Cognitive Behavioral Therapy
Change What You Do
I specialize in cognitive-behavioral therapy (CBT) for anxiety and related disorders. CBT is a gold-standard psychotherapy that focuses on disrupting dysfunctional relationships between thoughts, feelings, and behaviors. Among the many psychotherapies available to treat anxiety and depression, CBT has arguably the largest evidence base of any; decades of clinical research attest to this.
I’m what they call a “big B” therapist. I find that people get the most relief by changing what they do, not how they think. We have much more control over our behaviors than our thoughts, and doing things differently is what will ultimately culminate in a sense of mastery over anxiety or depression.
Specific CBT methods I use include Exposure and Response Prevention (ERP), Behavioral Activation, Habit Reversal Training (HRT), Dialectical Behavioral Therapy (DBT) Skills Training, Comprehensive Behavioral (ComB) Treatment for BFRBs, and others.
Test Your Fear
My approach is guided by our modern understanding of how CBT is effective for anxiety. In the past, therapists thought that the best way to treat anxiety was to put you in anxiety-producing situations of increasing difficulty and encourage you to remain in those situations until your anxiety decreased. That way you would gradually learn not to be anxious in those situations.
Today, we know that what seems to help anxious people the most is to recognize—in as many different situations as possible—that the feared outcome isn’t a foregone conclusion. This new learning (that the worst seldom happens) competes with, or inhibits, the old learning (that the worst is bound to happens).
Tolerate Your Discomfort
CBT involves a lot of time spent doing things differently, and practicing skills that make you uncomfortable. This includes re-engaging with activities and in situations typically avoided, and deliberately provoking uncomfortable emotions and sensations using a variety of strategies. To many, this sounds counter-intuitive; we believe therapy should ease discomfort, not stimulate it.
In a sense, CBT is more akin to exercise than to traditional “talk therapy”. Easy workouts don’t work, and neither does easy therapy. CBT is all about learning to tolerate discomfort and “leaning in” to feared scenarios rather than avoiding them.