

Cognitive Behavioral Therapy, or CBT, is a common buzz word and psychological term, but what is Cognitive Behavioral Therapy? According to the Beck Institute, In clinical terms, it is a specific theoretical therapy that is used as a psychological treatment. Since its creation in the 1960’s by Dr. Aaron Beck, CBT has been proven to help reduce the symptoms associated with a range of mental health concerns including diagnoses like Anxiety, Depression, Substance Abuse, PTSD, Marriage and Relationship issues as well as many other chronic mental health concerns. CBT has been clinically proven to be as effective as medication in many instances. At other times, CBT is a helpful adjunct to medication therapy. Specifically, CBT helps the patient or client to identify the ways in which their thoughts and behaviors contribute to their mental health concerns.
The basis for cognitive behavioral therapy is embedded in the idea that psychological problems are at least partially influenced by maladaptive thought patterns. Furthermore, CBT recognizes that mental health issues are further solidified within unhealthy patterns of behavior that make our mental state feel worse. Finally, CBT provides a way to manage this and develop more helpful and constructive ways of dealing with patients’ lives and the issues that come up in them.
Changing the way that we think has a profound effect on our well-being. Remembering; thoughts become feelings and our emotional state affects even our heart rate and breathing patterns. A common way to enact CBT involves several steps.
First the patient begins to recognize their distorted thinking patterns, particularly the ones that are “created” emotional reactions.
An example would be: ‘I always mess up relationships.’
The next step becomes to challenge the maladaptive thought with a more healthy or realistic thought. In the example above it would be helpful to examine the use of ‘always.’ Instead, a healthy way to frame the above thought might be to make the statement, ‘My last relationship didn’t work out but I learned a lot from it.’
By managing our thinking instead of being overcome by it we empower ourselves and set up a more positive feedback loop to our thoughts, feelings, mind/body connection and even into our relationships. Another benefit to CBT is that problem solving skills are enhanced. Cognitive behavioral therapy is very much focused on the present, in contrast to psychoanalytic counseling which will spend a lot of time fostering informed connections between early childhood experiences and present day defense mechanisms and mental health concerns. In CBT, your therapist is most concerned about what is happening in the here and now, and it is within the present moment that we have the opportunity to change.
The therapist and client collaborate in a mutual fashion by challenging unhealthy thinking, enhancing the development of positive emotional feedback loops and by planning for enhanced wellness. Just as with all forms of counseling, it is not just about the therapy that happens in the 53 minute hour, but CBT especially uses homework exercises to help the clients solidify the changes that they are working on. CBT is one of the most effective tools and some therapists will use it along with other forms of therapy to further benefit the clients’ needs.
References
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Meditation and Mindfulness
Want to Become a Meditation Master? This is the Most Common Mistake that New Meditators Make and How to Fix It!
So maybe you have read the abundant data that meditation is one of the most fantastic tools that there is to enhancing mental clarity, reducing individual response to stress, and enjoyment of the great benefit of greater calm. According to the National Institute of Complimentary Health and Medicine which is a branch of the National Institute of Health (NIH), symptoms and consequences associated with anxiety, anger, depression, and stress disorders are all distinguished and well managed with a self-care plan which incorporates meditation. In knowing all of these benefits, with abundant enthusiasm, you have decided to get started on utilizing this most fantastic tool to wellness.
The fact is many people struggle in their meditation and may even feel so defeated that they quit altogether, and this is due to one common misconception about meditation and how to do it. When starting out with a meditation practice, we summon our inner oracle and alight with the goal of embodying our inner Buddha. Fantasies turn to reality and we stuff and mold our shape into some oddly contorted seated position and with our full lotus blooming, we close our eyes and turn our wellness aspirations inward toward the journey of the self. We imagine that the goal in mind with all of this blood, sweat and ‘OM’ is to turn off our mind.
Here we have it, this is the number one mistake that we make that prevents us from developing a meditation practice, you see “We are not able to turn off our thoughts.” I promise that for any meditator who has climbed the precipice to ascend mindless nirvana, you have faceplanted while careening down the jagged cliff face and end up irritated and hopeless with yourself and the whole concept of mediation. The fact is, it is the nature of our thoughts to keep producing other considerations, a typical inner monologue during meditation might be thinking;
“how uncomfortable the cross legged position, belly is hungry, need breakfast, am I done yet, hope my hair isn’t close to getting singed by that candle, why was my boss so upset yesterday?”
All of this thinking is just fine, in meditation, we anticipate that the endless churning of our thinking will ramble on as it always does. In a mindfulness meditation, we breathe deeply and acknowledge the existence of all of the thoughts that our mind produces and then we take a step back and we become conscious of the kind and quality of the thoughts that we are having. We practice an ever present non-judgmental position with ourselves. For example, for the above thoughts, I would label the overall thinking state as anxious and fearful. I was desiring breakfast, fearing my hair could get burned, wanting to complete the meditation. Those are all anxious and desirous thoughts. As we become more skilled at meditation, we add in a thought or question to assess how we are thinking and we keeping breathing deeply through it. For example, as we are having our inner monologue during the above meditation, we would have the same thoughts and every so many moments we pause to think about how we are thinking.
“how uncomfortable the cross-legged position, belly is hungry, need breakfast, am I done yet? Oh yes, I am thinking of the future, I always am thinking about what is next. I hope my hair isn’t close to getting singed by that candle? I am fearful sometimes. Why was my boss so upset yesterday? I am often very concerned with what others are feeling.”
When we are mindful, and aware of our thoughts and consciousness, we become able to know that we are sentient beings, with vivid imaginings, with endlessly burning thoughts. Yet we are not these thoughts, we are some where afar and above all of the background and inward noise of being, we are the observer, conscious of our selves and the world around us, free and responsible to choose our actions and to develop ourselves, to become a more aware, and well version of our most mindful and well self.
Be Well,
The Therapists of-Counseling and Wellness Center of Pittsburgh
830 Western Avenue Pittsburgh Pa 15233
2539 Monroeville Blvd Monroeville Pa 15146
https://nccih.nih.gov/health/meditation/overview.htm
Learn MoreAgoraphobia
Agoraphobia is a type of anxiety disorder that can sometimes co-occur with panic disorder. Its prevalence rate in the population is low, occurring in only about 1.1% of the population. Agoraphobia is hallmarked by a fear of leaving the house or other safe place. This often cooccurs with panic attack or panic disorder because a person has experienced a panic attack and then fears that they may have one again or that they will experience some other feared situation such as traveling on a bridge, going through a tunnel, or being stuck in a crowd of people. In some situations, the person may be able to encounter the feared situation, but they do so with such dread that the activity and many other parts of life lose their joy and peacefulness, which can even lead to depression and other psychiatric disorders. In some instances agoraphobia can be diagnosed without a history of panic disorder.
The criteria for Agoraphobia are as follows:
A person who has experienced a panic disorder may state “ Before I sought treatment and recovered from agoraphobia, I rarely left my apartment for 2 years. It all started when I was walking down a crowded street in downtown Pittsburgh and suddenly I had hot flashes, I was sweating and couldn’t breathe, the pain in my chest became so bad that I ran for help and reached for the lady next to me and told her to ‘Help, call 911!’ When I was diagnosed as having a panic attack the hospital I couldn’t believe it, everything changed for me then. I wanted to avoid having another episode and the only place I felt better was at home. I avoided everyone and even did my grocery shopping online. It became so bad that I started to feel anxious when I thought about leaving home for anything.”
A person with agoraphobia suffers greatly, their ability to function in life is limited including socially, emotionally, and psychologically. Treating panic disorders can be extremely difficult because the person may not want to leave their home even to seek help, fortunately treatment using distance or online counseling is now an option. The best treatment for Agoraphobia is psychotherapy, a counseling or therapy approach which uses exposure therapy and cognitive behavioral therapy. Medication or Pharmacological therapy including anxiolytic medications and SSRI’s are often used effectively to treat Agoraphobia too, medication is often used in conjunction with counseling or psychotherapy.
Learn MorePost-Traumatic Stress Disorder
Post-Traumatic Stress Disorder is a form of anxiety disorder which stems from exposure to a traumatic event or situation which caused real or threatened injury to and this can also be caused by the witnessing of an event or situation which injured or threatened injury to another person. According to the DSM IV, there is a lifetime prevalence rate of about 8% for the development of PTSD. Muggings, rape, terror, hostage attacks, natural disasters, car accidents, are situations that can increase the likelihood that a person may develop PTSD.
As a therapy practice which also specializes in marriage and family counseling, we support the research which suggests that individuals who have experienced an infidelity in their relationship may also go on to develop symptoms of PTSD or Acute Stress Disorder.
There are certain occupations which put people at risk for developing Post Traumatic Stress Disorder by exposing them to frightening and dangerous situations. Those who work as military/armed forces, policeman, fireman, and detectives may be particularly vulnerable for developing PTSD. Finally, there is a second form of PTSD, Vicarious or Secondary trauma, this form of trauma is caused by exposure to information related to traumatic events and is commonly seen in therapists, social workers, attorneys, judges and persons who offer support and services to those who have had trauma.
The Diagnostic Criteria for PTSD are;
Treatment for Post-Traumatic Stress Disorder often involves Trauma Focused therapy with a licensed professional counselor or therapist as well as medication therapy in certain instances. Another form of therapy which has proven effective in clinical models is EMDR.
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Obsessive Compulsive Disorder
Obsessive compulsive disorder is a type of anxiety disorder which afflicts .5-2.5% of the population. The disorder greatly effects the quality of life for the sufferer and becomes a consuming pattern of anxieties and rituals which are centered around both obsessional worries and compulsive behaviors. Most of the individuals who have this disorder at one time or another acknowledge or have insight that their worry is excessive or disproportionate to the actual fear or anxiety. An example of someone who may be experiencing Obsessive Compulsive disorder is that “It started when I was in my mid 20’s, I was always worried that I would get something wrong, I made lists so I could try to manage my daily living tasks. Soon lists became my life, I would write a list of everything that I needed to do while I was in the shower, then I would check the list 3 times after writing it, to be sure that I did get everything right. Then I would reread my list again 2 times before entering the shower and read it out loud, If I didn’t perform this task I was simply unable to take my shower for the day because I would lapse into such overwhelming anxiety.”
Some examples of symptoms and behaviors association with this disorder are as follows
according to the Diagnostic and Statistical Manual;
That the individual has either obsessions or compulsions and which the definition of these are;
Compulsions are defined as
Obsessive compulsive disorder is a treatable anxiety disorder, the best form of therapy often involves both pharmacology including SSRI’s delivered in conjunction with long-term psychotherapy. Cognitive behavioral therapy has proven effective in managing the symptoms associated with this diagnosis as well as Behavioral Therapy such as Exposure therapy are all effective treatment or counseling models to progress beyond this disorder and take back control over life.
Learn MorePanic Attacks and Panic Disorder
As many as 4.7% of people will experience a panic attack at some point in their lives, panic disorder is a form of anxiety disorder which can be extremely intense, many times individuals who have a panic attack end up going to the emergency room imagining that the rapid heart beat and dizziness are a heart attack. Symptoms and features of anxiety disorder according to the Diagnostic and Statistical Manual IV, laid forth by the American Psychiatric Association are as follows: To have experienced at least 4 of the following 13 symptoms;
Heart Palpitations
Trembling
Shaking
A feeling of smothering
Feeling of Choking
Discomfort or Pain in the chest
Nausea
Abdominal distress including a heightened need to urinate or defecate
Dizziness or Lightheadedness
Derealization or Depersonalization
Fear of losing control or a feeling that you are “going crazy”
Sweating, Chills or Hot Flashes
The symptoms of a panic attack are hallmarked by their sudden onset and intensity, unusually a panic attack has an onset in as little as 10 minutes. In example a person who has experienced a panic attack may say “I was sitting on the bus when all of the sudden I felt like I couldn’t breathe, it was like my throat closed up and I was choking but there was nothing in my mouth. I became dizzy and my heart felt like it was beating out of my chest, I started looking around and was going to cry for help. My fingers and toes felt numb and tingling, in a few minutes my heart slowed down a little bit but my stomach was really tight for hours after.”
As you can imagine someone who is experiencing a panic attack is suffering greatly. There are several different types of Panic disorder according to whether they are caused by a specific cue, such as public speaking or encountering an enclosed space such as the panic that can happen with claustrophobia. In other instances, panic attacks can be un-cued or non-specifically cued, this means that sometimes a person who has a panic attack may not understand what the trigger for their panic is until they seek treatment for the panic and uncover the deeper fears and how to manage the panic with their therapist. A panic attack is differentiated from having a panic disorder which is to have had recurrent and unexpected panic attacks for a period of one month or more. Treatment for panic disorder are therapy, often most effectively Cognitive Behavioral Therapy, with a licensed professional counselor and also medication is sometimes the best treatment. Usually it is a combination of these two treatments which best helps to manage panic disorder. Untreated panic disorder can greatly reduce quality of life, leading to long standing feelings of guilt and shame and even agoraphobia.
Learn MorePhobia
A phobia is a fear or anxiety response of heighted arousal, ie rapid heart rate, rapid breathing, and thoughts of intense worry and this most likely leads to avoidance of the situation or object. Some examples of typical phobias are fear of public speaking, fear of choking or vomiting, fear of spiders (arachnophobia), fear of enclosed spaces (claustrophobia), fear of bridges, fear of tunnels, fear of large crowds, fear of blushing, fear of water or other natural environments, fear of contamination or germs. Phobia is distinct and much more severe than a natural aversion, for instance in the example of arachnophobia, many people do not like spiders and insects but wouldn’t qualify for a disorder because this doesn’t interfere with their functioning and enjoyment of life. A person who simply doesn’t like spiders may sheik if they encounter one and quickly try to remove it from their environment. A person who has a phobia of spiders may feel anxiety if they think about a spider, they may never go into a forest or stay away from other natural environments, they may start to take precautions like spraying repellant everywhere and have continual intrusive thoughts about the possibility of encountering spiders and even stop leaving home or developing agoraphobia because their wish to avoid the spider is so powerful.
The Diagnostic Criteria for A Specific Phobia are;
The best way to treat a phobia disorder is with psychotherapy, your licensed counselor can help you by using a very specific kind of therapy called Exposure Therapy. This is a behavioral therapy which a licensed therapist who specializes in treating anxiety disorders will be able to guide you through. In other instances, medication including anxiolytic medication, anti-anxiety and SSRI’s are best used medication therapy to treat and manage panic disorder. Other forms of therapy which may help to manage specific phobias including meditation, mindfulness, exercise and other integrative options like nutrition counseling and acupuncture.
Learn MoreTreatment for Anxiety
Treatment for anxiety takes many forms, there are generally three main agreed upon and clinically verified methods to manage and reduce symptoms of anxiety. Counseling or Therapy with a licensed counselor or therapist is the first treatment route. The treatment route for this form of help can vary from short term, brief solution-focused counseling interventions as well as long term treatment including cognitive behavioral therapy and even existential therapy. Only you and your counselor or therapist can determine which method will be best for you.
Other ways to manage symptoms related to anxiety are to enhance total wellness, this includes integrative medicine, nutrition counseling, acupuncture, fitness, meditation, and mindfulness. Some people experiencing anxiety find that a holistic approach suites their lifestyle best, in turn they explore clinical herbalism and integrative interventions to learn how this can support positive emotional health and wellness. Holistic therapy is best utilized along with counseling or psychotherapy from a licensed counselor which is therapy which will focus on finding triggers and changing the cognitive response to anxiety. The final way to treat anxiety is to use medication therapy. Medication has many different options including SSRI’s which must be taken for several weeks before taking effect and then other anxiolytic medication which is more short acting, talk with your psychiatrist or prescribing PCP to explore which form of medication therapy is the best for you to treat your anxiety. Medication often works best to diminish anxiety when it is paired with counseling and therapy which can change the thought patterns, discover underlying causes of anxiety and mange the full way in which it effects quality of life.
Remember that the worst way to manage your anxiety is by doing nothing at all in the hope that your symptoms will disappear. Managing anxiety is done best when we treat it early and completely with solid medical and therapeutic interventions.
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Melissa Taylor, LMFT
Melissa Taylor, LMFT, MS is a very enthusiastic and compassionate professional that believes in the power of combining counseling and physical activity when working through personal issues. As a marriage and family therapist, Melissa works through family system issues that may influence a person’s current life situation, relationship issues, and emotional instability. As individuals, we have grown up with different family dynamics, viewed many family relationships and observed different ways of communicating that influence present time relationships and how we cope with issues. Family patterns exist, so Melissa helps people identify and understand those patterns, and then learn how they influence current problems. Melissa has worked for years with adults and adolescents that have been abused, abandoned, felt depression and anxiety, or struggle with current relationships; therefore, she is very comfortable working with individuals, couples and families that are dealing with past and current difficulties. She encourages self-care practices through counseling and exercise to build self-esteem, trust, communication and coping skills, to improve their own lives. Melissa is a psychoanalytic therapist that also provides CBT and other family system theories in her work. She encourages clients to trust her and themselves in the counseling process to work together towards healing and personal goals.
Melissa has lived in multiple states to complete her education and build her career while learning different cultures. She received her Bachelor’s Degree in Psychology at the University of Kentucky, and completed her Master’s Degree in Marriage and Family Therapy at Drexel University in Philadelphia. She also had the privilege of completing a Master’s degree in Kinesiology at LSU in Baton Rouge, which allows her to integrate physical activity for clients in their therapeutic treatment process. She has provided therapy in Kentucky, Indiana, Louisiana, Texas and now Pennsylvania. She has worked with Rape Crisis Centers, FQHC’s, Inpatient and Outpatient locations, integrated healthcare centers, and group practices. Melissa has experience in different levels and types of mental health care and has learned how mental health symptoms affect all populations.
Melissa recently moved to Pittsburgh from Texas and enjoys exploring her new city with her husband and two young children. She enjoys playing and teaching her children, Zumba and other exercises, and cooking with her family. Melissa is very energetic and is always seeking new experiences for herself and her family.
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