We provide treatment for a very wide range of problems or disorders. These include mild difficulties and common life challenges such as decision-making about career options, low self-esteem, or finding a life mate; moderate problems such as adjusting to divorce, breaking away from compulsive behaviors and habits, or overcoming a fear of driving on the freeway; and more pervasive or severe problems such as panic disorder, OCD, or depression. We frequently offer group treatment for conditions such as panic disorder, social anxiety, depression, or OCD. We also provide relationship therapy for couples, families, and others. The following are some of the primary areas of expertise at the Cognitive Therapy Institute.
Panic disorder, often accompanied by agoraphobia, has caused tremendous distress and limitation in the lives of many people. The intense physical symptoms of panic may include racing or pounding heart, difficulty breathing or “getting enough air”, lightheadedness or dizziness, sweating and feeling hot, numbness or tingling, feelings of “unreality” or being “mentally detached”, racing thoughts, or urges to flee a situation. A feeling of extreme fear or terror seems to “come out of the blue” and escalates rapidly, with a sense that one is losing control, going crazy, passing out (fainting), dying, and/or going to embarrass them self. The central cognitive component in panic is a “catastrophic misinterpretation” of the intense sensations, the fear that they are a sign of impending disaster (when in fact they are not). Even if full blown panic attacks are no longer occurring, many people may become locked into an ongoing worry or apprehension about future risk of panic.
Agoraphobia refers to a pattern of fear and avoidance of situations in which the person has experienced and / or might experience panic attacks. Agoraphobia often includes a fear of being alone or away from a trusted person, or a fear of not being able to escape a situation, or a fear of traveling away from home. Fortunately, the new cognitive-behavioral treatments for panic and agoraphobia have been very effective, with lasting results. About 80% of people treated with CBT recover, and few relapse after treatment.
Multiple worries and excess anxiety that occur more days than not, constant tension, inability to relax, fatigue, and sleep disturbance are just a few of the many symptoms that may be seen in this condition.
Social phobia or social anxiety disorder involves a persistent fear of being scrutinized, evaluated, or judged by others. There is typically a fear that the anxiety symptoms (e.g. red face, sweating, trembling, stumbling over words) or some other behavior will be noticed by others and will result in being embarrassed, humiliated, or rejected. Social anxiety often interferes with employment opportunities, restricts social activity, and diminishes one’s ability to enjoy a full life. Variations of social anxiety may include fear of public speaking, extreme shyness, fear about very specific situations (e.g. eating or writing in front of others), or a more general fear about many or most social situations.
Excessive fear and avoidance regarding specific objects, animals, or situations comprises the central theme in a specific phobia. Examples may include excessive fears of heights or of driving on the freeway (or over bridges), fear of dogs or other animals, fear of elevators or other enclosed areas without windows (claustrophobia), or fear of some other particular situation, feeling, or object.
At some point in the future, after experiencing or observing a very traumatic event (e.g. car accident, assault, rape, war), the individual begins to experience intense “flashbacks”, nightmares, images, or other memories of the past trauma. Symptoms may include anxiety and panic, detachment, sleep problems, difficulty relaxing or trusting, hyper-vigilance, irritability or anger outbursts, avoiding people or situations, guilt, and / or low self-esteem.
OCD involves the recurrent intrusion of upsetting obsessions (thoughts, urges, or images) and / or the urge to carry out certain compulsive behaviors (particular activities or internal thoughts/images that are often repeated). The person become consumed in a pattern of repeated cleaning or checking rituals or other excessive behaviors, sometimes including avoidance, that feel necessary in order to reduce high levels of anxiety and fear, or to avert a potential disaster (e.g. getting a disease, or being responsible for a bad act or outcome, or being a “bad” person).
Depression is a fairly common condition that can be treated successfully for most individuals through cognitive-behavioral therapy (CBT), antidepressant medication, or a combination of the two. Even mild levels of depression, which are quite common in the general population, can usually be improved by CBT. There are various diagnoses and subcategories of depressive disorders: depressive symptoms may arise in relationship to a recent stressful event (Adjustment Disorder with Depressed Mood), or reach a severe level that significantly interferes with daily life (Major Depressive Disorder), or involve additional diagnostic criteria or symptom phases (Bipolar Disorders), or be defined by other types of symptoms or criteria. Often depression is mixed with symptoms of anxiety.
Typical symptoms of clinical depression include at least two of the following: a persisting state of depressed mood (sadness or feeling “empty”) or irritability; fatigue or loss of energy nearly every day for weeks; diminished interest or pleasure in activities; insomnia or excess sleeping; significant weight loss or gain and / or changes in appetite; low self-esteem or feelings of worthlessness; poor concentration and / or difficulties making decisions; and in more severe levels, a sense of hopelessness or thoughts of wanting to die.
Low self-esteem and low self-confidence can contribute to unhappiness and can interfere with pursuit of relationships, education, career advancement, and other important areas of life. CT provides a supportive relationship in which you will learn and practice specific steps and strategies that can significantly improve self-esteem.
Many Americans suffer from daily stress in their work, family, or other situations in their life. Headaches, fatigue, muscle tension, sleep disturbance, ulcers and other gastrointestinal problems, or even more serious medical conditions can result from exposure to excessive or prolonged stress. You may constantly feeling rushed or on edge, experience loss of joy in life, or even have “burn out” from your work or other types of stress. CBT teaches relaxation and other coping techniques and helps you to evaluate priorities or pursue changes that can improve your health and quality of life.
Many people experience problems related to anger and anger management that can affect their physical health, emotional health, relationships, or job. Research has shown a connection between chronic anger and cardiovascular disease. Certainly many relationships are damaged and opportunities lost due to anger problems. CBT has definite programs and strategies that have been shown to be helpful in bringing anger under control.
Many couples suffer from conflicts, resentments, loss of affection, and sexual difficulties. Differences in expectations about marriage or roles between partners, misinterpretations and misunderstandings, communication problems, different values and styles for parenting, arguments about money, and other problems can plague relationships. Many couples benefit significantly from CBT. CBT can also be integrated with other types of family therapy to enhance success in parenting and child rearing, reduce conflicts, improve communication, and increase enjoyment of family life. Even reconciliation between parents and their adult children can often be facilitated in this type of therapy. Other types of relationship problems addressed include fears about dating, or conflicts with coworkers, employees, or supervisors.
CT / CBT can be helpful in making adjustments to divorce, new jobs, moving, the “empty nest syndrome”, or other life changes. It has also been shown to be effective in treatment of eating disorders, substance abuse, and other compulsive behaviors, and in addressing personality patterns such as procrastination or avoidance. Therapists at the Institute also have experience in working with these and other types of issues.