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Prof. Blair Patton Bisher, NCC, PhD(c), MS is an addiction therapist in Amesbury, MA specializing in addiction therapy and counseling.
Connect with this therapist via:
Video Visits - connect over video conferencing software for a virtual session -- almost as if you're there in person
Phone Visits - good old-fashioned technology for those who don't want to worry about appearance or who have might have internet bandwidth limitations; a little bit like connecting with an old friend, but with a counselor instead
Instant Message (IM) Visits - real-time chat -- like a phone call, but over text
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Anxiety
Anxiety is a generic name given to a variety of conditions characterized by unusual amounts of fear and worry, especially unrealistic fears and tension. People who suffer from anxiety often are aware that their fears are irrational, but that knowledge does not make the feeling of being scared and anxious go away. To qualify as anxiety, symptoms must last for 6 months or more and interfere with the way a person lives their daily life. Some cases may be mild, where, for example, a person simply avoids certain situations. Other cases can be severe enough to be disabling.
Some of the specific conditions covered under the general label of anxiety include:
Collectively, anxiety disorders are the most common mental health issues diagnosed in the United States -- even more common than depression. Women are more likely than men to be diagnosed with anxiety, and it is extremely common for a person with anxiety to have another illness at the same time, such as depression, a physical illness, or substance abuse.
Treatment for anxiety usually involves medication and psychotherapy together. Medications used may include antidepressants (which also work for anxiety), anti-anxiety medications, or beta blockers (which can be used to control the physical symptoms of anxiety). Psychotherapy can be useful to teach patients new ways of thinking and reacting so that they can manage their feelings of worry and fear. Support groups can also be very effective for anxiety, and they can be a form of treatment themselves for social phobias. Stress management, relaxation techniques, and meditation all help reduce feelings of anxiety or of being out of control. Finally, having a strong support network of family and friends is an excellent way to help manage the difficulties of life with anxiety.
Couples Therapy
Couples therapy refers to a specific type of counseling where relationship issues are the focus of the treatment. It used to be referred to as marriage counseling and still may be called that in many places, but because participants are not always married to each other, couples therapy is a more accurate name.
Closely related to family therapy, couples therapy is a type of counseling that seeks to help couples improve their relationship. A therapist may teach each partner in the relationship specific skills, such as managing or expressing their emotions, conflict resolution, communication skills, and problem solving. Both people in the couple need to be committed to learning new skills themselves as well as putting effort into supporting the relationship. The typical goals of couples therapy are to decrease conflict, unhappiness, and resentment, as well as increase communication, intimacy, and connection.
Couples therapy may be offered privately, at a university, or in a group practice. It is usually short-term therapy, lasting a few weeks until the participants have learned new skills and have the ability to repair their relationship. Its effectiveness depends on the willingness of both participants to commit to therapy and make the relationship a priority. For many couples it can be extremely helpful.
Dialectical Behavior Therapy
Dialectical behavior therapy, or DBT, is a form of cognitive behavior therapy (CBT) that was originally developed to help the most severely mentally ill and depressed patients accept therapy. It relies on the same concept in CBT that examines the relationship between thoughts, feelings, and actions, but in DBT the emphasis is first on acceptance rather than change. There is also an emphasis on mindfulness, 'being in the moment,' and relaxation techniques such as yoga. These are combined with a great deal of validation and encouragement from the therapist.
The word 'dialectical' means acting through opposing forces, and this word refers to a few different opposing concepts in DBT:
Dialectical behavior therapy was developed when therapists attempting to use CBT techniques on the most seriously ill patients ran into a problem. When they suggested that a patient change their thoughts, these very vulnerable patients would become overwhelmed and turn aggressive or suicidal. DBT was developed to support these patients with acceptance and validation while still guiding them towards changing problematic thoughts. Although also used for suicidal and self-harming patients today, these days, DBT is mainly used to treat borderline personality disorder. It is one of the few effective interventions for this serious illness.
DBT has been shown to be very effective at reducing self-destructive behavior. It can also be used to teach new coping skills and increase a patient's self-esteem and motivation to become healthier.
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Mr. Blair Bisher is a counseling specialist in Dedham, MA.
