San Francisco Therapist Blog

Lourens Crous, Psy.D. provides therapy in San Francisco at his practice in the Castro neighborhood.

He writes in this blog to provide insight to those curious about psychology and Cognitive-Behavioral Therapy, CBT.



How to cope with anxiety in public.
Monday, 28 December 2009 14:01

An Interview with Psychologist Lourens Crous, Psy.D. by Jale. For original interview click here.

Do you feel anxious about going out in public? Are you unsure on what to do about your feelings of anxiety when you're out in public? To help learn how you can cope with feelings of anxiety out in public and what type of professional help is available, I have interviewed psychologist Lourens Crous, Psy.D.

Tell me a little bit about yourself.

"I am a licensed clinical psychologist in private practice in San Francisco. I graduated from the California School of Professional Psychology in 1998 with a doctorate in clinical psychology. In my practice I work primarily with adults and specialize in anxiety and mood disorders. I always strive to use interventions that have scientific data supporting its effectiveness. During the last few decades some very exciting and powerful therapeutic modalities were developed based on cutting edge research in the behavioral sciences. I use a cognitive behavioral and acceptance and commitment therapy approach in my work. This modality works particularly well with anxiety related difficulties."

What type of impact can feelings of anxiety have on someone who is out in public?

"Anxiety is a fear-based emotion triggered by the perception of a real or imaginary threat. As such it is a very uncomfortable feeling to experience, especially in a environment where someone may feel vulnerable, like out in public. All living organisms, including humans, naturally avoid the experience of discomfort. It's a basic survival mechanism. Therefore it is not uncommon for a person with anxiety in public to start avoiding places and people they associate with the discomfort. This can lead to social isolation, more anxiety and even depression."

How can someone cope with his or her anxiety out in public?

"Take deep calming breaths to signal to the body that there is no real threat, while noticing what thoughts are going through the mind in a non-reactive, non-judgmental way. This will be hard because when we experience anxiety, the mind instinctively attempts to protect us by worrying. This leads to more anxiety and can easily spiral into a feedback loop or trap. By observing what is going through your mind and labeling it as "worry thought", or "scary thought", a little space is created between you and the thought. This opens an opportunity to choose differently and focus attention on what is important and meaningful in that moment rather than on the worry thoughts. For example a person in a restaurant with anxiety my identify a worry thought and instead focus on being a supportive and attentive listener to the person they are with, thereby reducing the threat-signal, and decreasing anxiety."

What type of professional help is available for someone who is having a difficult time coping with his or her anxiety out in public?

"A psychologist, therapist or counselor with training and experience treating anxiety will be able to work with a person to help free them from their worry trap. Finding the right therapist is like shopping for shoes: it needs to be the right fit, and it needs to be the right shoe for the job. You won't buy dress shoes when you intend to go jogging; likewise you need to connect with a mental health professional with expertise in treating anxiety."

What last advice would you like to leave someone who is experiencing anxiety in public?

"Get treatment sooner rather than later. Fear diminishes us and the cost of anxiety can be huge if left unchecked. If you have certain unhelpful beliefs that are holding you back from taking action and seeking help, examine them honestly and re-connect with the part of you that wants to be healthy and free from anxiety. Empower yourself by taking committed action toward a richer and fuller life."

Thank you Dr. Crous for doing the interview on how someone can cope with anxiety out in public. For original interview click here.

 
Pain + Resistance = Suffering
Wednesday, 09 December 2009 18:14

Humans have emotions, both pleasant ones; joy, love, happiness, etc. and unpleasant ones; sadness, anxiety, guilt, etc. Emotions play a very important role in our lives. To live a healthy and happy life, we need to allow our self to feel all of our emotions. When we encounter life's ups and downs, we sometimes have painful emotional reactions to it. This is a normal part of life and of being human. However, when we resist what we have, we turn normal pain into unnecessary suffering. Resisting can manifest as avoiding, escaping, blaming, pushing away, and judging.

For example: when you apply for a job and do not get an offer, it is normal to feel disappointed, but when you resist and are unwilling to accept the disappointment by judging yourself to be a loser, and therefore feeling shame, you create suffering. It is OK to feel disappointment for not getting the job. Accept it, allow the feeling of disappointment to pass through you, and move on. However, when you resist (judging self to be a loser) having the pain (disappointment) the result is suffering (the feeling of shame).

To stop suffering, you have to be willing to take a step back into your observing self and take notice of all the thoughts and feelings you have about an upsetting situation. Then ask yourself if your reactions are reality pain given the situation as it is, vs suffering caused by what your mind is telling you about the situation, in other words resistance: judging, blaming, avoiding, escaping, denying. Only with this awareness can you begin to let go of suffering and allow yourself to get in touch with your true feelings in order to heal and move on.

"Much of your pain is the bitter potion by which the physician within you heals your sick self."  (Kahlil Gibran)

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A life worth living
Sunday, 20 September 2009 12:37

When you feel emotionally stuck or suffering, you may be fighting yourself so hard that your body is reacting by feeling discomfort in the form of depression, fear, or anxiety. You fight yourself when you make huge demands on yourself by holding yourself to unreasonably high standards, rules, shoulds and should nots, regrets, what ifs, self criticism, and name calling: "I'm stupid, and idiot, a loser, etc."

So much of your energy goes into thinking about past regrets, future uncertainty, judging yourself, and worry what others think of you, that you live with the constant background feeling of discontent, feeling like something is wrong or missing from your life. Inside your mind you are never still, always thinking, and thinking about your thinking, and judging yourself for having those thoughts. It’s exhausting!

Compulsive thoughts and the disturbing moods they produce can only stop when you no longer fuel them with your attention. Becoming mindful and fully aware of what you are thinking and feeling, moment-to-moment, is the first crucial step on the journey to freedom. Accepting the presence of whatever you have, without reaction or self-judgment, allows you to let it go, and take action to move you closer to your life-aspirations and values;  - a life worth living.

"A moment's insight is sometimes worth a life's experience."
- Oliver Wendell Holmes
 

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