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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How to Protect Your Mental Health During the Coronavirus Outbreak

By Lynne Gots, posted on April 1st, 2020.

In my last post, I talked about strategies for managing anxiety during these harrowing times. I have added some new tips for boosting psychological immunity and staying on track with sound mental health practices while sheltering in place in a post I wrote for the National Alliance on Mental Illness (NAMI).




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Posted in Articles, Depression, Health Anxiety, mindfulness, Obsessive Compulsive Disorder, Self-help, Techniques |

The Best Resolution for the Anxiety-Prone

By Lynne Gots, posted on January 20th, 2020.

It’s that time of year. New Year resolutions. Tips on motivation and habit change. Life hacks for cooking healthy meals, fitting in exercise, and taming the clutter.

If you’re looking for such advice, please check out other blogs or previous posts in my archives.  Today I will be talking only about the most important New Year’s goal to set for yourself if you struggle with anxiety.

 Do more exposures!

An essential component of evidence-based practices for OCD, social phobias, generalized anxiety, panic disorder, and even more common anxieties, such as fears of public speaking and flying, is Exposure and Response Prevention (ERP).  In brief, ERP involves putting yourself in a situation that spikes your anxiety while refraining from engaging in “safety behaviors” (eg, carrying a bottle of water or antianxiety medications “just in case”) or compulsions to make yourself less anxious.

Sound scary? Yes! But that’s the point.

Instead of avoiding your triggers, seek them out. Make yourself anxious. You don’t have to jump off the high dive to plunge yourself into the anxiety pool. If slow and steady is more your style, you can dip in just a toe, or a foot. But don’t avoid getting wet.

Here’s the good news. Unlike going to the gym or stocking up on healthy groceries, exposure practice doesn’t require you to carve out extra time in your already over-packed schedule. You can do exposures anywhere or anytime, even while you’re building those new habits, say, going to the gym or stocking up on healthy groceries. Just look for opportunities to get anxious; a little or a lot, it doesn’t matter.

Once you start to move towards these challenging situations, you’ll find it’s not as bad as imagined. You might even start looking for opportunities to face your fears: by approaching, rather than avoiding, your anxiety triggers, your world will open up.

Now wouldn’t that be an incredible way to enter the new year?




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Posted in Anxiety, Behavior Change, Obsessive Compulsive Disorder, Phobias, Social Anxiety Disorder, Techniques |

How to Weather a Setback without Getting Discouraged: Understanding Trigger Stacking

By Lynne Gots, posted on March 9th, 2019.

I learned a new term this week:  “trigger-stacking.” I wasn’t attending a professional conference or catching up on my journals.  I heard the phrase from a veterinary behaviorist.

Six months ago we adopted Clifford, a three-year-old Australian Shepherd who had been a stray in rural New Jersey. Let’s just say the adjustment has been very rough.

During the three-hour drive from New Jersey, he draped himself across my lap, instantly claiming me as his ”person.” But he has what the Aussie rescue groups euphemistically call “a strong guardian instinct,” causing him to be overly protective of his turf, his food, his toys, and…me.  So from the moment he entered our house, he treated my husband as an enemy invader.

Whenever my husband crossed a threshold into a room I was in, Clifford launched a canine air-missile strike.  We began to feel under siege, on constant alert for the next attack.

Fast forward six months. Thankfully, through a combination of medication prescribed by the veterinary behaviorist and lots of counter-conditioning—which derives from the same learning principles underpinning the treatment approaches I use for anxiety—we now have a much more relaxed dog. I’ve stopped my Google searches for “Farms that Take Unadoptable Animals,” and Clifford has gradually been forming a tentative bond with my husband. We’re cautiously optimistic.

But because behavior modification isn’t linear, the aggressive displays we’ve been working so hard to eliminate will occasionally resurface.  And even though I should know better, I was disheartened one day last week to observe a spike in Clifford’s territorial barking along with his refusal to come back into the house after he went out in the yard while I was at work. He stood on the deck for two hours, nervously casting glances at my husband, who tried to lure him back inside with a smorgasbord of tasty treats. Even steak couldn’t entice him.

After reviewing the behavioral log I keep to remind myself of Clifford’s progress (a practice I heartily recommend, by the way, if you’re working on changing your own behavior), the cause of his regression became clear:  trigger-stacking.

I identified three major triggers, each of which individually heightened Clifford’s arousal and, cumulatively, pushed him over the edge: 1) A stressful visit to the vet for a vaccination the previous day; 2) Loud noises overhead while workmen repaired our roof; and 3) Repeated invasion of his territory while my husband walked in and out of his office moving books.

In hindsight, it makes perfect sense. But at the time, I had trouble convincing myself we weren’t back to square one.

When you experience an uptick in the anxiety or compulsive behaviors you’ve been working hard to manage, you might assume a setback means you haven’t made progress. Not so. A bad day at work, a fight with a partner, a sick child, a sleepless night—any one of those triggers might be manageable alone but in combination might just be too much to handle without reverting to the coping behaviors you’ve been trying to change.

So when you suffer a setback, don’t view it as a relapse. Instead, ask yourself if you’ve been facing more triggers than usual. Cut yourself some slack—but don’t make excuses to justify avoidance–by taking on lower intensity challenges, if necessary, to keep yourself from slipping back into old habits.

And, then, start back where you left off, as we did with Clifford. For a week, he continued to balk at coming inside whenever my husband let him out in the yard. But a few days ago, the sight of his leash brought him back in the house. And, for the first time, they walked around the block together.




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Posted in Behavior Change, Dogs |

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

Email >

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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