Of the psychological challenges modern people struggle with, stress and anxiety hit our society the hardest.

It doesn’t have to be this difficult.

Stress and anxiety are normal components of our everyday lives. Stress is the result of frustration, anger, or anxiousness over a particular situation. Usually stress is caused by something we feel we have no control over. Anxiety is characterized by fear or apprehension, and in many cases, the cause may be unknown. If these feelings persist for more than six months however, a specific anxiety disorder is usually responsible. It should be emphasized that stress and anxiety are very personal experiences; what is stressful for one person may not be for another.

The good news is that stress and anxiety-related problems are increasingly well-understood and amenable to treatment. I often tell people, 'don't reinvent the wheel if you don't have to.' Too many good options are now available. In my practice, I offer a number of techniques and treatment approaches for turning the tide against stress and anxiety, including behavioral, cognitive-behavioral, and mindfulness and acceptance-based techniques.

It’s difficult to understand depression until you’ve lived through it. The challenges can be immense. Thankfully, even the most severe depression is treatable.

If depression is keeping you from living the life you want, don’t hesitate to seek help. While medication is the most common treatment today for depression, it is rarely an ideal first choice, and has been shown to be more effective when combined with therapy. Many scientific studies support the idea that therapy can be a powerful treatment for depression. One recent large-scale trial involving more than 400 patients with treatment-resistant depression found, for example, that the use of cognitive behavioral therapy (CBT) helped to significantly reduced depression symptoms.

What you learn in therapy gives you skills and insight to help prevent depression from coming back. There are many types of therapy available. In my practice, I incorporate methods from both cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), which together comprise two of the most scientifically well-supported depression treatments. One of the hallmarks of depression is feeling overwhelmed and having trouble focusing. I teach my clients practical techniques on how to reframe negative thinking and employ behavioral skills in combating depression. Therapy can also help you work through the root of your depression, helping you understand why you feel a certain way, what your triggers are for depression, and what you can do to stay healthy. Three of the most common “big picture” themes that I emphasize are relationships, setting healthy boundaries, and handling life's problems.

Relationships can be the source of our greatest joys and deepest turmoil. In few other areas are the stakes so high...and the rewards so compelling. 

The sooner relationship issues are addressed, the easier they are to work out. Sometimes couples therapy is all that is needed, providing space to think through and explore the situation. Relationship counseling can offer the opportunity to understand the deeper, more unconscious blockages and patterns in a relationship. This frequently links to our earliest and most powerful emotional experiences. Through mutual understanding, a couple often finds new strategies for enjoying their relationship.

Seeking professional help is a big step toward dealing with these issues, and it is one that I emphasize takes courage. Difficulties between couples are very rarely due to just one person. We are complex individuals with all sorts of fears, hopes, fantasies, and needs. In my work with couples and families, my immediate goal is to provide a place where these kinds of issues can be explored and expressed without the world coming to an end.

Relationship difficulties often cluster around major events; for instance, trading the single life for coupledom, having a baby, financial difficulties, sexual differences, career changes, lifestyle changes, or retirement. I understand the diverse feelings that exist in these situations, and help couples to make sense of these experiences. In my couples work, I facilitate a process in which each member can become clear about what is happening between them and within themselves. This allows each individual to make decisions with greater clarity and understanding, and helps couples to more truthfully know themselves and each other.

Relationship counseling is not an easy process at times. There is much on the line for couples, families, and individuals who are facing such difficulties. The journey may be hard, but the rewards are great. For most of us, relationships are at the very heart of what makes life rich, meaningful, and fulfilling.

Trauma and PTSD have a massively negative impact. Whether rooted in childhood abuse, or a more focal traumatic experience in adulthood, the repercussions can be painful, confusing, and destructive. You can free yourself from this darkness.

The word “trauma” describes experiences that are emotionally painful and distressing, and that overwhelm your ability to cope. You feel powerless. Many different kinds of experiences can overwhelm our coping capacities and lead to trauma. Common situations that lead to trauma include life threatening situations, such as motor vehicle accidents, violence, and combat exposure, and experiences involving extreme personal violation, such as rape and sexual assault.

Severe abuse experienced during childhood can lead to what is referred to as 'complex trauma,' a type of trauma that occurs repeatedly and cumulatively over an extended period of time. Complex trauma can be especially challenging, because it is difficult to separate traumatic symptoms from a person's basic personality structure. The effects are quite deep, by definition.

Many people recover from trauma with time and through the support of family and friends, bouncing back with great resiliency. For others, the effects of trauma are lasting, causing a person to live with deep emotional pain, fear, confusion, or posttraumatic stress far after the event has passed. The issue is not one of "strength" or "courage" - Medal of Honor winners have been diagnosed with PTSD. Fortunately, today, more than ever, there are good treatment options for trauma-related problems.

As a therapist with the Department of Veteran's Affairs, I had considerable training and experience in the treatment of trauma. The treatment approach that I most often recommend is Prolonged Exposure (PE) therapy. PE therapy is one of two "gold-standard" PTSD treatments (the other is Cognitive-Processing Therapy, or CPT), and is among the most scientifically well-supported treatments currently available.

Anger is a protective emotion, but when it gets out of control, the consequences can be deadly serious. Anger management refers to the process by which a person learns how to identify stressors, take necessary steps to remain calm, and handle tense situations in a constructive, positive manner.

Anger management therapy is designed to help you decrease the heightened emotional and physiological arousal associated with anger. It is impossible to avoid all the people, things, and settings that incite anger, but you can learn how to control reactions and respond in a socially appropriate manner. The more you master yourself, the more you can master situations. The support of a mental health professional can be very helpful in this process.

Along with my colleague, Dr. Robert Puff, I wrote a comprehensive book on anger called 'The Everything Guide to Anger Management.' For more information on this book, please click here.

When working with anger management clients, I provide a controlled platform for the release of emotion while aiming to achieve positive and constructive responses, rather than negative and destructive ones. Clients are encouraged to examine the circumstances that trigger their anger and to become aware of their emotional state at each level of arousal. Affected people are taught how to use those psychological signs as a road map to control their anger through the use of more effective coping strategies. By identifying the emotional reaction to specific situations, my clients gain awareness and insight into the way their body responds to past and future circumstances. In addition, I work to help clients in identifying anger responses that may actually be defense mechanisms for other concerns such as depression or anxiety. Often, for example, people will express anger when, fundamentally, what they are really experiencing is hurt.

Some of the techniques I use in anger management therapy include:

• Impulse control
• Self-awareness
• Meditation
• Cognitive restructuring
• Frustration management (sometimes by writing in an anger diary)
• Relaxation strategies

Addiction is horrible to live with, whether it is in you or a loved one.  It is also, by definition, something that is very difficult to overcome on one’s own. Therapy can help overcome addiction.

As a therapist, I help people who are addicted to set achievable and empowering short-term goals as they work to overcome psychological dependence. Once sobriety is achieved, adaptive skills are developed, and underlying causes and contributing factors are explored. Together, we will often set long-term goals that may include rebuilding damaged relationships, accepting responsibility for actions, and releasing guilt.

Even when addiction involves a physical substance like drugs or alcohol, it is almost always more than merely a physical dependence. Even after detox, when physical dependence has been cured, addicts are at high risk for relapse. Psychological and social factors are often powerful triggers:

• Stress, especially sudden life stresses
• Cues in the environment, like visiting a neighborhood
• Social networks, like spending time with friends who continue to use drugs

These factors can create ongoing, nearly irresistible urges to use. With therapy, a person who has become dependent on drugs or alcohol more likely to overcome an addiction, and several types of therapy are helpful in this process. In particular, cognitive behavioral therapy (CBT) and motivational interviewing (MI) have demonstrated effectiveness in this arena. Therapy can also provide a supplemental form of support for people attending a self-help group, such as Alcoholics Anonymous, or who are transitioning out of inpatient treatment or sober living.