Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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202-331-1566

2440 M Street, NW
Suite 710
Washington, DC 20037

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Seeing Anxiety as an Opportunity Instead of a Threat

By Lynne Gots, posted on August 22nd, 2017.

My newly rescued terrier Dewey is, in almost all ways, an excellent dog. He’s energetic, inquisitive, friendly, and affectionate. But when we’re out walking and he spies another dog, he turns into a whirling, barking Tasmanian Devil. Luckily he weighs only eighteen pounds—any bigger and he’d knock me off my feet. Still, the prospect of a surprise canine encounter made me dread our daily outings.

So I signed up for a Distracted Dog class. I already had been working on undoing some of the bad habits Dewey had acquired over the seven years of his life before coming to us. He’s learning how to wait for his food, lie down instead of jumping up and begging, and walk on a leash without pulling. The challenge now is to keep his attention on me in more stressful situations.

Before the first day of class, our instructor asked us to send her a hierarchy of our dog’s top five distractions, much like the hierarchy of anxiety triggers used in CBT for exposure and response prevention. At the top of Dewey’s list was “seeing another dog approach while on a walk.”

In treating anxiety, I help people stop avoiding and start approaching what they most fear. I needed to apply the same mindset to changing my dog’s (and my own) reactions to the stimuli that send him into a frenzied display of doggie frustration.

So, instead of anxiously scanning the environment for other dogs in order to do an about face before Dewey spots them, I’ve started looking for ways to practice building his self-control. As a result, I’ve observed a dramatic change in my own (if not yet Dewey’s) emotional reaction. I’m excited instead of tense when I see neighbors out walking their dogs. I now interpret a potential trigger not as a threat to steer clear of but as an opportunity to seek out.

If I were drawing only from my personal experience, my method wouldn’t carry much weight. But the results of several research studies support my anecdotal evidence. Saying, “I feel excited” instead of attributing physical arousal to anxiety—a technique called “anxious reappraisal”—can improve singing, test-taking, and public speaking performance by putting people in an “opportunity mindset” even though the physiological markers of anxiety such as increased heart rate and cortisol levels remain elevated.

In fact, you don’t even need to tell yourself you’re excited; just believing that anxiety can improve rather than impair performance helped test takers score higher on the GRE. It’s a trick actors often use to cope with stage fright. Those who are successful don’t necessarily feel less nervous. But they’re able to view the fluttering of their hearts and rumbling of their stomachs as feelings that give energy to their performance.

Confronting anxiety is hard. You can’t make progress unless you’re willing to face the situations you fear. But changing the way you think about arousal might make it a little easier to rise to the challenge.




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The Value of Sadness

By Lynne Gots, posted on April 25th, 2017.

My dog Baxter died last week. At fifteen years and nine months old, he had reached the end of his time. He was the canine equivalent of a human nonagenarian. But, still.

No matter how expected, the loss of a loved one always delivers a sucker punch to the gut. It knocks the wind out of you and leaves a cavernous hole. When I come home to the empty mat by the garage door where Baxter always waited for my return, I feel his absence. When I’m doling out food for one dog instead of two, I feel it. When I’m chopping cucumbers for a salad and, out of habit, drop the ends on the floor for Baxter (whose longevity quite possibly was related to his voracious consumption of vegetables), I feel it. And when I  see his unoccupied bed in the corner when I wake up in the morning, I feel it.

My nine-year-old Aussie Freddie also feels it. Herding dogs need jobs, and his was to shepherd Baxter around our property to make sure nothing untoward happened. Baxter once killed a bunny, and instead of partaking in the hasenpfeffer feast, Freddie circled the carnage barking while Baxter gleefully eviscerated his prey. Whenever I let them out, Freddie body blocked Baxter to control his access to the yard . Now he stands on the deck looking back, waiting.

I’ve heard some people say they would never have a pet because they couldn’t bear the pain of losing it. But protecting yourself from strong emotions, like sadness, only sets you up for more problems in the long run because experiential avoidance prevents you from learning you can withstand the inevitable pain and difficulty of living. And, by too carefully protecting yourself from feeling bad, you also risk limiting the full range of human emotional experiences–like joy and love–that makes life worthwhile.

So I’m embracing my sadness. I’ve made Baxter’s picture the lock screen 0n my phone so I can remember him when I text or send an email. The lump in my throat comes up every time. I welcome it.




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“Do I Need Medication?”

By Lynne Gots, posted on February 18th, 2015.

 

I discuss this question so often in my practice—and have so frequently considered blogging about it—I had to scroll through my archives to see if I’d already written a post on the topic. But, apparently, it only existed in my mind.

I’m prompted finally to address the issue of medication because I attended an interesting discussion the other day about a book titled Does My Dog Need Prozac? Everyone in the group, including me, has a fearful dog (my Australian Shepherd Freddie, as I’ve mentioned before, is tightly wound and “reactive” to other dogs, people unknown to him, and the television). We talked about how to help our sensitive pets be more comfortable in the world while at the same time learning to accept them as they are rather than being disappointed when they don’t behave like TV dogs. Come to think of it, this attitude of acceptance would make it a lot easier to be content with children, spouses, friends, and colleagues who don’t quite meet our expectations, either.

Given the title of the book, the conversation eventually turned to the use of medication to help ease reactive animals’ fears. According to the animal behaviorist who moderated the discussion, people are as reluctant to medicate their anxious canines as they are to consider pharmacological treatments for themselves—although she encounters, as I do, less resistance to so-called “natural” remedies, such as herbal compounds and vitamin supplements. (I’m always puzzled when someone who is adamant about not taking medication will ingest an uncontrolled, unregulated substance, however natural it may be. After all, poisonous mushrooms and hemlock are natural, too. But lethal.)

My position on medication is flexible. I’m more than happy to try a course of CBT sans meds if someone comes to me with that preference. The research suggests that CBT alone can be as effective as a combination of medication and CBT together in treating anxiety. and I’ve certainly seen many people benefit from CBT interventions without the help of a prescription. Medication alone, on the other hand, is not as effective. It may lessen discomfort, but it won’t resolve the patterns of avoidance people develop—and often become consumed by– to cope with their distress.

Here’s the rub. If anxiety is off the charts, a person (or dog) won’t be able to think clearly enough or stay in a triggering situation long enough for tolerance and habituation to take place. So medication can be very helpful in dialing down the arousal enough to facilitate the behavioral practice crucial for success.

I doubt animals feel stigmatized if they need to take Prozac (though their owners certainly might). But many humans I’ve worked with are ashamed, or see themselves as weak, if they can’t white-knuckle it through without the aid of a pill. Despite advances in modern neuroscience, culturally we’re still stuck in the last century when it comes to psychiatry, seeing mental disorders as failures of will or character flaws rather than disturbances of brain chemistry.

I personally have nothing to gain from recommending a course of medication. I can’t even prescribe it. But I believe in doing what works best—for people and for pets. And sometimes that means using all the tools we have at our disposal, including pharmacology, to make the process of coping more manageable.

[For the record, we did try Prozac with my late Golden Retriever Calvin, who suffered from separation anxiety and compulsive licking. Freddie hasn’t been on any medication because we’ve taken great pains to work with him behaviorally, and he’s responded to the training. In the interest of full disclosure, I confess to having been one of those owners who gravitated towards holistic remedies, such as DAP (dog-appeasing pheromone) and lavender spray. Sadly, none of them worked, so we’re back to plain old desensitization. And lots of dog treats.]

 

 

 

 

 

 

 

 

 

 

 

 




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This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.

Contact Dr. Gots

202-331-1566

2440 M Street, NW
Suite 710
Washington, DC 20037

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If you don't receive a response to an email from Dr. Gots in 48 hours, please call the office and leave a voicemail message.

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© 2008-2017 Lynne S. Gots, PhD. Photographs by Steven Marks Photography.