ANGER AND EXPLOSIVE DISORDER THERAPY

Anger is largely a reaction of tension and hostility that is aroused by frustration, physical restraint, threats, derogatory remarks, unfairness, injustice and/or discrimination. Feelings of anger involve such physical responses as an increase in blood pressure, respiration, heart rate, perspiration and the sudden release of blood sugar all of which serves to put the individual on a “war footing”. Expressions of anger include threats, insults, caustic remarks, swearing, irritability, fighting, and name calling, etc. Those whose anger erupts into aggressively impulsive behavior manifest an explosive disorder. These outbursts can result in serious assaultive behavior or acts of property destruction. The degree of an aggressive expression during an explosive episode is always significantly out of proportion to any provoking or precipitating stressor.

Life History Questionnaire Interview: Self Report Mental Status Psychological Tests
The patient’s anger disorder is measured according to intensity, frequency and duration. In addition, it is very important to determine: Where these episodes occur; Are people threatened or injured; and, Whether property damage occurs.
Anger Disorders are treated as an impulsive disorder All factors in the “arousal process” are thoroughly reviewed Perceptions and Interpretations re-

interpreted Assessing and remolding behavioral styles.

Clients are encouraged to actively participate in determining the direction and outcome of treatment

Progressive Observation (tracking) of Symptom Reduction

A weekly typewritten written summary of the previous therapeutic session is available upon request to each client.


ANXIETY DISORDER THERAPY

Anxiety is defined as a pervasive feeling of dread, apprehension and impending disaster. These feelings are usually in response to an undefined or unknown threat which in many cases stems from unconscious conflicts, feelings of insecurity or forbidden impulses within ourselves. Because anxiety is characterized by this fear of future misfortune, the body mobilizes itself to meet this potential threat such as an increase in one’s pulse, muscles become tense and breathing becomes faster often observed during a “panic attack.” Long periods of subtle anxiety can leave the individual drained of energy and perpetually tired. Severe anxiety may resemble a panic disorder.

Life History Questionnaire
Interview: Self Report
Mental Status
Psychological Tests (If required)
An assessment regarding the specific features surrounding your anxiety are carefully examined. Some conditions may be the result of situational factors, while others are more profound.

Re-shaping one’s thinking may be useful in order to minimize over reaction. Unrealistic fears are “redefined” within a proper perspective Experience (past or present) may be reframed through utilization of techniques based on CBT (cognitive behavior therapy) and/or systematic desensitization.

Progressive Observation (tracking) of Symptom Reduction.

A weekly type written summary of the previous therapeutic session is available upon request to each client.


COMPULSIVE AND ADDICTION BEHAVIOR THERAPY

Behavior labeled “compulsive” presents serious problems to many individuals. Though society on occasion may regard some variants of compulsive behavior as semi acceptable, (workaholics; perfectionists; micromanagers) individuals who find themselves victim to any type of compulsiveness suffer a type of enslavement that can be highly tortuous. Many compulsive types have a strong irrational, ritualistic and uncontrollable characteristic. Addictive cravings, though not necessarily irrational or ritualistic, nevertheless compel an individual to repetitively seek some form of immediate gratification on a never ending basis. Examples would include gambling, eating, sexual activity, video games, stealing, smoking, etc. These cravings are usually characterized by a physical and/ or a psychological dependency. Compulsive / addictive behavior are predictably repetitive and appear out of the control by the individual. However, they potentially respond well to therapy.

Life History Questionnaire
Initial interview and Mental Status
Anxiety assessment protocols
Identification of problem behavior re-inforcement
Individuals present their experience as to when problematic behavior began, intensity, cycles and circumstances. A historical graph of incidents and events will be chartered to study possible causes for the inception of dysfunctional cycles.

Anxieties and avoidant behaviors are explored. Patients participate in their own treatment by keeping logs of both thinking and behavior patterns. Behavioral modofication techniques may be employed along with the re-training of cognitive thinking approaches.

Progressive Observation (tracking) of Symptom Reduction.

A weekly type written summary of the previous therapeutic session is available upon request to each client.


COUPLES AND MARRIAGE DISTRESS THERAPY

Couples experiencing distress in their relationship frequently discover their attempts at resolution are either ineffective or sometimes even exacerbates the situation. Blame starts to be tossed around in “buckets” as to who is most at fault. Continued conflict results in the polarization of opposing positions. One or both of the individual within the couple begins to sense a greater degree of entrapment. Couple distress can become sufficiently intense, leaving partners wondering whether there is a future for their relationship.

Life History Questionnaire
One Joint Session with the couple
Individual Sessions with each partner
Presenting Problem is formulated
It is imperative that partners feel heard and validated while sharing their input with regards to conflicts. In general, the following questions need to be addressed: How distressed is the couple? How committed is this couple to the relationship? What major issues divide the couple? Why are these issues a problem for them? What strengths keep the couple together? What can treatment do to help them?

Partners are encouraged to accept the other partner’s concerns as valid. The second level of recognition is that both parties will need to make significant changes. Partners will need to engage in “unified detachment” where they can step back from the emotional intensity of the problem (blame game) and recognize the dynamics that inflame the problem…thus becoming more objective problem solvers as opposed to the typical self-serving approach. In addition, partners learn greater tolerance towards each others differences. Finally, the couple are trained in listening and communication skills which tends to promote compromise and greater harmony.

A weekly type written summary of the previous therapeutic session is available upon request to each client.


DEPRESSION THERAPY

Emotional pain can be one of the most disrupting experiences that can occur to any one’s quality of life. Feelings can span a wide spectrum beginning with a state of discomfort and continuing towards out right physical pain. Naturally, these feelings can originate from either internal/clinical factors and/or environmental / situational circumstances. The common labels which we have given for these feelings include: anxiety; depression; fear or phobias; anger and bitterness; disappointments; losses; humiliation; defeat; etc. Most emotional disorders can be corrected utilizing psychotherapy and when necessary, psychiatric medications. Most people will acknowledge that they experience occasional episodes of some form of emotional problem. However, these situations tend to be fleeting, and the individual is able to return to their normal emotional state. However, interventions are recommended when individuals experience long continuous bouts of serious emotional problems with no end in sight. Such chronic states can easily lead to additional collateral problems leaving the individual languishing and feeling completely helpless and out of control. Desperate measures may be attempted to resolve these situations which can frequently prove futile sending the individual at an ever increasing pace into a downward spiral. If the situation becomes too dangerous, the individual may have to be hospitalized.


DOMESTIC VIOLENCE COUNSELING

Domestic Violence within families is a serious social concern. Some estimates suggest that as many as one in every five families experience some form of domestic abuse. Traditionally, men were the most likely to engage in domestic violence, but social and court related data today indicate that any member of a family may be at risk when domestic violence/abuse occur. Frequently some or most of the following behaviors occur including: physical battering; gender role stereotypes who assume that men should rule and dominate; significant family / environmental stress; isolation from personal and social support; high level of anger, rage and hostility; ever increasing learned helplessness; loss of personal control; depression; guilt; financial pressures coupled with insufficient income; unrealistic expectations imposed on a spouse; one partner handling all major family decisions; etc.

Life History Questionnaire
Interview: Self Reported Information
Psychological Tests
Household Survey of Rage and Violence
The physical safety of all family members must initially be secured. Subsequently, a thorough determination is made regarding power and control; anger/rage; violence; and humiliation. A determination is required to “tease out” the roles and functions of each partner within the existing family structure. Primary triggers and contributing circumstantial factors that ignite violence and rage are identified.
Family members who perpetuate any form of domestic violence must:
Fully acknowledge their unacceptable behavior;
Fully acknowledge the degree of disruption that they cause family or partner;
Must express unequivocally a genuine desire to change their ways;
Anger, rage, violence disorders are treated. Violence must cease immediately!
Roles and functions are redefined.
Communication and listening skills are taught.
Partners are trained in de-escalation strategies.
Family management issues are reviewed if essential for reducing stressors.
Additional cognitive and behavioral strategies may be employed.

Progressive Observation (tracking) of domestic-violence behavior reduction.

A weekly written summary of the previous therapeutic session is available upon request to each client.


PSYCHOLOGICAL EVALUATIONS

Situations may arise which require specific evaluations or assessments. These may include psychological testing, mental health assessments, diagnostic testing, child custody evaluations, social security disability, domestic violence, sexual acting out, anger management and others.


SELF MANAGEMENT AND LIFE ENRICHMENT

A common perception shared by the public is that therapeutic education is restricted to problematic issues. However, many find significant help and benefit by taking advantage of the opportunity to discuss and examine their life goals and objectives and seek a more defined and effective world view. Examining one’s patterns and discovering ways to better tune one’s self management skills and techniques can be very enriching and meaningful. Though many may enjoy the occasional participation at a motivational training, it is often the quiet therapeutic workouts which produce lasting results.


SELF-INJURIOUS BEHAVIOR THERAPY

Many individuals who engage in self-injurious behaviors (SIB) experience a compulsion to harm themselves in a variety of ways which is initially concealed from both family and friends. It may start as incidental scratching, nail biting, or repetitive removal of healing scabs from sores and wounds. Both frequency and severity of self inflicted injury may increase over time. Continued SIB behavior may eventually appear suicidal. Severe cases result in serious self mutilation. As bizarre and “crazy like” that SIB appears, these behaviors are not usually the result of severe mental illness, though cases are certainly on record where people exhibited both types of pathology. Treatment is designed based on the emotional factors that initiated the SIB behavior and the subsequent reinforcements that perpetuate self injurious behavior.


SEXUAL ACTING OUT THERAPY

Individuals who struggle with sexual difficulties often encounter numerous variations of compulsive sex; deviant methods of arousal and desire, fetishism, sexual masochism/sadism, voyeurism, exhibitionism and other paraphilias. Sexual misconduct may involve the sexual violation of other people driven by the demand for self gratification at the expense of another person, power, violence and sexual sadism. All these disorders significantly interfere with the individuals normal day to day activities. Besides the risk that many of these disorders pose with respect to unlawful activities and arrest by law enforcement, sexual disorders almost always become very disruptive to family and friend relationships. Most sexual deviancy is treated as a compulsive disorder. Arousal imagery must be changed to begin to extinguish deviant arousal which in turn reduces sexual acting out and brings the individual more in line with socially acceptable sexual behavior.