Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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Got Anxiety? News from the ADAA Conference

By Lynne Gots, posted on April 16th, 2012.

My brain hurts. It’s overstuffed with the supersized servings of research data and clinical strategies I devoured during four days at the annual meeting of the Anxiety Disorders Association of America (ADAA). Each day I studied the catalogue of courses to decide which to attend, salivating at the rich array of workshops. It was like surveying the dessert table at a fancy Bar Mitzvah. I ended up sampling as many offerings as I could fit into my schedule until the last day, when just opening the meeting planner made me feel queasy.

And speaking of queasy, I picked up some useful tips on how to make the ultimate fake vomit and supplement it with YouTube vomit videos to provide realistic visual and sound effects when doing exposure therapy for emetophobia (the surprisingly common fear of vomiting). There’s even a site where you can customize the appearance of bodily emissions by typing in different ingested foods, and one where you can weigh in on the relative grossness of a gallery of vomit pictures. Who knew?  And if this is grossing you out, I can also help you with your overactive disgust reaction, having attended a workshop on the topic.

We anxiety specialists have so much fun!

I’ve been thinking about how to distill the volumes of information about anxiety into one pithy sound bite (a recommendation from the ethics workshop I attended on psychology and the media). Here’s what I’ve come up with:

AVOID AVOIDANCE!

It has a nice ring to it, and it’s paradoxical to boot, which fits with the mindfulness training I participated in.

But, in truth, learning how to accept anxiety (rather than fearing it and pushing it away) is a key component of all anxiety treatments across the spectrum of evidence-based practices.

For example, pure behaviorists define avoidance as a negative reinforcer (escaping from the aversive, anxiety-inducing stimulus relieves anxiety, thus making avoidance behaviors more likely to occur). Cognitive therapists emphasize the role of avoidance in perpetuating thinking errors such as catastrophic predictions about the outcome of an anxiety-producing situation. And proponents of the mindfulness and acceptance approaches suggest that experiential avoidance—turning away from negative emotions—promotes an unhelpful, judging state of mind that adds to the pain of anxiety.

So, no matter what mechanism you invoke to explain it, avoidance makes anxiety worse.

This isn’t news to anybody who’s come to me for treatment. But learning about the latest research and clinical applications from the academic experts in the field has made me eager to try out some promising new techniques.

In the meantime, I need something to settle my brain—a mental antacid, so to speak. Catching up on the latest episode of Mad Men should do just fine.

 

 

 

 




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Posted in Acceptance and Mindfulness, Anxiety, Behavior Change, Generalized Anxiety Disorder, Health Anxiety, Obsessive Compulsive Disorder, Phobias, Self-help, Social Anxiety Disorder, Techniques |

Anxiety: Telling It Like It Is

By Lynne Gots, posted on February 6th, 2012.

 

In my last post I said I’ll be writing about how media portrayals of psychological problems contribute to misinformation.  That’s still coming.  But I’m taking a slight detour to comment on two first-person accounts of anxiety that stand out because they’re spot on.

Several of my patients told me a recent New York Times piece really resonated with them. The author teaches creative writing, and she describes her myriad fears and phobias with vivid, skin-crawling imagery. She also skillfully injects some wry, self-deprecating humor into a painful subject without turning it into Woody Allenesque schtick. One warning, though. While most of the couple hundred readers who commented identified with the author’s experiences, a few passed judgment on her and some others were just plain wrong in their assessments of how to treat the problem. So as with all internet opinions about mental health issues, please read with a critical eye.

I’ve also discovered a website to recommend. I stumbled upon it during an hour freed up by a last minute cancellation last week when I should have been getting my taxes in order and instead avoided the task by surfing the internet. ( OK, I don’t always practice what I preach.) Daniel Smith, the blogger and author of an upcoming memoir about his anxiety, does a great job of capturing the experience of living with an anxiety disorder. He’s also very funny, which for me is his biggest therapeutic selling point.  Because even though anxiety disorders are no laughing matter, it’s healthy to be able to laugh at yourself from time to time.

 





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Posted in Generalized Anxiety Disorder, Mental Health and the Media |

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.

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