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Exposure Therapy’s Most Common Mistake: All Eggs in the Habituation Basket

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Many people have an incomplete understanding of exposure therapy… …be it exposure and response prevention (ERP) for OCD, intentional mistake practice for social anxiety, or interoceptive exposures for panic disorder… This is true for exposure newbies, seasoned exposure veterans, and even some good CBT therapists. This limited understanding is based on the following flawed logic: Premise 1: Anxiety disorders involve fear. Premise 2: Fear is reduced through habituation. Premise 3: Habituation is accomplished via exposure. Conclusion: Habituation is the process by which individuals recover from anxiety disorders. Note: This conclusion is only partially correct. Exposure, when done right, is about much more than just habituation. It’s about learning to see the world in a new way and developing a different type of relationship with your symptoms. Exposure can help you challenge unhealthy, false beliefs about yourself and the world;...

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Health-Related Anxiety: Symptoms, Disorders, & Treatment

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Think about the most significant health scare you have ever experienced. Then multiply this experience by a factor of about 10. Unfortunately, this is a daily reality for many individuals suffering from health-related anxiety, a debilitating condition that can have devastating effects on one’s mood, relationships, and ability to function in academic and professional settings. What is health anxiety? Health-related anxiety is a general term that refers to intense fear or worry about one’s physical health. Fear about illness (or potential illness) might develop in situations in which an individual has a diagnosed medical illness. These health conditions might include: a diagnosed, progressive medical condition (e.g., worry about advancing symptoms of Alzheimer’s disease). a diagnosed medical condition that requires management and/or health behavior changes (e.g., anxiety following a diagnosis of diabetes or after experiencing a heart attack). a diagnosed...

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Agoraphobia – Symptom Attacks, Triggers, Panic, & Avoidance Behaviors

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Let’s dispel a common misconception about agoraphobia. Agoraphobia is not a fear of the outdoors. Many people mistakenly believe this myth, due to the word’s Latin roots.  Because agoraphobia can be broken down into the roots agora (“marketplace”) and phobia (“fear of”), many people assume that agoraphobia is a “fear of the marketplace” or a fear of being in wide open spaces. What is agoraphobia? However, this literal interpretation is different than what psychologists mean when they use the term agoraphobia. Clinical psychologists, therapists, and psychiatrists conceptualize agoraphobia as a fear of experiencing physical symptom attacks in certain types of situations (Zuercher-White & Pollard, 2003). Symptom attacks include full-blown panic attacks, limited symptom panic attacks (sweating, dizziness, disorientation, difficulty breathing. heart pounding, nausea), diarrhea, other gastrointestinal (GI) issues, vomiting, headaches, and feelings of dissociation, depersonalization, or derealization. Agoraphobia-related Situations The...

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Fear, Doubt, Uncertainty, ERP, & the Monster Under the Bed

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Everyone I know has, at some point, had to deal with the monster under the bed. Some do it with grace. Others falter. I’ve always been clumsy. I can vividly recall many terrified nights from my childhood, when I would lie rigidly in my bed, utterly paralyzed by fear. Afraid to make the slightest movement, to breathe, to call out for my parents…lest I be detected by IT. The pounding of my heart would be so loud in my ears, and my breathing so ragged, that I could swear the entire house could hear me. And yet…no one came to help. The moment would stretch out like taffy. At some point, my raw fear would ever so subtly decline, freeing me up to end the stalemate in one of several ways. Some nights, I would call out for help....

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School Refusal & Parental Stigma: Am I a Bad Parent?

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Like any other behavior, school refusal does not have a singular cause. This is pretty self-evident, but in the heat of the moment when your child is having a tantrum, this fact is quickly forgotten. It is simply too easy to conclude that you have raised a “bad child.” Sadly, much of society might wrongly agree with you. For many, the term “school refusal” has automatic negative connotations. Although school refusal is a behavior that has many different potential causes, it often gets lumped together with rebelliousness, conduct problems, and oppositionality. This is unfortunate because many cases of school refusal do not actually involve any of these factors. Am I a Bad Parent? Parent Social Stigma in School Refusal. Regardless of the origins of your child’s school refusal, it is important to consider a separate parent-related factor that maintains...

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