Problems I Treat

If you have Panic Disorder you may suffer repeated, unexpected, and sudden attacks of intense terror or apprehension that make you feel like you are dying or going crazy – for no apparent reason. Symptoms can include racing heart, trouble breathing, chest pain, lightheadedness, numbness or tingling in limbs, feelings of unreality, stomach or bowel symptoms, sweating, trembling or choking.  You may become preoccupied with fear of future attacks and attempts to prevent them.

When panic attacks or other symptoms lead to significant avoidance, Agoraphobia may develop, in which you fear having a panic or other symptom attack in places or situations from which escape might by difficult or embarrassing. These situations include crowds, certain buildings, being alone, being far from home or a trusted person, or traveling by car, bus or airplane.  The cost of agoraphobia can be a very restricted lifestyle.

If you have a Specific Phobia you may suffer from an intense fear reaction to a common object or situation, such as vomit, spiders, dogs, heights, water, air travel, or enclosed spaces. You recognize that your level of fear is irrationally out of proportion to the situation. Such intense fear can lead to avoidance of common, everyday situations, and can interfere with your life.

If you experience a Medical Phobia you suffer from fear of blood, injections, doctors, dentists, or medical procedures. You may be prone to fainting. Your anxiety may keep you from attending doctor or dentist appointments, having blood drawn, visiting hospitals, getting flu shots or other inoculations, or donating blood. You may also avoid pursuing pregnancy or a career in health care.

If you are struggling with Social Anxiety Disorder you may have become excessively self-conscious, and wish to avoid one or more situations involving social interactions or performances. Commonly feared situations include public speaking; meeting new people; writing, eating or performing in front of others; attending parties; asking for dates; speaking to people in authority; having conversations; texting or talking on the phone, e-mailing or posting on-line; using public restrooms; or disagreeing with others. People with social anxiety worry about being judged by others or behaving in a way that might cause embarrassment or ridicule.  This phobia can result in having few, if any, friends or social or romantic relationships.  Physical symptoms such as blushing, shaking or sweating can increase the fear of humiliation or embarrassment.

If you have Obsessive-Compulsive Disorder (OCD) you are plagued by intrusive, persistent and recurring thoughts, images or impulses (obsessions) that may seem senseless or distasteful. Typical obsessional topics concern disease, dirt, disorder, sex, religion or violence. These unwanted thoughts may lead you to perform a ritual or routine (compulsions) to try to neutralize, suppress or reduce the distress caused by the obsession. Common compulsions include repetitive hand washing, excessive cleaning and arranging, checking door locks and other objects, excessive reassurance seeking, ritualistic counting, repeating phrases, and rereading.  Significant avoidance can result from OCD.

If you worry all the time, you may suffer from Generalized Anxiety Disorder. In this condition, people experience excessive, unrealistic worry that feels uncontrollable. The constant worry may concern topics such as financial problems, loved ones, school, career, health, etc.  “What if” thoughts and negative mental scenarios seem endless. This worrying leads to a number of unpleasant symptoms including restlessness, fatigue, trouble concentrating, insomnia, muscle tension, irritability, and abdominal upset.

If Health Anxiety (also known as Illness Anxiety Disorder) is a problem, you suffer from fears of being seriously or even terminally ill, when no symptoms of serious illness exist. You may misinterpret normal bodily sensations or physical symptoms as being dangerous and life threatening. Reassurance from friends, family, the internet, medical tests or health care professionals may provide temporary relief, but the fears return anyway. You may make many unnecessary visits to the doctor or undergo unnecessary medical testing and procedures, or even avoid contact with health care providers for fear that you will receive bad news.

Trichotillomania or Hair-Pulling Disorder, is the recurrent pulling out of one’s hair, resulting in hair loss. Hair might be pulled from the scalp, eyebrows or eyelashes, among other areas. If you have “trich,” you may or may not experience strong urges to pull, which you cannot resist. Episodes are accompanied by such feelings as gratification, relaxation, relief, shame or depression. You may avoid activities that you fear will reveal your hair loss, or go to great lengths to conceal bald spots, using scarves, wigs, makeup, clothing, etc.  Tremendous emotional distress, isolation and difficulties in social, school, and work settings can result.

Other Body-Focused Repetitive Behaviors (BFRB’s) include Excoriaton (Skin-Picking) Disorder, compulsive nail biting, biting the insides of the cheeks, lip picking, blemish squeezing, nose picking, etc.  Skin-Picking may involve rubbing, scratching, picking, and/or digging at one’s skin in attempt to address perceived imperfections, in spite of repeated attempts to stop.  Although lightly regarded as “nervous habits” by many, these disorders can have serious negative impacts upon you, such as intense shame, scaring, infections, depression and social isolation.

Body Dysmorphic Disorder (BDD) is characterized by having a distorted perception of one’s appearance, leading to agonizing shame and despair. It is generally diagnosed if you are extremely critical of your physique or body-image, despite the fact there may be no noticeable disfigurement or defect. If you suffer from BDD, you may anxiously focus upon monitoring and hiding the aspect of appearance (e.g. skin, hair, nose) that you view as ugly. This can lead to social avoidance, compulsive reassurance seeking, unnecessary surgeries, etc.

Insomnia is one of the more troubling experiences for depressed or anxious patients. If you have problems falling or staying asleep, or experience non-restorative sleep that occurs on a regular or frequent basis, you may have Chronic Insomnia. Insomnia can affect not only your energy level and mood, but also health. Fortunately, a course of CBT, without the use of drugs, can be quite effective in controlling insomnia problems.

I can also help you with

  • Discontinuing psychiatric medication
  • Reducing shyness and social isolation
  • Managing clinical depression
  • Cultivating self-esteem, optimism and psychological resilience
  • Developing assertiveness and social skills
  • Overcoming procrastination, perfectionism and self-criticism
  • Maintaining a healthy life style (e.g., exercise plans)
  • Improving time management
  • Improving self-care
  • Achieving and maintaining weight loss (including use of “The Beck Diet Solution”)
  • Navigating life transitions and loss
  • Controlling “shy bladder syndrome” (Paruresis)
  • Learning improved stress management skills
  • Clarifying values, direction, purpose and life goals

For more information on these problem areas, refer to my list of recommended books or links to some helpful websites.