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Driving Fears & Driving Avoidance in Teens & Young Drivers

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Reader Question: My daughter just turned 15, and no matter what I say, I can’t seem to convince her to practice her driving. It’s strange, because in the past, all she could do is talk about how excited she was to finally get her permit. I truly thought that she’d be practicing constantly once she was legally able to. Have you seen this before? Could her driving avoidance possibly be related to her OCD? Sincerely, Stressed-Out Parent Answer: Maybe, maybe not. Driving Fears May Be Normal… Driving-related anxiety is a completely normal phenomenon. For many people, learning to drive is the first time that they are individually responsible for handling a situation that could potentially be life-threatening. Although car accidents are (hopefully) rare for most individuals, accidents can be harmful (or deadly) when they do occur. Being in charge...

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Vomit Phobia – Fear of Vomiting (Emetophobia)

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Flu season will be quickly upon us and with it comes an unfortunate increase in the likelihood of experiencing fevers, coughs, runny noses, vomiting, and the like. Although no one enjoys being sick, this time of year poses particular challenges for individuals suffering from “vomit phobia”, or emetophobia, the fear of throwing up. The fear of vomiting can affect individuals of all ages. It sometimes emerges in childhood and, if untreated, may follow a relatively chronic course. However, it can also develop well into adulthood, sometimes taking root after a negative health experience (e.g., after getting food poisoning or after experiencing an episode of severe or uncontrolled vomiting). Vomit Phobia in Children and Teens Consequences associated with the fear of throwing up can be extreme. In children, vomit phobia can lead to school refusal and avoidance. Academic performance may...

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Does Non-Avoidance = Exposure? No! Anxiety Disorder Treatment Principles for OCD, Panic, Social Anxiety, & Phobias.

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Anxiety Principle of the Day: Non-Avoidance is not equivalent to exposure. Although exposure is predicated upon the purposeful non-avoidance of anxiety-related stimuli, non-avoidance of anxiety triggers is not equivalent to exposure. What is non-avoidance? I liken non-avoidance to being in a particular place at a particular time. Essentially, it involves being in a situation in which your anxiety is triggered by proximity to anxiety-related cues. Non-avoidance requires no action on your part aside from being physically present in the situation. As such, like a hole, it’s possible for a person to accidentally stumble into a non-avoidance exercise. Isn’t that the same thing as exposure? No. Exposure is not merely a situation, and as such, it can’t be entered into by accident. Although exposure therapy has situational elements, it is a dynamic experience that has best practices, as well as...

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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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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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