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Phone: 858-354-4077

Email: info@csamsandiego.com

7860 Mission Center Ct, Suite 209
San Diego, CA, 92108

858.354.4077

At The Center for Stress and Anxiety Management, our psychologists have years of experience. Unlike many other providers, our clinicians truly specialize in the diagnosis and treatment of anxiety and related problems. Our mission is to apply only the most effective short-term psychological treatments supported by extensive scientific research. We are located in Rancho Bernardo, Carlsbad, and Mission Valley.

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Blog

Read our award-winning blogs for useful information and tips about anxiety, stress, and related disorders.

 

Filtering by Tag: cognitive restructuring

How Do I Control My Anxious Thoughts?

Jill Stoddard

By Annabelle Parr, MA, AMFT

The human mind is a meaning making machine; it searches for patterns (even where there are none) and does it’s best to make sense of the world around us so that it can help keep as safe and surviving. But if you are reading this, I’m guessing while you are surviving, you might not feel like you are thriving. Because sometimes the thoughts our minds generate feel less than helpful. Sometimes, they get us stuck.

Anxiety tells us all kinds of stories about ourselves and the world around us.

If you’ve ever experienced anxiety, you are probably familiar with all the catastrophic stories your mind can generate in a difficult moment, from “I’m going to fail” to “nobody likes me” to “this is going to be a disaster!” Anxiety disorders, OCD, and PTSD all include sticky thoughts that tend to govern and restrict behavior and continue to drive the anxiety and emotional difficulties. And it makes sense that if your anxious thoughts seem to be controlling your life that you might want to control your anxious thoughts for a change. 

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So what do we do when our thoughts seem to be holding us back or getting us stuck? We have a couple of options.

Cognitive Behavioral Therapy works on changing the content of our thoughts.

From a traditional Cognitive Behavioral Therapy (CBT) perspective, we might try what is known as cognitive restructuring. CBT challenges sticky thoughts, examining evidence for and against the thought, and then replacing it with a new, more balanced thought in place of the original. In addition, CBT asks you to act in new ways that might allow you to directly experience evidence that challenges your thought.

For example, say you are stuck on the thought, "I always fail at everything I do." CBT might invite you to consider that although you did fail your last 2 math tests, you aced your last 5 history tests, you are great at taking care of your dog, and you make a mean lasagna. Significantly, this isn't just about "thinking positive." And you aren't replacing the thought with it's complete opposite ("I will never fail at anything I do" or "I am the best at everything"). Those thoughts would not be helpful or true either. You are instead aiming for a more balanced and helpful way of viewing the situation: "I failed this time, but that doesn't mean I have or will always fail at everything.

What if I can’t control my thoughts?

But what if you have tried to challenge those thoughts that tell you how incapable you are or how dangerous the world is, and no matter how many times you try to replace the old thought and control your pesky mind, it doesn’t seem to work? What if trying to change your thoughts only makes you feel like even more of a failure because it’s not helping? Some thoughts are too sticky to challenge. You might be able to come up with a more balanced thought, but you still may have trouble believing it to be true. And guess what? The more we try not to think something, the more present and entrenched it tends to become. (For example, DO NOT THINK ABOUT PUPPIES. SERIOUSLY. DON’T THINK ABOUT A BUNCH OF CUTE, FLUFFY, SNUGGLY PUPPIES…I bet you just thought about puppies.)

Maybe you don’t have to fight with your mind.

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Acceptance and Commitment Therapy (ACT) comes at our thoughts from a different angle. ACT says that the problem is not that your mind has thoughts, but rather that you believe that those thoughts reflect the truth about how things are and you behave accordingly. ACT is not concerned with whether a thought is factually correct or incorrect. Instead, ACT asks, is this thought workable? Does it help you to move around in your life effectively? Does it move you closer to what matters most? Or is listening to it preventing you from engaging in your life in important, meaningful ways?

Getting a little distance from your mind is different from controlling it.

In ACT, rather than trying to “correct” a thought or control the content of your mind, the focus is on helping you to step back, get some space from those sticky thoughts, and observe them for what they are: words. This process is known as cognitive defusion. 

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A simple trick to get some space from your mind is to refer to it as a separate entity. So when you have a sticky thought, you might think, “my mind is telling me that I can’t handle this.” Or you might give your mind a name: “Neville is telling me that I can’t handle this.” Then, rather than trying to convince yourself that you can in fact handle it, you would focus on connecting with what matters to you, and choose to act in service of your values regardless. Because the thing is, you can have a thought and choose to behave in direct opposition to it. And this can be really powerful. Let’s try it right now. Say to yourself, “Self, I cannot raise my hand.” And raise your hand. See? No matter how sticky the thought is in your mind, it doesn’t have to keep you stuck with it.

If you can change your mind, great! If you can’t, no problem.

Whether you choose to replace a sticky thought with a new, more balanced thought or whether you choose to remind yourself that a thought is just your brain trying to make sense of the world, you do not need to fight with your mind. You just need to give it a little wiggle room. Minds can change. But what matters is that you know that your thoughts are not in control, even when it feels like they are. No matter what your mind is saying at any given moment, it is the YOU that has those thoughts that gets to decide what you do.

CSAM Is Here to Help

If you or someone you love needs support and might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, or stress related to COVID-19, or if you would like more information about our telehealth services, please contact us at (858) 354-4077 or at info@csamsandiego.com

How To Listen When Someone You Love Is Struggling

Jill Stoddard

by Annabelle Parr

Life presents us each with challenges.  While it is often uncomfortable and painful to grapple with adversity, to experience this struggle and to feel pain is to be human.  At some point, we will all find ourselves in this place, as will those we love.  So how can we help each other?  How can we listen when someone we love is struggling, whether it is with a mental health condition or with a painful experience in his/her life?

 LET GO OF THE IMPULSE TO TRY TO FIX

Source URL: https://scott-williams.ca/2013/03/

Source URL: https://scott-williams.ca/2013/03/

It is painful to watch someone we care for struggle or hurt.  And it’s natural to want to take away her pain or try to fix the problem at hand.  However, despite our best intentions, trying to “fix” does not actually help.  It tends to make the person struggling feel as though she cannot share her pain, sadness, or anger.  Trying to “fix” sends this message: “I can’t handle seeing you in pain, so I have to make everything better.”  It also implies that it is not okay to feel sad or angry or anxious, and that these feelings should be avoided at all costs.

AVOID ADVICE

Just like our impulse to fix the pain, we also often believe that the best way to help is to offer advice.  But advice is usually not helpful for several reasons.

  1. If we offer good advice, our loved one will think that anytime he is struggling, he needs our instruction.

  2. If we offer bad advice or our advice doesn’t work as we hoped, our loved one can place the blame on us instead of owning responsibility.

  3. Advice takes away the gift of helping our loved one to realize that she knows herself best, and ultimately she is capable of navigating difficult situations herself. (Though, of course, she will always have our love and support).

LIMIT SHARING YOUR OWN SIMILAR EXPERIENCES

Source URL: http://www.lifehack.org/articles/communication/the-biggest-communication-problem-not-listen-understand.html

Source URL: http://www.lifehack.org/articles/communication/the-biggest-communication-problem-not-listen-understand.html

If you have had a similar experience or believe that you have felt the same way, you can share this with your loved one.  But don’t make it all about you.  Keep your story brief, and make sure the purpose of the story is to let him know that he is not alone.  Also, be sure to include that you understand that your experience, while maybe parallel in some ways, is yours, and you are not claiming to have experienced the exact same situation or feelings.  This allows him to feel comfort in not being alone, but also gives him space to communicate how his experience may be different.

If we shouldn’t try to fix the pain or offer advice, and we should limit how much we share of our own experience, what can we do to help?

REFLECT OR PARAPHRASE BACK TO YOUR LOVED ONE WHAT YOU HEAR HIM/HER EXPRESSING

This shows that we are listening, and gives us the opportunity to clarify that which we don’t understand fully.  While it may sound too simple to just reflect what our loved one is saying, it actually makes the person feel heard and understood.  It also offers her the opportunity to hear what she is expressing, and to clarify how she feels or what she wants.

USE NONVERBAL SIGNALS TO SHOW YOU ARE ENGAGED

Nodding and using eye contact and engaged body language shows that we are interested and open to what our loved one is sharing.  It gives him the space to express himself, and makes him feel heard.

SHOW EMPATHY

Empathy is: “I see that you are struggling and hurting right now, and I am so sorry.  I can’t fix it for you or take it away, but I will sit here with you and listen to your story.  As much as this hurts, it is okay to feel this way.”

Check out Brene Brown’s brilliant short on empathy.

Sometimes, all our loved ones need when they are in pain is to be heard; to be given a space with someone they trust to express how they are feeling.  Sometimes, however, they may need some extra support or professional help.

CSAM IS HERE TO HELP

If you or someone you love might benefit from acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at csamsandiego@gmail.com.

REFERENCES:
Brown, B.  (2013, Dec 10).  Brené Brown on empathy. Retrieved from https://www.youtube.com/watch?v=1Evwgu369Jw

 

That Which Fuels the Fire of Anxiety: Unhelpful Thinking Patterns

Jill Stoddard

By Lauren Helm, M.A.

 

 

We’ve all felt it at some point in our lives (likely many times over, in fact), though perhaps it manifested in different ways. You may have noticed the rapidly increasing pitter-patter of your heart, the fast, constricted breaths, the growing tension in your shoulders and neck, clammy hands, or maybe a funny feeling in the pit of your stomach. The experience of anxiety is unpleasant, to say the least, and as it builds, it certainly has a way of getting our attention.

Why do we experience these uncomfortable sensations that we call anxiety? From an evolutionary perspective, fear and anxiety (two related but slightly different emotions) have a function: they keep us alive. More specifically, fear and anxiety are emotions that occur in response to a perceived threat. When we believe that something may harm us or is dangerous, we feel these emotions and they motivate us to protect ourselves from the danger, typically either by avoiding or escaping the threat. Without fear or anxiety, we may not react to truly dangerous situations in an adaptive way, and thus not survive as a species. Imagine walking along and crossing paths with a Grizzly Bear. Would it be helpful to feel no fear, and to run up and hug it? Obviously for most of us, this would not end well! Our emotions give us invaluable information about the environment and about what actions we should take, based on how we feel.

As incredible as our brains are, they also are prone to errors. We are not always able to accurately assess the true amount of danger (or safety) that may be present in our surroundings. Sometimes this means that we may miss a true threat that was present and suffer the consequences. However, in our modern day society, more often than not we experience the opposite – we overestimate the true amount of threat and thereby experience excessive anxiety as a result.

The problem with excessive anxiety is that it can negatively impact the quality of our lives in multiple ways. Prolonged, pervasive anxiety has an impact on our physical well-being, in addition to our psychological well-being. Chronic stress and anxiety can lead to a deterioration of optimal physical functioning, preventing your immune system, digestive system, and heart from performing the best that they can. Chronic anxiety may also interfere with your ability to sleep, eat, and generally function as you’d like to in life.

 

 

 

How does anxiety become problematic? Cognitive-behavioral therapists tend to understand most mood and anxiety disorders using the cognitive triad, which breaks down our experiences into thoughts, behaviors, and feelings. In brief, anxiety is both developed and maintained by an interplay between certain unhelpful thinking and behavioral patterns. For example, anxiety may be perpetuated by certain ways of thinking. A low threshold for perceiving threat (i.e. situations very easily feel threatening) and an attentional bias to threat (i.e. focusing and narrowing your attention on potential dangers that surround you) can contribute to feeling anxiety. In other words, if we easily feel threatened and continue to be on the lookout for threat, we will likely frequently feel anxious. Another thinking pattern that feeds anxiety is called catastrophic thinking. Catastrophic thinking occurs when our mind jumps to imagining worst-case scenarios when we are uncertain about an outcome.  For example, our mind may imagine that our loved one has been involved in a car accident because they still haven’t returned home 30 minutes after they said that they would. Furthermore, probability overestimation occurs  along with catastrophic thinking – this is when we overestimate how likely it is that the “worst-case scenario” has or will occur. When we are feeling anxious, we often feel very certain that the worst-case scenario will occur  even though realistically-speaking, the chances are much lower (or are little to none) that what we fear will actually happen. Unfortunately, we are unlikely to recognize this while we are in the midst of severe anxiety – instead, we may engage in worry orrumination (i.e. brooding) about the many possible negative “what if” scenarios, and use extensive cognitive energy to plan for or prevent potential future threats from occurring. In moderation, worrying and planning for future threats can be helpful, but when it begins to take excessive time and energy (which is quite exhausting), it becomes maladaptive and interferes with your ability to function optimally. More often than not, the cost of worrying exceeds the benefits (it may become a waste of energy) and actually feeds the anxiety that it is intending to placate.

 

These are just a few ways that our patterns of thinking can create and maintain anxiety. In our next blog, we will talk more about unhelpful or inaccurate thinking patterns (also called cognitive distortions) and some suggestions for creating more adaptive ways of thinking and behaving in response to anxiety.

 

 

If you'd like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety, please click here.

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Resources

http://www.webmd.com/balance/guide/how-worrying-affects-your-body

http://www.apa.org/divisions/div12/rev_est/cbt_gad.html

 

 

 

References

Barlow, D. H. (2004). Anxiety and its disorders: The nature and treatment of anxiety and panic. Guilford press.

Behar, E., DiMarco, I. D., Hekler, E. B., Mohlman, J., & Staples, A. M. (2009). Current theoretical models of generalized anxiety disorder (GAD): Conceptual review and treatment implications. Journal of Anxiety Disorders23(8), 1011-1023.

Beck, A. T., Emery, G., & Greenberg, R. L. (2005). Anxiety disorders and phobias: A cognitive perspective. Basic Books.

Sibrava, N. J., & Borkovec, T. D. (2006). The cognitive avoidance theory of worry. Worry and its psychological disorders: Theory, assessment and treatment, 239-256.

Tags: anxietycognitive behavioral thearpyanxiety therapy san diegoanxiety therapyworryCognitive Behavioral TherapyCenter for Stress and Anxiety Managementcognitive distortionsemotion regulationanxiety disordersunhelpful thinking