounting of constructive feedback)
  • Flexible Responding to adapt to changes in the environment (instead of compulsive needs for structure and order, hyper-perfectionism, compulsive planning/rehearsal, and rigid rule-governed behavior)
  • Emotional Expression and Awareness to have genuine emotional experiences (as opposed to inhibited expressions or fake expressions and low self-awareness or minimizing of feelings)
  • Intimacy and Connection to form long-lasting bonds (instead of aloof/distant relationships, excessive social comparison, envy and bitterness, and low empathy and validation skills)

Ways to Build Flexibility, Openness and Social Connection

In addition to most of the traditional DBT skills, RO-DBT also teaches additional new skills  to build the qualities of flexibility, openness and social connection including:

Radical Oppenness Skills LegosRadical Openness Skills Module is a completely new skills module where you will learn to change your physiology, engage in new behaviors, learn from constructive feedback, validation skills, build compassion and forgiveness, stimulate positive emotions toward yourself and social connectedness with others through loving kindness meditation,verbal and non-verbal skills to signal openness and friendliness, and communication of emotions to increase social connection and reduce social isolation and loneliness.

Mindfulness Skills to recognize when you are in fixed mind vs. fatalistic mind and how to get to flexible mind and to teach self inquiry.

Emotion Regulation Skills to reduce envy, bitterness, resentment and revenge.

Some Examples of RO-DBT Skills

There are three steps involved in building the skill of Radical Openness:

  1. Acknowledge the presence of unwanted or uncomfortable feelings such as irritation, tension in the body, negative emotions or feelings of uncertainty
  2. Turn toward the discomfort and use Self-Inquiry to ask yourself, “What do I need to learn from this?” instead of automatically distracting or accepting
  3. Flexibly Respond by doing what’s needed in the moment

Practicing being open to feedback from others includes the following steps:

  1. Acknowledge the feedback
  2. Describe your emotions, sensations, thoughts and images
  3. Be Open to new information by cheerleading yourself, adopting an open body stance, and fully listening to the feedback
  4. Pinpoint what the new behavior is and confirm
  5. Try out the new behavior
  6. Self-soothe and reward yourself
How To Get Help in Building Flexibility and Other Positive Traits

The Cognitive Behavior Therapy Center of Silicon Valley specializes in helping individuals change unhelpful thinking and coping styles and build flexibility, openness and social connection. With our convenient location just a half mile from Highway 85 and the Saratoga Avenue exit, we serve the Silicon Valley communities of San Jose, Saratoga, Mountain View, Santa Clara, Sunnyvale, Los Gatos, Los Altos, Cupertino and Campbell, CA. We also have a CBT Online Video Therapy Program for clients in California who live to far away to drive for our specialized therapy in person. Contact us at (408) 384-8404 for more information on how we can help you manage you become more flexible, open and joyful.

Exposure & Response Prevention for Obsessive Compulsive Disorder (OCD)

Exposure and Response (Ritual) Prevention for Obsessive Compulsive Disorder (OCD)

Exposure and Response Prevention OCD PennI recently attended intensive training in Exposure and Response Prevention for OCD at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania in Philadelphia. In addition to terrific presentations by Dr. Elna Yadin, OCD Clinic Director, and staff members, we were honored with a Q&A session with Dr. Edna Foa. While I already considered myself a skilled therapist in treating OCD, this training helped refine my skills in systematically implementing a specialized form of OCD treatment called “Exposure and Response (Ritual) Prevention,” also know as EX/RP or ERP.

What is Obsessive Compulsive Disorder (OCD)?

Obsessive compulsive disorder (OCD) is a neurological disorder that causes severe anxiety/distress and affects your thinking and behavior. OCD tends to attack the things you value the most. When you feel anxious, it might feel like you are in danger. OCD tells you to respond, react, protect yourself, and do something to get rid of the distress. You might recognize that the fear is excessive or doesn’t make sense, yet it still feels very real, intense, and true. If you have OCD, the warning system in your brain is not working correctly. Your brain is telling you that you are in danger when you are not.

Common Types of OCD

OCD CartoonObsessions are unwanted, intrusive thoughts, images, or impulses that occur over and over again and feel out of your control. They are disturbing, anxiety-provoking and perhaps even disgusting to you. Common obsessions include contamination from germs, bodily fluids, diseases, or chemicals; causing or failing to prevent harm to others; fear of losing control; sexual, religious or morally offensive thoughts and images; perfectionism; and not-just-right feelings.

Compulsions are repetitive behaviors or mental rituals that you engage in to neutralize, undo or make your anxiety go away. Compulsions can also include avoiding situations that trigger obsessions. Common compulsions include checking, washing and cleaning, repeating an action, putting things in order, praying, counting, mental review, reassurance seeking, apologizing and confessing. These actions are designed to prevent or reduce emotional discomfort and avoid the occurrence of a dreaded event. Compulsions tend to provide temporary relief but the obsessions soon return.

It is important to note that OCD comes in many different forms and no two OCD sufferers are alike in their combination of obsessions and compulsions as well as the meaning they attribute to their feared catastrophe.

What is Exposure and Response (Ritual) Prevention (EX/RP)?

In a nutshell, EX/RP consists of exposing you to the triggers that cause anxiety and fear and teaching you to resist doing any compulsions or rituals to reduce the distress. The basic principles of EX/RP can be boiled down to three steps that need to be practiced consistently to overcome OCD:

  1. Confront the things you fear as often as possible.
  2. If you feel like you have to avoid something, don’t.
  3. If you feel like you have to perform a ritual to feel better, don’t.

With EX/RP, your brain learns that you can tolerate anxiety and that your anxiety will eventually come down without rituals. Your brain will learn that the feared catastrophe does not happen or that you could handle it if it did. And you may start to realize just how ridiculous or unrealistic your obsessional fears are and how much OCD is taking away from your life. Basically, OCD is a bully! We will teach you how to take charge and not give OCD the attention it craves.

The main treatment components of EX/RP include:

  • Assessment, Education and Treatment Planning: We’ll identify all your triggers, obsessional fears and related rituals and make a plan to systematically approach your fears without engaging in rituals. We will also teach you about the sneaky ways OCD tries to trick you and lies to you. You will learn that OCD is like a “tic” in the brain that is trying to protect you but instead OCD is making you a slave and ruining your life.
  • In Vivo Exposure: Exposures are the heart of OCD treatment. In this step, we will expose you to real life triggers that elicit fear, anxiety and/or disgust in a gradual hierarchical manner. We will start with easy exposures and, as you gain confidence you can cope with your anxiety, we will move up the hierarchy to confront situations that are more challenging.
  • Imaginal Exposure: This involves prolonged exposure in your imagination to your worst fears without doing any rituals. We’ll develop a script (or series of scripts) for you to record and listen to every day until you are no longer scared of the content of your obsessions and you can visualize yourself facing your fear without any rituals.
  • Response (Ritual) Prevention: RP is the identification and elimination of all physical and mental compulsions so you can learn you can cope with distress without doing rituals or avoidance. You will learn that while your rituals reduce anxiety/distress in the short term, they are not building your courage that you can handle anxiety without them. Rituals are actually fuel to OCD’s fire and maintain the OCD cycle.
  • Cognitive Processing: The key to long term, permanent change is gaining new beliefs and increasing your self-confidence. OCD is making you believe things that aren’t true and exaggerating the danger of your fears. In order to help you overcome OCD, we won’t tell you what to think because OCD will just argue with you. Instead, we’ll discuss what you have actually learned through your EX/RP activities and reinforce your experiential learning in order to create new beliefs about the meaning of your obsessions.

Treatment Description

Stop Being OCDIn EX/RP, you will purposely experience your obsessive thoughts without ritualizing so you can learn that your discomfort/anxiety will come down and your fear is eventually extinguished. With your therapist, you will develop a hierarchy of exposures that will elicit your obsessional fear and we’ll develop a plan for systematically targeting each of the items. We’ll identify both behavioral and mental rituals to eliminate. EX/RP generally takes about 20 sessions total. We recommend two 75-minute sessions per week to help you maintain continuity and motivation in doing the exposures and to progress more quickly to relieve your suffering.

Initial Evaluation Session

The goal of the initial evaluation session is to learn about your background and history as well as determine what type of anxiety you have. If the diagnosis is OCD, then we will discuss the EX/RP treatment approach and determine if it is a good fit for you. We will also begin to assess your motivation since completing daily exposures in between sessions is essential to success in this program.

Information Gathering and Education

In the next one to two sessions, we will gather a lot of information about the content of your obsessions, types of compulsions/rituals you use to reduce obsessive fears, and the feared consequences if you are unable to perform your rituals. We will use a standardized assessment tool called the YBOCS, which helps us assess all the OCD symptoms and rate the severity of your OCD from mild, moderate to severe. You will also be asked to monitor your OCD symptoms throughout the week. The goal of this phase is to develop a thorough understanding of your obsessions and compulsions and the situations likely to trigger them. We will continue to assess your motivation for treatment and how much support you will need by the therapist and family members in implementing your EX/RP plan.

Treatment Planning

Next, we will spend one to two sessions determining what the feared catastrophe is, creating the hierarchy, identifying and ranking the order of exposures, deciding whether imaginal exposure is needed, creating the plan for reducing and eliminating rituals, and deciding whether exposure requires travel outside the therapist’s office such as a home visit. The question often arises as to whether we need to create different hierarchies for each type of OCD. While this may be helpful when the OCDs seem completely unrelated to one another, it is often not needed because the ultimate fear is often the same for all the OCDs. By creating one master hierarchy and working on fears by level of discomfort/anxiety, you will learn the principles of treatment and the therapy often generalizes more effectively from one symptom to the next.

To create a hierarchy, you and your therapist will generate a list of all the situations that provoke obsessive fear and avoidance behavior. We will then ask you to rate how much distress each situation causes for you on a scale of 0 to 100 and we will place the items in order from easiest to hardest. We generally start working on exposures rated in the 40-50 range and progress to harder exposures and the easier ones are mastered.

Imaginal exposures are used when engaging in the actual situation is not possible in real life, when your feared consequences are so far into the future that they can not be disconfirmed, or when you have so much fear approaching the real life situations that we need to start with thinking about the situation before progressing to actual exposures.

Exposure and Response Prevention Treatment

EX/RP treatment begins when we start working on the first situation on your hierarchy. Generally, 15 exposure sessions are recommended but some people with mild OCD may progress more rapidly while others with more severe OCD may need extra sessions. We will start with doing exposures during the therapy session and then assign the same exposure as homework for you to practice on your own. When your distress significantly declines and you no longer fear the situation, then we will move to the next item on the hierarchy. Since we are starting with items you ranked at a moderate level and only moving up when your distress has declined, it makes working on the harder items on the hierarchy feel much easier. If you find that you are not feeling a reduction of anxiety within 45 minutes, then we have probably underestimated the difficulty of that situation and we would move to an easier item. If we are working at the right pace, you should be feeling challenged in exposure sessions but not so uneasy that you can’t do it.

While doing exposures, you will not be allowed to perform any rituals to undo the anxiety or distress. Sometimes we may allow you to modify a ritual to allow you to approach situations that are more difficult and higher on the hierarchy but our goal will be to quickly eliminate the all rituals associated with that situation. We want your brain to learn that it can face your fears and overcome obsessional fears without doing any rituals.

A key to success in EX/RP is changing how you relate to the meaning of danger created by your OCD. This is called cognitive processing, where we will discuss what you learned from the exposure without doing your normal rituals. We will stress that the content of your obsessions doesn’t matter because OCD will latch onto whatever is important to you. Most people have multiple types of OCD and notice it morphs and evolves over time into new symptoms. We want you to learn the general principles of EX/RP so you can “zap” whatever part of your life OCD wants to target in the future.

We will move up the hierarchy as quickly as you can tolerate it. When all the items on your hierarchy no longer cause distress and you are no longer performing rituals to reduce anxiety, then we can formally end the EX/RP treatment phase.

Relapse Prevention

Generally, we’ll plan on two to three relapse prevention sessions spaced out over time. OCD symptoms often wax and wane with stress and life transitions. Relapse prevention consists of reviewing your progress, identifying the tools you can use to manage any future OCD flare ups, identifying and planning how to handle potential future stressors, and knowing the warning signs of OCD and how you can treat it yourself with your tools, especially self-exposure.

Train your Brain for Social Success

CBT and Mindfulness for Social Anxiety

Did you know that by practicing cognitive behavioral therapy (CBT) and mindfulness, you can create new circuits in your brain? You can actually change your brain so it’s more flexible, focused and compassionate.

We’ve known for a while that CBT and mindfulness work for many problems especially stress, anxiety and depression. New research is emerging from Stanford University and elsewhere indicating that CBT and mindfulness are effective for social anxiety.

Social Anxiety Model

Social Anxiety ModelIf you have social anxiety, you know that some key problems include negative thinking about yourself, doubt about whether others like or respect you and whether you fit in, and excessive worry and anxiety before, during and after social situations. The model of social anxiety below shows how social anxiety is triggered and maintained. We experience a social or interpersonal situation that activates negative beliefs and assumptions about ourselves or others. Once triggered, we feel anxious because of the negative meaning we’ve given to the situation. We may use “safety behaviors,” or do things that make us feel less anxiety in the moment, but end up making us feel hopeless and discouraged because we don’t learn that we can tolerate anxiety and nothing really bad or scary generally happens. (The exception would be if you are being emotionally, verbally or physically abused or intentionally hurt in some way.) Once social anxiety is triggered, we become self-conscious, worry about what others are thinking, fear being embarrassed, humiliated or looked down on and our self-consciousness causes us to look inward.

Changing Your Thoughts

An example might be thinking about going to your high school reunion. You tell yourself, ” No one will remember me. I was such a nerd in high school. The other kids used to make fun of my thick glasses. I really don’t want to go and make a fool of myself again.” You perceive the social danger as rejection. You become self-conscious and focus on yourself and your anxiety reactions. You might predict, “I will end up standing in a corner by myself and no one will talk to me. I’ll make a fool of myself. I’ll feel anxious and won’t be able to stand it.” So you don’t go (safety behavior) and stay home alone with a bottle of wine and ice cream, feeling sad and discouraged.

Imagine, alternatively, if you believed the following: “In high school I was very studious and a few of the jocks made fun of my glasses. I’ve changed now. I’ve grown up, have a good job and people tell me I’m attractive. Even though I didn’t have a lot of friends in high school, I did have a few close friends who may end up going. I would really like to see them. Yes, I might feel anxious in the first half hour or so but I know it’ll pass as I start talking to my friends and having fun.” How might the model of social anxiety change if you had these beliefs instead?

Be a Flexible Thinker

CBT helps you learn more flexible and accurate thinking as well as effective behaviors and coping skills. CBT does not discount the negative but helps you put it into perspective and see what information you might be missing that could help you develop more helpful thoughts and beliefs. Mindfulness can complement CBT by increasing your ability to direct your attention to more productive thoughts and activities and reduce anticipatory anxiety and obsessive rumination.

 

Note: This article originally appeared on MentalHelp.net on August 16, 2011.

We are in the Mercury News!

CBT Center in the Mercury News

Read about the opening of the Cognitive Behavior Therapy Center of Silicon Valley in the Mercury News.

 

Schemas in Schema Therapy

What is Schema Therapy?

Schema TherapySchema therapy is an extension of cognitive behavior therapy designed to treat a variety of long-standing emotional difficulties with significant origins in childhood and adolescent development. The goal of schema therapy is to help clients get their core needs met in an adaptive manner by enhancing positive schemas and developing healthier coping responses when negative schemas are triggered.

Negative schemas develop when core childhood needs are not met. When parents can more or less meet the child’s core emotional needs in appropriate amounts, the child develops into a healthy adult. Children’s basic needs include:

  • Safety
  • Stable Base, Predictability
  • Love, Nurturing & Attention
  • Acceptance & Praise
  • Empathy
  • Guidance & Protection
  • Validation of Feelings & Needs

Schema Therapy vs. Cognitive Behavior Therapy

Compared to traditional cognitive behavior therapy, schema therapy incorporates:

  • Greater emphasis on the therapeutic relationship
  • More emphasis on affect (e.g., imagery, role-playing) and mood states
  • More discussion of childhood origins and developmental processes
  • More emphasis on lifelong coping styles (e.g., avoidance and overcompensation)
  • More emphasis on entrenched core themes (i.e., core beliefs and schemas)

Schemas — What Are They?

A schema is a stable, enduring negative pattern that develops during childhood or adolescence and is reinforced through thoughts, core beliefs, actions and relationships throughout an individual’s life. We view the world through our schemas. Schemas incorporate core beliefs and feelings about oneself and the environment which the individual accepts without question. They are self-perpetuating, and are very resistant to change.

Even though schemas persist once they are formed, they are not always in our awareness. Usually they operate in subtle ways, out of our awareness. Everyone has schemas since no parent could be a perfect parent and fulfill every emotional need 100% of the time. While the schema descriptions may sound negative, it is normal to have some elements of some schemas within your personality structure. However, when a schema erupts or is triggered by events, our thoughts and feelings are dominated by these schemas. It is at these moments that people tend to experience extreme negative emotions and have dysfunctional thoughts.

18 Common Schema Themes

  1. Emotional Deprivation: This schema refers to the belief that one’s primary emotional needs will never be met by others. These needs can be described in three categories: Nurturance—needs for affection, closeness and love; Empathy—needs to be listened to and understood; Protection—needs for advice, guidance and direction. Generally parents are cold or removed and don’t adequately care for the child in ways that would adequately meet the above needs.
  2. Abandonment/Instability: This schema refers to the expectation that one will soon lose anyone with whom an emotional attachment is formed. The person believes that, one way or another, close relationships will end imminently. As children, these clients may have experienced the divorce or death of parents. This schema can also arise when parents have been inconsistent in attending to the child’s needs; for instance, there may have been frequent occasions on which the child was left alone or unattended to for extended periods.
  3. Mistrust/Abuse: This schema refers to the expectation that others will intentionally take advantage in some way. People with this schema expect others to hurt, cheat, or put them down. They often think in terms of attacking first or getting revenge afterwards. In childhood, these clients were often abused or treated unfairly by parents, siblings, or peers.
  4. Social Isolation/Alienation: This schema refers to the belief that one is isolated from the world, different from other people, and/or not part of any community. This belief is usually caused by early experiences in which children see that either they, or their families, are different from other people.
  5. Defectiveness/Shame: This schema refers to the belief that one is internally flawed, and that, if others get close, they will realize this and withdraw from the relationship. This feeling of being flawed and inadequate often leads to a strong sense of shame. Generally parents were very critical of their children and made them feel as if they were not worthy of being loved.
  6. Failure: This schema refers to the belief that one is incapable of performing as well as one’s peers in areas such as career, school or sports. These clients may feel stupid, inept or untalented. People with this schema often do not try to achieve because they believe that they will fail. This schema may develop if children are put down and treated as if they are a failure in school and other spheres of accomplishment. Usually the parents did not give enough support, discipline, and encouragement for the child to persist and succeed in areas of achievement, such as schoolwork or sport.
  7. Dependence/Incompetence: This schema refers to the belief that one is not capable of handling day-to-day responsibilities competently and independently. People with this schema often rely on others excessively for help in areas such as decision-making and initiating new tasks. Generally, parents did not encourage these children to act independently and develop confidence in their ability to take care of themselves.
  8. Vulnerability to Harm and Illness: This schema refers to the belief that one is always on the verge of experiencing a major catastrophe (financial, natural, medical, criminal, etc.). It may lead to taking excessive precautions to protect oneself. Usually there was an extremely fearful parent who passed on the idea that the world is a dangerous place.
  9. Enmeshment/Undeveloped Self: This schema refers to a pattern in which you experience too much emotional involvement with others – usually parents or romantic partners. It may also include the sense that one has too little individual identity or inner direction, causing a feeling of emptiness or of floundering. This schema is often brought on by parents who are so controlling, abusive, or so overprotective that the child is discouraged from developing a separate sense of self.
  10. Subjugation: This schema refers to the belief that one must submit to the control of others in order to avoid negative consequences. Often these clients fear that, unless they submit, others will get angry or reject them. Clients who subjugate ignore their own desires and feelings. In childhood there was generally a very controlling parent.
  11. Self-Sacrifice: This schema refers to the excessive sacrifice of one’s own needs in order to help others. When these clients pay attention to their own needs, they often feel guilty. To avoid this guilt, they put others’ needs ahead of their own. Often clients who self-sacrifice gain a feeling of increased self-esteem or a sense of meaning from helping others. In childhood the person may have been made to feel overly responsible for the well being of one or both parents.
  12. Emotional Inhibition: This schema refers to the belief that you must suppress spontaneous emotions and impulses, especially anger, because any expression of feelings would harm others or lead to loss of self-esteem, embarrassment, retaliation or abandonment. You may lack spontaneity, or be viewed as uptight. This schema is often brought on by parents who discourage the expression of feelings.
  13. Unrelenting Standards/Hypercriticalness: This schema refers to the belief that whatever you do is not good enough, that you must always strive harder. The motivation for this belief is the desire to meet extremely high internal demands for competence, usually to avoid internal criticism. People with this schema show impairments in important life areas, such as health, pleasure or self- esteem. Usually these clients’ parents were never satisfied and gave their children love that was conditional on outstanding achievement.
  14. Entitlement/Grandiosity: This schema refers to the belief that you should be able to do, say, or have whatever you want immediately regardless of whether that hurts others or seems reasonable to them. You are not interested in what other people need, nor are you aware of the long- term costs to you of alienating others. Parents who overindulge their children and who do not set limits about what is socially appropriate may foster the development of this schema. Alternatively, some children develop this schema to compensate for feelings of emotional deprivation or defectiveness. Positive schema to enhance would be empathy and compassion for others.
  15. Insufficient Self-Control/Self-Discipline: This schema refers to the inability to tolerate any frustration in reaching one’s goals, as well as an inability to restrain expression of one’s impulses or feelings. When lack of self-control is extreme, criminal or addictive behavior rule your life. Parents who did not model self-control, or who did not adequately discipline their children, may predispose them to have this schema as adults.
  16. Approval-Seeking/Recognition-Seeking: This schema refers to the placing of too much emphasis on gaining the approval and recognition of others at the expense of one’s genuine needs and sense of self. It can also include excessive emphasis on status and appearance as a means of gaining recognition and approval. Clients with this schema are generally extremely sensitive to rejections by others and try hard to fit in. Usually they did not have their needs for unconditional love and acceptance met by their parents in their early years.
  17. Negativity/Pessimism: This schema refers to a pervasive pattern of focusing on the negative aspects of life while minimizing the positive aspects. Clients with this schema are unable to enjoy things that are going well in their lives because they are so concerned with negative details or potential future problems. They worry about possible failures no matter how well things are going for them. Usually these clients had a parent who worried excessively.
  18. Punitiveness: This schema refers to the belief that people deserve to be harshly punished for making mistakes. People with this schema are critical and unforgiving of themselves and/or others. They tend to be angry about imperfect behaviors much of the time. In childhood these clients usually had at least one parent who put too much emphasis on performance and had a punitive style of controlling behavior.

At the Cognitive Behavior Therapy Center of Silicon Valley, we have an in-depth interview process and series of questionnaires that can help us identify your primary schemas.

About the Cognitive Behavior Therapy Center of Silicon Valley

The Cognitive Behavior Therapy Center of Silicon Valley offers Schema Therapy for chronic and long standing problems and patterns. With our convenient location just a 1/2 mile from Highway 85 and the Saratoga Avenue exit, we serve the Silicon Valley communities of San Jose, Saratoga, Mountain View, Santa Clara, Sunnyvale, Los Gatos, Los Altos, Palo Alto, Cupertino and Campbell, CA. Contact us at (408) 384-8404 or send an email for more information on how we can help you with long term schema change.

10 Ways to Manage Anxiety, Worry and Stress

Anxiety GirlAnxiety is Sneaky

You’re doing fine, and then suddenly you feel like you can’t breathe. Maybe your chest hurts, and you’re convinced you’re having a heart attack. Maybe something happened, like your car won’t start or you heard layoffs might be coming at your company. Or maybe you can’t pinpoint why you are feeling like you are – you woke up in the middle of the night sweating and with a feeling of dread.

You are probably having an anxiety attack — an extreme reaction to stress. Even if you aren’t having a full-blown panic attack, anxiety can leave you feeling apprehensive, uncertain and fearful, paralyzing you with indecision and avoidance.

What is Anxiety?

It’s normal to feel anxious when facing a challenging situation. However, if your worries and fears seem overwhelming and out of proportion with what’s happening and interfere with your daily life, you may be suffering from an anxiety disorder. Common symptoms of anxiety include a surge of overwhelming panic, feelings of losing control or going crazy, a racing heart, heart palpitations or chest pain, feeling like you’re going to pass out, trouble breathing or hyperventilation, trembling or shaking and nausea or stomach cramps. If you have chronic anxiety, you may feel like you are living with constant feelings of apprehension or dread, have trouble concentrating, feel tense or irritable a lot of the time and tend to anticipate the worst.

Anxiety disorders are the most common mental health problems affecting children and adults. According to the Anxiety and Depression Association of America, an estimated 40 million adults (18% of the U.S. population)  suffer from anxiety disorders. Only about one-third of those suffering from an anxiety disorder receive treatment, even though anxiety disorders are highly treatable. Below are some steps you can take yourself to manage your anxiety.

10 Steps to Reduce Anxiety, Worry and Stress

1. Get Active. Ride your bike, take a walk, go to a yoga class or go to the gym. There’s no better therapy to reduce the physical sensations of an anxiety attack than to get your blood pumping and endorphins moving through your body with exercise.

2. Cut out all caffeine. Caffeine adds to that tense, jittery, anxious feeling. Sources of caffeine include chocolate, beverages like coffee, tea, soda, and some prescription and over-the-counter medications, like Excedrin.

3. Avoid stressful conversations when you’re tired, overwhelmed, or stressed. For instance, tell your kids that you’re simply not available for problem solving after 8 p.m. Try to protect a “trouble free” time, especially before bed, when you don’t address difficulties but focus instead on pure relaxation.

4. Get sleep. Buy a white-noise machine and use it when you go to sleep. The soothing sound will help you fall and stay asleep. A good night’s sleep is critical when you’re stressed, since sleep deprivation fuels anxiety even as anxiety leads to sleep deprivation.

5. Write about one thing that is making you anxious. Sit down and write out all the fears you have about that one thing. If it’s money, write down what would happen if you lose your job and can’t pay your bills. What is the absolute worst thing that could happen? Now look at each item and mark it on a scale of 1 to 10, with 1 being highly unlikely it would ever happen, 10 being likely that it would happen. You’ll be surprised at how few items rank above a 5. This understanding should help reduce your anxiety. If something does rank higher than 5, you may want to develop a coping plan for it. Nothing works better to calm anxiety than turning from pure worry to an action plan.

6. Practice mindfulness meditation. Relax your body from the toes up. Follow your breath as you observe and detach from your thoughts. Center yourself in the moment (e.g., feel your head upon the pillow, or your feet on the ground, etc.). When your mind wanders, don’t judge it. Simply bring your attention back to your breath.

7. Don’t focus on future problems. Many people get into a cycle of predicting and worrying about future concerns. Ask yourself, “Is this something that could actually happen and, if so, can I do something about it right now?” If the answer to either of these questions is no, tell yourself you will focus on it later. Keep a journal of what makes you anxious. Then revisit these same items when you’re feeling calm and develop plans to deal with them.

8. Experience your anxiety for 45 minutes. That’s usually all it takes for you to become used to it and for the anxious feeling to dissipate. The worst thing you can do is try to ignore your feelings because anxiety tends to fight back if you push it down.

9. Talk to yourself. Remind yourself of how you handled similar situations in the past, your strengths, and how long you will need to get through it. Show yourself that this anxiety is manageable and time-limited.

10. Get busy. Go to the museum, see a movie, read a good book, or take up oil painting (or some other hobby). Rent a comedy and watch it. Let yourself laugh out loud. The act of laughter stimulates endorphins that help blow stress hormones out of your system the way a good thunderstorm can blow away hot, humid weather.

How To Get Help for Your Anxiety

The Cognitive Behavior Therapy Center of Silicon Valley specializes in anxiety, worry and stress in adults, children and teenagers. With our convenient location just a 1/2 mile from highways 85 and the Saratoga Avenue exit, we serve the Silicon Valley communities of San Jose, Saratoga, Mountain View, Santa Clara, Sunnyvale, Los Gatos, Los Altos, Palo Alto, Cupertino and Campbell, CA. Contact us at (408) 384-8404 for more information on how we can help you overcome anxiety, worry and stress.

Are You Ready to Change?

Stage of Change and Motivational InterviewingWhen you show up for therapy, it’s natural to assume you are ready to change, right? Otherwise, why would you be paying a therapist to help you work toward a solution? However, sometimes after a few sessions, you may find your motivation is uneven and you aren’t sure you want to do the work involved in getting better and changing your life. That’s where an innovative style of counseling called Motivational Interviewing can help you move through the stages of change.

Stages of Change

If you are wondering what’s going on and asking yourself, “Why aren’t I doing the things I know I need to do to get better?,” then you are perfectly normal. Research indicates there are five stages that indicate readiness for change and most people move between them when working on achieving any goal. The five stages of change are:

  1. Pre-contemplation – you have no intention to take action and may be uninformed about the consequences of your behavior. This is also called “denial” in ordinary language.
  2. Contemplation – you become aware a problem exists and intend to change but have not yet made a commitment to take action.
  3. Preparation – you are intending to take action in the next month, may have already tried to change, and may have a plan of action in mind.
  4. Action – you are beginning to make overt behavioral or environmental changes.
  5. Maintenance – you are working to prevent relapse and maintain gains.

Strategies Need to Match the Stage You Are In

Most clients, when they first see a professional, are not at the action stage. About 80% are in one of the first three stages and only 20% are in action or maintenance. Resistance to change arises when you and the therapist assume you are in the action stage and start making an action plan to get things done when, in reality, you are not there yet. Instead, it would be better to take a less aggressive approach, acknowledge what stage you are in, and modify homework assignments accordingly.

What Can You Do to Increase Your Readiness to Change?

There is a counseling approach called Motivational Interviewing (MI) that is defined as a “client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.” In Motivational Interviewing, ambivalence is regarded as a normal part of the change process. MI can increase motivation in the early stages by helping you understand why you want to change. MI can then be followed with cognitive behavioral exercises in the action stage to help you acquire the skills for change.

Principles of Motivational Interviewing

One of the major goals of MI is to help you start thinking about and talking about change before taking action. Talking about your desire and intent to change can be a powerful predictor of change. There are 4 major strategies that the counselor uses to encourage change talk:

  1. Expressing empathy – using reflective listening to convey understanding of your message.
  2. Developing discrepancy – between the your most deeply held values and the current behavior you want to change.
  3. Supporting self-efficacy – building confidence that change is possible.
  4. Rolling with resistance – meeting resistance with reflection rather than confrontation.
Getting Started with the Process of Change

So even if you are not yet in the action stage, Motivational Interviewing can get you ready for change. If you are interested in reaching a goal this year, maybe the best way to do so is to start with Motivational Interviewing.

How to Get Help in Saratoga/San Jose

The Cognitive Behavior Therapy Center of Silicon Valley offers Motivational Interviewing as a precursor to engaging in action-oriented CBT. The Cognitive Behavior Therapy Center is located at 12961 Village Drive in Saratoga. We are just a 1/2 mile from Highway 85 and the Saratoga Avenue exit. You can contact us (408) 384-8404 for mrs information about how we can help you start the process of change.

Be A More “Perfect” Perfectionist: Coping with Failure

Perfectionism and Coping with FailureIf you are a hard core perfectionist, you’ve probably been criticized at some point for it and your perfectionism might have even annoyed or been intimidating to others. There are lots of advantages to being a perfectionist like striving to do your best, producing great work, being successful, paying attention to details, making fewer errors and being someone people can count on. Some disadvantages of perfectionism include overworking, beating yourself up for making mistakes, never feeling like you are good enough, comparing yourself to others and judging yourself on your performance and other externals. On the other hand, some perfectionists procrastinate because the thought of all the hard work required to do a “perfect” job feels exhausting or they don’t take risks because of fear of failure. When perfectionism gets out of control, it can lead to anxiety and depression.

Can You Be a More “Perfect” Perfectionist?

You can learn to be an “perfect” perfectionist by keeping the advantages of perfectionism and minimizing the disadvantages. Some strategies like positive reframing, acceptance and humor are the most effective coping skills for dealing with setbacks and helping people feel satisfied at the end of the day. In contrast, some of the least effective coping skills were venting, denial, behavioral disengagement and self-blame. Perfectionists felt worse after using these strategies.

What is Positive Reframing?

Positive reframing involves trying to see things in a more positive light and looking for something good in what happened. Positive reframing, as you’ll see below, is not about turning a negative into a positive but, rather, being able to see reality in a more helpful light. For example, the reframing skill can help you view a setback as a challenge to be overcome or see failure as a learning experience. Reframing is a way of changing the way you look at something and, thus, changing your experience of it. This can relieve stress and help you create a more positive life before you actually start making any changes in your circumstances.

Steps for Reframing a “Failure”

Positive reframing involves four steps:

  • Learn about your thinking patterns. Do you tend to fall into the same thinking traps over and over again?
  • Notice your thoughts. Catch yourself when you are slipping into overly negative or rigid thinking patterns.
  • Examine the truth and accuracy of your negative thoughts. Be a scientist. Ask yourself: What is the evidence for and against this thought? What would I tell a friend? How helpful is it to think this way?
  • Develop realistic responses to your negative thoughts about failure and setbacks. If you can’t think of a more positive response, then be more compassionate with yourself, accept the failure and put it into perspective.

If you want to be feel good about yourself and live a more satisfying life, the best way to deal with failure and setbacks may be to accept it, reframe it realistically and compassionately, and then have a good laugh about it.

Summer Self-Soothing Ideas

RelaxationSoothing with the Five Senses

Self-soothing is a key part of self-care. The goal of self-soothing is to comfort yourself emotionally and physically by doing things that are sensually pleasant and not harmful. Self-soothing is a mindfulness practice when you are focusing your full attention on the feelings being experienced by your five senses. By being fully present on what you are experiencing in the moment, you will be able to get you outside of your head and away from troubling thoughts, feelings, and impulses.

Here are some ideas on how you can practice self-soothing this summer.

Vision: Plant some bright flowers in your garden. Go on a hike and notice the trees and flowers. Watch the stars on a clear summer night. Attend a summer art festival.

Hearing: Listen to music at an outdoor concert. Go to the beach and hear the sounds of the ocean. Listen to the crackling of firecrackers at a Fourth of July festival.

Smell: Buy some flowers with vibrant fragrances at the Framer’s Market. Take in the savory smells at a barbecue this summer. Bake an apple pie.

Taste: Sample some summertime fruits. Mindfully eat an ice cream or a popsicle. Sip a cold smoothie. Let a piece of dark chocolate melt in your mouth.

Touch: Soak your feet in the pool. Walk barefoot in the sand at the beach. Apply suntan lotion to your skin. Feel the heat of the sun on your body.

Playing the Anxiety Mental Game

Anxiety Mental GameIn July, I had the privilege of traveling to Chicago to observe a two-day intensive live Anxiety & OCD treatment group led by Reid Wilson, Ph.D. There were eight people in the group with anxiety and OCD, many of whom had been suffering for years with chronic anxiety, panic, social anxiety, depression, obsessive thoughts, mental rituals and/or compulsive behaviors. I was skeptical the morning of the first day. Reid Wilson was making some big claims like “You will need to trust me. You can listen and think you will work on it later…and you will fail. Or you can listen and act – today – and begin your healing.” Given the severity of this group’s long-standing problems with anxiety and OCD, I didn’t believe that these folks could achieve significant progress by the end of a two-day, 16 hour treatment group. Boy was I wrong!

Steps To Playing the Anxiety Mental Game

Dr. Wilson spent the first four hours introducing the concepts behind the Anxiety Mental Game and enhancing motivation to play the game. He said, “You have OCD or Anxiety. You’ve been working on it, struggling with it, worrying about it, trying to control it, and you haven’t won yet.” Dr. Wilson said the only way to win against anxiety is to follow some paradoxically absurd strategies. He outlined three steps:

  • The first step is to identify how anxiety is ruining your life and to identify how your future will be different if you face your fears. This step creates your reason or motivation for wanting to play this game. You need to have a compelling reason because this game is hard.
  • The second step is to understand the principles behind playing the anxiety game. You need to be able to gain a mental shift from “I must avoid anxiety at all costs” to “I want to seek out anxiety (frequency), I want it to be strong (intensity), and I want it to last (duration).” And you need to learn that “whatever happens, I can handle it.”
  • The third step is to provoke anxiety. Instead of avoiding, resisting or simply tolerating anxiety (which is where anxiety wins), you need to proactively invite more anxiety into your daily life. This means being able to genuinely believe and tell yourself, “I really want anxiety to keep happening. I win if it keeps happening” and then to go out and actually create opportunities (called “exposures” or “behavioral experiments”) to feel anxious.

You might be thinking, “I am already doing the things that make me anxious. How can doing more of them help?” The difference is you are probably muscling through your daily life if you aren’t actively avoiding. You are probably telling yourself, “This is uncomfortable. My anxiety is unbearable. I can’t handle this anymore. I need relief from anxiety.” And you might go into anxiety-provoking situations with some subtle safety behaviors to try to protect yourself, like over-preparing, not talking, leaving early, sitting in a place where you won’t be noticed or distracting yourself during the situation.

Preparing to Play The Anxiety Mental Game

To prepare for the Anxiety Mental Game, the group members were asked to identify and review their hierarchy of anxiety-provoking content and to pick one item that they would practice experiencing at lunch time. Every time the group member could enthusiastically say things to themselves when they felt anxious like “Excellent! Just what I wanted,” or “I can handle this,”  or “Give me your best shot. I want my life back,” they would get a point. Dr. Wilson gave each group member a clicker to keep track of their points. After lunch, they came back and reported on how many points they had accumulated. Some of the folks had 80+ points in just two hours!

In addition to the new self-talk, the participants were also coached about where to put their attention while they were playing the Anxiety Mental Game. Dr. Wilson said, “The problem is not what you think it is. The problem is not the content of your fears. The problem is where you put your attention. You will either pay attention to the content (i.e. your list of anxiety-provoking fears, worries and other negative thoughts) or you will pay attention to anything else. You will decide – moment by moment. You have to choose to withdraw your attention from your content. That is your job here.”

Rules for Winning the Anxiety Mental Game

Winning the Anxiety Mental GameThe way to win the Anxiety Mental Game is to change your frame of reference from “This is serious and dangerous” to “This is a mental game.” The new rules you need to learn are:

  1. Do not pay attention to your content.
  2. Accept obsessive and anxious thoughts when they pop up.
  3. Want to make yourself uncertain about the content.
  4. Want to be anxious and stay anxious.
  5. If necessary, make rules and follow them (to get you through the exposures).

By the end of the two-day treatment group, all the group members reported some amount of reduction in their anxiety and fears. Through the exposures, they learned that “This is hard and I want it” and “I can handle this.” By observing the group members’ improvements, I became a believer in the power of playing this mental game to beat anxiety and OCD.

You can listen to Reid Wilson talking about the Anxiety Mental Game by clicking to listen to this Anxiety Mental Game podcast. If you are interested in learning to play the Anxiety Mental Game, call us at (408) 384-8404 to set up an appointment with one of our therapists.