Areas of Clinical Focus
Anxiety Disorders
Anxiety disorders include a range of conditions characterized by excessive fear or worry that interferes with daily functioning. This might include panic disorder, social anxiety, specific phobias, or other anxiety presentations. Common experiences include physical symptoms like rapid heartbeat or shortness of breath, avoidance of triggering situations, catastrophic thinking, and difficulty managing uncertainty. The anxiety often persists even when you logically know the feared outcome is unlikely.
Treatment includes cognitive-behavioral therapy tailored to your specific anxiety presentation. This typically involves gradual exposure to avoided situations, challenging unhelpful thought patterns, and learning to tolerate discomfort rather than avoiding it. You learn through direct experience that the outcomes you fear are less likely and less catastrophic than your anxiety suggests. Over time, your nervous system recalibrates and your range of comfortable activity expands
Obsessive-Compulsive Disorder (OCD)
Obsessive-compulsive disorder involves intrusive thoughts that generate significant anxiety, along with compulsive behaviors designed to neutralize that discomfort. This might look like mental reviewing, checking behaviors, repeated reassurance-seeking, or researching until you feel certain. The difficulty is that certainty never fully arrives, and the compulsions provide only temporary relief. Over time, this creates a self-reinforcing cycle that can be difficult to break without targeted treatment.
Treatment involves Exposure and Response Prevention (ERP). We systematically and gradually expose you to situations that trigger intrusive thoughts while preventing the compulsive response. Over time, your nervous system learns that the anxiety decreases on its own without the compulsion. The cycle breaks, and you regain flexibility in how you respond to intrusive thoughts.
Body-Focused Repetitive Behaviors (BFRBs)
Body-focused repetitive behaviors include skin picking, hair pulling, and nail biting. These behaviors often happen automatically, particularly during stress, boredom, or focused concentration. You may have tried repeatedly to stop and found it difficult to maintain control. The behaviors can lead to physical consequences and emotional distress. BFRBs represent complex behavioral patterns tied to emotional regulation, sensory processing, and automatic routines that develop over time
Treatment utilizes Habit Reversal Training and the Comprehensive Behavioral Model (ComB). We work on increasing awareness of triggers, urges, and the behavioral sequence. You develop competing responses and alternative strategies for managing the emotions or sensations that typically precede the behavior. Treatment also addresses any shame or self-criticism that may be maintaining the pattern
Perinatal Mood and Anxiety Disorders (PMADs)
Perinatal mood and anxiety disorders encompass a range of symptoms that occur during pregnancy or in the postpartum period. This includes depression, anxiety, panic, obsessive-compulsive symptoms, and intrusive thoughts. You might experience persistent worry about your baby's health, intrusive thoughts about harm, difficulty bonding, or feeling overwhelmed or disconnected. These symptoms are more common than many people realize, and they are very treatable.
Treatment typically involves cognitive-behavioral therapy adapted for the perinatal period. For obsessive-compulsive symptoms, we use exposure-based approaches. Treatment addresses your specific symptoms while acknowledging the real demands and adjustments of pregnancy and new parenthood. The goal is both symptom reduction and helping you feel more confident and connected during this transition.
Chronic Illness
Living with chronic illness creates distinct psychological challenges. Autoimmune conditions, hypermobility spectrum disorders including hEDS, and other chronic health conditions often involve anxiety about symptoms and flares, hypervigilance about bodily sensations, difficulty navigating healthcare systems, and sometimes medical trauma from previous experiences. There is also the complex overlap between autonomic nervous system symptoms and anxiety symptoms, which can make it difficult to know what you are experiencing at any given moment.
Treatment focuses on cognitive-behavioral therapy that acknowledges the reality of your medical condition while addressing the psychological impact. We work on managing health-related anxiety, building tolerance for uncertainty about symptoms, and reducing hypervigilance without dismissing your physical experience. The goal is not to minimize your symptoms but to help you live more fully despite the challenges your condition presents.
