Treatment

My Approach: Cognitive-Behavioral Therapy (CBT)
CBT is a form of psychological treatment that has been carefully developed and tested by psychologists and psychiatrists using high scientific standards. I have conducted some of the research supporting its use with anxiety disorders. CBT is a skills-based approach that begins with building a supportive relationship. The therapist listens carefully to the patient's description of the problem, identifies maladaptive patterns of thinking and behaving, and then helps the patient apply various skills and techniques to modify problematic behaviors and reduce anxiety and fear. The goal of CBT is to learn to use these skills to reduce anxiety and get on with life.

Obsessive-Compulsive Disorder
For the past 15 years I have worked extensively with adults with OCD to help them reduce the burden of obsessions, anxiety and doubt; and to help them eliminate time consuming and disruptive ritualistic behavior. The key to overcoming this problem is learning to live with acceptable levels of risk and uncertainty. This takes lots of practice. I begin with a thorough assessment of OCD symptoms so that we can build an effective treatment plan together. The centerpiece of my approach is exposure and response prevention, a research-proven set of techniques in which I help the patient gradually and systematically confront his or her fears and uncertainties while learning to resist ritualistic urges. I have put these techniques into a self-help format in my book Getting Over OCD.

Panic Attacks and Agoraphobia
It may seem paradoxical, but it's true: anxiety and fear just get worse the more you try to fight or avoid them. CBT for panic attacks and agoraphobia involves techniques to help you learn that anxiety and panic are not dangerous, and that you don't need to rely on "safety strategies," avoidance, or anti-anxiety medications to manage your anxiety or keep you safe.

Social Anxiety
For better or for worse, others don't pay nearly as much attention to us as we sometimes think that they do. People with social anxiety, however, are afraid of being embarrassed in front of others. They often feel that avoiding social situations and using strategies like drinking alcohol are the only ways to manage their fears. CBT strategies help the person learn that feeling embarrassed, if it happens at all, is not as terrible as it seems.

Specific Phobias
When you overestimate the degree of danger posed by certain situations or objects-- storms, animals, the dark, heights, airplanes, enclosed places-- the result is a phobia or "irrational fear." Trying to avoid these feared objects may seem like a good strategy in the moment, but this backfires in the long-run. In CBT, you practice confronting your fears so that you can learn that these situations are less dangerous than you thought.

Health Anxiety
Living with the specter of an unresolved health issue is frightening and isolating. No one believes you're really sick, but you can sense it in your body. Even the doctors can't seem to explain your symptoms--they just say it's "stress." I understand that it's not "all in your head," and I draw on CBT techniques developed from behavioral medicine specialists to help you manage your symptoms in new and more helpful ways. Think about it-- you don't have anything to lose by considering how worrying about your health could be making you feel even sicker.

Generalized Anxiety Disorder
My approach to general anxiety and worry is to help the person identify patterns of jumping to conclusions about awful events that never seem to materialize, or turn out as bad as expected. When you learn how to change the way you think about worrysome situations, you gain control over your emotions and take back back your life.

Posttraumatic Stress Disorder
Experiencing or witnessing a traumatic event -- a physical or sexual assault, natural disaster, serious accident, military combat, etc. -- can change a person's view of the world from a relatively safe place to a dangerous one. The mind and body change too: maybe you get nightmares and flashbacks, pehaps you're more hypersensitive and easily startled, you expect the worst, become distant from loved ones, and experience guilt and depression. CBT for these symptoms includes various strategies for helping you process the traumatic event in a safe and controlled way so that you can put your life back together.