Psychotherapy Services

Cognitive behavioral therapy (CBT) is a focused, problem-solving psychotherapy that has been shown in over 400 outcome studies to be highly effective for the treatment of many emotional, psychological and personal problems. In contrast to other forms of psychotherapy, cognitive therapy is usually more focused on the present, more time-limited, and more problem solving oriented. In cognitive-behavioral therapy, individuals learn specific skills to resolve current areas of difficulty, and use in dealing with future life challenges. These skills include identifying distorted thinking, modifying beliefs, relating to others in different ways, and changing behaviors. Dr. Bryson provides a safe, caring and confidential environment to explore new, more satisfying paths to living.

Dr. Bryson uses cognitive therapy to help individuals with a wide range of problems and disorders. The following are some of her areas of expertise.

Coping with Divorce

Combining an extensive knowledge of family law and cognitive-behavioral therapy, Dr. Bryson offers a unique therapeutic & educational intervention to manage the stress of a divorce. Concerns frequently addressed include dealing with negative emotions, relating to a difficult spouse, understanding the court system, helping children cope, and planning for the future.

Post-Traumatic Stress Disorder

After experiencing or observing a potentially life-threatening event such as an armed robbery, car accident, assault, rape, etc., individuals can experience disruptive emotions including “flashbacks”, nightmares, intrusive images, and memories of past traumas. Cognitive therapy is very helpful in resolving the trauma and reducing the symptoms than may include anxiety, hyper- vigilance, insomnia, detachment, avoidance, irritability and guilt.

Depression

Depression is a fairly common condition that can be treated successfully for most individuals with cognitive behavioral therapy alone or in combination with antidepressant medication. Depressive disorders are numerous and range in severity from mild to levels that significantly interfere with daily life. Typical symptoms of a clinical depression include a persistent state of depressed mood (sadness or feeling “empty”) or irritability, fatigue or loss of energy, diminished interest or pleasure in activities: insomnia or excessive sleeping; worthlessness; poor concentration and/or difficulties making decisions; and at more severe levels, a sense of hopelessness or thoughts of wanting to die.

Anxiety

There is a wide variety of anxiety disorders. Generalized anxiety includes worries and anxieties that occur more days than not. Symptoms may consist of feelings of being restless and “edgy”, fatigue, insomnia, muscle tension, irritability and trouble concentrating. CBT addresses the cognitive distortions in anxiety which usually include the overestimation of danger and/or the underestimation of one’s ability to cope.

Panic

Cognitive therapy theorizes panic disorders result from the catastrophic misinterpretation of body or mental sensations. Individuals who panic enter a vicious cycle in which sensations (e.g. increased heart rate) are followed by catastrophic beliefs (e.g. “Maybe I’m having a heart attack) that lead to anxiety and fear (e.g. .“I might be dying”) and therefore more sensations (e.g. the release of adrenaline which further accelerates heart rate, difficulty breathing, etc.). It’s not uncommon for these experiences to lead to the avoidance of activities or situations in which previous panic attacks occurred. Cognitive restructuring and behavioral techniques are highly effective in ending this very distressing sequence of events.

Phobias

A phobia is excessive fear and avoidance of specific objects, animals, or situations. Individuals may be able to dismiss their fears when in a “safe” place, but still feel they are in real danger when faced with the thing that they fear. There are three main types of phobias: simple phobia (e.g. spiders, heights, sight of blood); social phobias (e.g. fear of rejection or being negatively evaluated by others); and agoraphobia (e.g. the fear of confined spaces or being far from home). Treatment includes a thorough assessment, and precisely designed interventions to reduce or extinguish the anxiety.

Obsessive-Compulsive Disorder

OCD is the recurrent intrusion of upsetting obsessions (thoughts, images, urges) and/or the urge to carry out certain compulsive behaviors. The individual becomes consumed in a pattern of repeated checking or cleaning rituals or other excessive behaviors that feel necessary to reduce high levels of anxiety or fear, or to avert potential disaster. Examples include “I’m contaminated, I have to wash my hands again”; “Having that awful thought must mean I’m a bad person, or that I’ll lose control and do it”; and “If I don’t go back and check the stove again, I’ll be responsible if there is a fire.” Cognitive behavioral therapy is the most effective evidence-based treatment for this disorder and includes relapse prevention techniques.

Low Self-Esteem

Low self-esteem and low confidence can significantly interfere with the pursuit of relationships, career advancement, educational aspirations, and other important goals in life. Cognitive behavioral therapy offers a supportive, collaborative approach in which therapist and patient actively work together to identify problems, recognize resources, and develop systematic methods for overcoming difficulties and enhancing one’s sense of control.

Anger Management

Recurring anger that is inappropriate, (e.g. extreme, out of proportion, explosive, or experienced as out of control) not only negatively affects relationships, but can have serious physical consequences. Cognitive behavioral therapy is highly successful in helping individuals learn how to manage their anger and use more effective, successful ways on interacting. Understanding how the patterns developed and finding alternative ways of reacting are key in breaking the self-defeating patterns of uncontrolled anger.

Relationship Problems (couples, families, work conflicts, etc.)

Cognitive therapy helps individuals identify the beliefs and expectations that underlie anger and disappointment in their relationships. For couples this can include differing expectations about roles, misinterpretations and miscommunications, different values and styles for parenting, and disagreements about finances. Cognitive therapy can also be integrated with family therapy to reduce conflicts, enhance success in childrearing, improve communication, and increase the enjoyment of family life. Other types of relationship problems addressed successfully with cognitive therapy include adult children and parents, dating relationships, and conflicts with coworkers, employees or supervisors.

What is Cognitive Therapy or CBT?

Cognitive Therapy and Cognitive Behavioral Therapy have emerged as the leading forms of psychotherapy for depression, anxiety, phobias, panic, posttraumatic stress disorder, social anxiety, obsessive compulsive disorder, stress and many other conditions. It was originally developed by Aaron T. Beck, M.D. the recipient of the prestigious Lasker Award in Medicine, and further developed, refined and evaluated over the past four decades by clinicians and researchers around the world. Cognitive Therapy is often referred to as Cognitive Behavioral Therapy (CBT) because it incorporates strategies and techniques originally within the behavior therapy field. The premise of cognitive therapy is that our thoughts influence our mood and behavior – a simple but revolutionary idea. Thoughts help define which mood we experience in a given situation. Once a mood is present, it is accompanied by additional thoughts that support and strengthen the mood. For example, an angry person thinks about ways he or she has been hurt, an anxious person sees danger everywhere, and a depressed person thinks about how bad things have become. One’s thinking may not be entirely wrong but intense moods can lead one to distort, discount, or disregard important information that contradicts one’s thinking and beliefs. By changing our thoughts or our relationship to our thoughts, we can change behavior and emotions.

In cognitive therapy, the therapist and the client work together as a team to identify and solve problems. It is provided within an emotionally supportive, empathic relationship that encourages the client to express feelings in addition to working directly on positive changes in thinking, behavior and mood. It is a highly collaborative process that includes an ever-evolving formulation of the client and his or her problems. Cognitive therapy is a more structured and more goal oriented than many other forms of psychotherapy. A variety of cognitive and behavioral techniques are used to facilitate change, and the success of cognitive therapy is highly dependent on active participation of the client. This includes the recording and analyzing of thoughts and feelings in between sessions. In cognitive therapy clients learn techniques that help in resolving current areas of difficulty as well as learn skills that are useful in preventing relapse and dealing with future life challenges.

The Role of Negative Thinking

Thoughts play an important role in emotional and psychological problems. Following are some examples of the type of thoughts we will help you address and change.

Generalized Anxiety

“What if I lose my job?” “What if I don’t get accepted?” “What if he got into an accident and is in the hospital?” “What if the plane crashes?” “What if they don’t like me?” “What if this pain is a sign of cancer?”

Depression

“I never do anything right, I’ve messed up everything.” “Things are not going to work out for me, people like me will fail.” “Who am I kidding? I won’t get this job.” “Others can be helped, but I’m different.” “I’m too depressed to even go for a walk.”

Panic

“What’s happening to me, I can’t breathe! I’m going to pass out!” “I’ve got to get out of here. I’m losing control, I must be going crazy.” “I’ve got to pull the car over or else I’m going to lose control and crash.”

Social Anxiety

“I don’t know what to say to people.” “I’ll look stupid, I’ll stumble over my words.” “They’re going to see how uncomfortable I am, I’ll turn red, I’ll look nervous. I’ll have to run out of the room, they will think I’m weird and won’t want to anything to do with me.”

Anger

“I shouldn’t have to explain this a second time, these people are so stupid!” “I shouldn’t have to put up with you.” “I can’t believe this is taking this long!” “I hate getting stuck in theses ridiculous lines.” “She is always doing that to me.”

Obsessive Compulsive Thinking

“If I don’t go back and check again, something bad will happen and it will all be my fault.” “I’m contaminated, I have to wash my hands again, I can’t take any chances.” “What if I left a word out, I’ve got to go over it again. “ “I can’t believe I’m doing this, it’s stupid but I need to turn around and see if I did run over someone.”

Relationship Issues

“He did that because he is trying to control me.” “The best way to deal with her is to just avoid the whole issue.” “If he really cared, I wouldn’t have to ask him to help when I’m overwhelmed with the baby and getting dinner on the table.” “She never wants to do what I want to do.”

Common Cognitive Distortions

  1. All-Or-Nothing Thinking (also called Black-And-White)
    Viewing a situation in only two categories instead of on a continuum.

    Example: “If I’m not a total success, I’m a failure.”

  2. Catastrophizing (also called Fortune Telling)
    Predicting the future negatively without considering other, more likely outcomes.

    Example: “I’ll be so upset, I won’t be able to function at all.”

  3. Mind Reading
    Believing you know what others are thinking; failing to consider other, more likely, possibilities.

    Example: “He’s thinking I don’t know the first thing about this project.”

  4. Tunnel Vision
    Seeing only the negative aspects of a situation.

    Example: “My son’s teacher can’t do anything right. He’s critical and insensitive and lousy at teaching.”

  5. Overgeneralization
    Making a sweeping negative conclusion that goes far beyond the current situation.

    Example: “[Because I felt uncomfortable at the meeting] I don’t have what it takes to make friends.”

  6. Personalization
    Believing others are behaving negatively because of you, without considering more plausible explanations for their behavior.

    Example: “The repairman was curt to me because I did something wrong.”

  7. “Should” and “Must” Statements
    Having a precise, fixed idea of how you or others should behave and you overestimate how bad it is that these expectations are not met.

    Example: “It’s terrible that I made a mistake, I should always do my best.”

  8. Disqualifying or Discounting the Positive
    Unreasonable telling oneself those positive experiences do not count.

    Example: “I did that project well, but that doesn’t mean I’m competent, I just got lucky.”

  9. Labeling
    Putting a fixed, global label on yourself or others without considering the evidence might more reasonably lead to a less disastrous conclusion.

    Example: “I’m a loser.” “He’s no good.”

  10. Magnification/Minimization
    When evaluating oneself, another person, or a situation, one unreasonably magnifies the negative and/or minimizes the positive.

    Example: “Getting a mediocre evaluation proves how inadequate I am.” “Getting high marks doesn’t mean I’m smart.”

  11. Mental Filter
    Paying undue attention to one negative detail instead of seeing the whole picture.

    Example: “Because I got one low rating on my evaluation [which also contained several high ratings] it means I’m doing a lousy job.”