At Psychological Associates of Michigan we treat a variety of problems, including: all forms of anxiety, depression, stress, and relationships issues.
UNDERSTANDING ANXIETY
All of us experience anxiety from time to time, particularly when we are under stress or we feel pressured or vulnerable. Essentially, anxiety involves activation of the sympathetic nervous system with a surge of adrenaline. We experience sympathetic activation any time our brain perceives a threat; albeit a physical threat (e,g. A gun pointed to our head) or a psychological threat (e.g. Such thoughts as: “I’m going to fail,” or “I’m going to make a fool of myself.”) Anxiety involves perceived psychological threats or thoughts that center around being vulnerable. In this way, anxiety involves “false alarms” by our sympathetic nervous system; thus, real physical danger is not imminent, though it may feel that way.
There are several types of anxiety problems: general anxiety (excessive worry), panic, social anxiety, obsessive-compulsive disorder, and health anxiety. Very often, when anxiety has been chronic, a secondary depression or substance abuse can develop. Additionally, people with anxiety often suffer with more than one type of anxiety. Research suggests that 25% of the population has suffered with an anxiety disorder.
The cause of anxiety is partly genetic and partly learned experience. It is estimated that 30 to 50 percent of anxiety is genetically related. Thus, anxiety prone individuals have a biological predisposition to become anxious or have a lower threshold for sympathetic nervous system activation. However, early life experiences or learning plays a large role, from 70 to 50 percent (e.g. loss of a parent, demanding standards for perfection, over protection). Typically, an individual’s current excessive expectations for themselves, as well as self-criticalness, play a major role in causing anxiety.
It should be noted that there are several medical problems that can trigger anxiety: an over active thyroid, mitro valve prolapse, and brain injury or dysfunction. Additionally, certain medications can trigger anxiety. Therefore, it is recommended for all patients who experience anxiety to undergo a medical examination.
It should be noted that there are several medical problems that can trigger anxiety: an over active thyroid, mitro valve prolapse, and brain injury or dysfunction. Additionally, certain medications can trigger anxiety. Therefore, it is recommended for all patients who experience anxiety to undergo a medical examination.
All forms of anxiety are highly treatable with Cognitive-Behavioral Therapy.
TYPES OF ANXIETY PROBLEMS
PANIC
Panic attacks involve severe levels of anxiety and sympathetic nervous system arousal. During a panic attack people often experience such physical sensations as: shortness of breath, tingling, racing heart, chest pain, choking, and dizziness. As a result of these sensations, people experience an impending sense of doom and typically think they are having a heart attack, losing control, or are going insane. As they think the latter, they then cause themselves to become more anxious. Panic is essentially anxiety about anxiety.
GENERAL ANXIETY
General anxiety involves long term, excessive worrying. Typically, people with general anxiety have difficulty relaxing and feel a lot of bodily tension that results in such problems as chronic tight muscles, tiredness, headaches, and teeth grinding. People who have general anxiety often say that they have been “worriers” most of their lives.
The thinking of an individual with general anxiety is characterized by “what if thinking.” They often attempt to predict the future and demand a sense of certainty when it is impossible in certain circumstances. They often get caught up in a series of “what if thinking” and imagine negative outcomes. As they continually try to predict the future, image awful outcomes and become anxious, a vicious cycle ensues in which they interpret their anxiety as indicating that their feelings and thoughts are true, which leads to more anxiety.
Research by Dr. Robert Leahy indicates that people who worry a lot often believe that their worry prepares them for live's challenges and protects them. They often desire perfect solutions.
SOCIAL ANXIETY
Social anxiety involves intense concerns about being evaluated or judged/criticized by others. Given intense anxiety about being evaluated, social situations are strongly avoided. Examples of social anxiety include: fear of carrying on a conversation with others, fear of writing in the presence of others, and concerns of using public restrooms. The avoidance of social situations only intensifies the anxiety and hampers the person from learning that they are capable of coping with social situations. Additionally, avoidance hampers the development of social skills, which are learned through experience.
SHYNESS
Intense shyness can develop into soical anxiety. Individual's who are shy are typically highly self-conscious and consequently experience anxiety or intense sympathic arousal (see above for details). Research suggests that people who are shy from an early age have a predisposition toward sympathic arousal. That is, in unfamiliar social situations, they are inclined to easily have their sympathic nervous system activated and thus become nervous. Nonetheless, people who are shy can learn to over ride this disposition through new learning and skill development.
SHYNESS
Intense shyness can develop into soical anxiety. Individual's who are shy are typically highly self-conscious and consequently experience anxiety or intense sympathic arousal (see above for details). Research suggests that people who are shy from an early age have a predisposition toward sympathic arousal. That is, in unfamiliar social situations, they are inclined to easily have their sympathic nervous system activated and thus become nervous. Nonetheless, people who are shy can learn to over ride this disposition through new learning and skill development.
OBSESSIVE-COMPULSIVE DISORDER
People with obsessive-compulsive disorder (OCD) can have obsessions and/or compulsions. Obsessions are repetitive thoughts that lead to anxiety. Examples of obsessions include: fears of getting germs/disease, fears of harming/killing someone, fears of doing something immoral (e.g. sexual fantasies of another woman when one is married). Compulsions are repetitive actions that the person feels he/she must do in order to not feel anxious or to prevent something awful from happening. Examples of compulsions include: repeatedly checking the stove, touching objects many times, chewing food until it is liquid, excessive hoarding of objects. People with ODC are misguided in that they believe that if they engage in obsessions and compulsions they will decrease their anxiety. Underlying this anxiety is typically the mistaken belief that “something is inherently wrong” with them.
HEALTH ANXIETY
People with health anxiety worry excessively about their health, believing that they have an illness or that a catastrophic illness will befall them, despite evidence to the contrary. They frequently seek out medical services and often seek medical reassurance.
TREATMENT FOR ANXIETY
At Psychological Associates of Michigan, we utilized Cognitive-Behavioral Therapy, as well as Mindfulness techniques, to treat anxiety problems. Our approach is three pronged, focusing on the physiological, cognitive, and behavioral aspects of anxiety. Thus, we teach strategies (deep abdominal breath, progressive muscle relaxation, and meditation) for reducing the physical symptoms of anxiety, we guide clients in learning how to identify errors in their thinking, and we help them learn how to challenge negative thoughts about themselves and their circumstances. We teach clients to develop effective coping skills. Typically, this also involves learning assertiveness skills. We also aid clients in developing the skills to not engage in avoidance. Clients are thoroughly educated about anxiety.
UNDERSTANDING DEPRESSION
Depressed individuals perceive themselves as helpless and as not possessing control over their present life as well as their future. They not only view themselves as helpless, but they view their future as hopeless. A depressed person's thinking typically involves thoughts that center around loss and rejection. They are also inclined to be highly self-critical, perceiving themselves as inadequate, inferior, or worthless. As the aforementioned shows, the depressed person's thinking tends to be highly negatively biased and very black/white.
Symptoms of depression include the following: depressed mood (feeling sad or empty) most of the day, diminished interest in pleasurable activity, weight gain or weight loss, insomnia or excessive sleeping, fatigue, feelings of restless or a sense of feeling slowed down, a lack of concentration, a sense of worthless, recurrent thoughts of death or suicidal thoughts. It should be noted that some of the aforementioned symptoms can be related to a medical illness (e.g. chronic infection), and therefore individuals who question whether they are depressed should be medically evaluated. Of course, depression can also be secondary to a medical illness. Depression can be mild, moderate, or severe. Individuals with moderate to severe depression typically exhibit at least 5 of the above symptoms. Many individuals suffer chronic mild depression, which includes symptoms such as: low self-esteem, low energy, poor appetite or overeating, feelings of hopeless, and difficulty making decisions. Usually, two or more of the above symptoms are exhibited for 2 years or longer when a person is considered mildly depressed.
Symptoms of depression include the following: depressed mood (feeling sad or empty) most of the day, diminished interest in pleasurable activity, weight gain or weight loss, insomnia or excessive sleeping, fatigue, feelings of restless or a sense of feeling slowed down, a lack of concentration, a sense of worthless, recurrent thoughts of death or suicidal thoughts. It should be noted that some of the aforementioned symptoms can be related to a medical illness (e.g. chronic infection), and therefore individuals who question whether they are depressed should be medically evaluated. Of course, depression can also be secondary to a medical illness. Depression can be mild, moderate, or severe. Individuals with moderate to severe depression typically exhibit at least 5 of the above symptoms. Many individuals suffer chronic mild depression, which includes symptoms such as: low self-esteem, low energy, poor appetite or overeating, feelings of hopeless, and difficulty making decisions. Usually, two or more of the above symptoms are exhibited for 2 years or longer when a person is considered mildly depressed.
UNDERSTANDING STRESS
Stress is a part of everyday life, and typically involves having to accommodate to changes and demands in our environment. Thus, stress is unavoidable. Additionally, we need some stress in order to be alert, motivated, and perform. Hence, stress is not necessarily negative, it can also be positive. For example, getting a new home or a new job both involve change and can be stressful. When we experience stress, there is a complex interaction between our thinking and our physical response. Our bodies are wired from prehistoric times to physically react with sympathetic activation, which involves surges of adrenaline and a fight or flight response, any time our brain perceives a threat.
Essentially, stress comes about from three sources: our environment, our body, and our thoughts. With regard to the environment, there may be excessive external demands on you that you believe you must accommodate to. For example, being faced with an extra work load, taking care of aging parents, or helping an ill spouse are all external demands. In regards to our body being a source of stress, such physiological events as illness, lack of sleep, poor nutrition, aging, and lack of exercise can all over tax the body and thereby add to stress. Another source of stress is our thoughts regarding the changes and demands that are placed on us. That is, how we interpret, perceive and label the changes or demands that are currently going on in our lives greatly influences our physical response. In this way, if we interpret or label the changes/demands in our life as catastrophic, overwhelming, awful, and perceive ourselves as helpless, we will likely experience anxiety or a great deal of sympathetic arousal/adrenaline response, and consequently have difficulty dealing with the changes/demands. In turn, if we misinterpret our physical response as indicating that we have no control over our life, this will add to our stress. Usually stress is short term. Chronic stress can trigger an individual’s predisposition to certain diseases to be activated. (e.g. Autoimmune illness, heart disease, diabetes)
Indicators that you may be experiencing too much stress include: weight gain, muscle tension, sleep problems, sexual dysfunction, teeth grinding, frequent illness, fatigue, stomach distress, and diarrhea.
TREATMENT FOR STRESS
TREATMENT FOR STRESS
The treatment for stress involves learning to influence the physiological response (anxiety) thru breathing exercises and progressive muscle relaxation, and learning how to change or alter your thoughts regarding the events (changes and demands) in your life that trigger stress (or anxiety). Additionally, clients are usually taught assertiveness skills.
People with relationship issues are highly inclined to personalize and misinterpret others' actions in a variety of negative ways; such as intending to hurt them, reject them, criticize them, or treat them unfairly. Many individuals who struggle with relationships problems exhibit the following: 1. They have difficulty asserting themselves or giving themselves permission to state their feelings or set limits with others; 2. They expect too little or too much from others; 3. They do not have conflict resolution skills; 4. They do not know how to effectively express themselves or effectively listen to anothers' point of view; 5.They do not understand that a relationships requires positive energy or effort.
Many people who are in unsatisfying relationships in which they feel that they are being taken advantage of or are being abused exhibit the following characteristics: 1. Excessively assume responsibility for others' feelings and/or behaviors. 2. Do not allow themselves to express their feelings, thinking that to do so is wrong. 3. Are afraid of their own feelings. 4. Tend to minimize how they feel. 5. Fear others' anger. 6. Value others' opinions more than their own. 7. Question or doubt their own values. 8. Tend to put others' needs and wants first. 9. Tend to be perfectionistic and place too many expectations on themselves as well as others. 10. Worry about how others my respond to their feelings. 11. Do not believe that being vulnerable or asking for help is alright and normal. 12. Excessively take care of others in a variety of ways. 13. Are steadfast loyal, even when it is personally harmful to them. 14. Need to be "needed" in order to have a relationship.
UNDERSTANDING RELATIONSHIP PROBLEMS
People with relationship issues are highly inclined to personalize and misinterpret others' actions in a variety of negative ways; such as intending to hurt them, reject them, criticize them, or treat them unfairly. Many individuals who struggle with relationships problems exhibit the following: 1. They have difficulty asserting themselves or giving themselves permission to state their feelings or set limits with others; 2. They expect too little or too much from others; 3. They do not have conflict resolution skills; 4. They do not know how to effectively express themselves or effectively listen to anothers' point of view; 5.They do not understand that a relationships requires positive energy or effort.
Many people who are in unsatisfying relationships in which they feel that they are being taken advantage of or are being abused exhibit the following characteristics: 1. Excessively assume responsibility for others' feelings and/or behaviors. 2. Do not allow themselves to express their feelings, thinking that to do so is wrong. 3. Are afraid of their own feelings. 4. Tend to minimize how they feel. 5. Fear others' anger. 6. Value others' opinions more than their own. 7. Question or doubt their own values. 8. Tend to put others' needs and wants first. 9. Tend to be perfectionistic and place too many expectations on themselves as well as others. 10. Worry about how others my respond to their feelings. 11. Do not believe that being vulnerable or asking for help is alright and normal. 12. Excessively take care of others in a variety of ways. 13. Are steadfast loyal, even when it is personally harmful to them. 14. Need to be "needed" in order to have a relationship.
TREATMENT FOR RELATIONSHIP PROBLEMS
For people who are having relationship problems we treat them either individually or in couples/family therapy. In individual therapy we help them to examine the thoughts and beliefs that they have about relationships and themselves, and to develop reasonable expectations for themselves as well as others. We explore the patterns that they may be inclined to get into when they are in a relationship. We also explore how they are inclined to misinterpret or misconstrue others' behavior. Additionally, clients are helped to develop assertiveness skills, problem-solving skills, and communications skills. For information regarding couples therapy please review the section on "Couples Therapy" listed within the information area of our website.
