Posts Tagged ‘Cognitive behavioral therapy’

May is Borderline Personality Disorder month! Who knew?  Well Dr. Barry Lubetkin certainly knew and this week he shares some insight into this very common but difficult diagnosis and treatment.

” Borderline Personality Disorder………The toughest diagnosis

Did you know that by an action of Congress, May is Borderline Personality Disorder month!!  BPD is a most challenging mental disorder; It is characterized by many of the following symptoms:
1.Emotional instability and impulsivity.
2.Poor interpersonal relationships and poor self image
3.Intense fears of abandonment.
4.Manipulative behavior to obtain nurturance
5.Drug and alcohol abuse
6.Increased probability of suicidal gestures or attempts.

Individuals with BPD (three times as many are woman then men), are often the toughest challenges to therapists, and often resist potentially effective treatment. While medication and directive Cognitive Behavior Therapy may help reduce paralyzing symptoms, progress is often slow and inconsistent.  Research now indicates that the most promising approach is called Dialectical Behavior Therapy (DBT).  It consists of intensive group and individual therapy focusing on helping patients control emotional upheavals by learning how to soothe themselves, practicing developing new interpersonal skills, resisting the impulse to condemn themselves, challenging irrational assumptions about how others view them, and a whole lot more.  In New York City, The Psychiatry Department at Columbia Presbyterian Hospital offers this treatment.

The best books out on the subject are…..”Stop Walking on Eggshells“, “I Hate You,Don’t Leave Me” and any excellent text by Dr. Marsha Linehan,the discoverer of DBT.  Contact me at the Institute For Behavior Therapy at IBT104@AOL.com for more info.”

Cover of "Stop Walking on Eggshells: Taki...

Cover via Amazon

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Death Calls Us All

Death Calls Us All

Mental Health Monday continues our weekly series today with an eye-opening, hard-hitting look at the deep-seated fear and anxiety we all have about dying and death.  Dr. Barry Lubetkin, interestingly chose this topic today, the very day after the Christians of the world celebrated the Resurrection of Jesus Christ – this is just my personal observation.

“A 76 year old gentleman consulted me recently concerning his lifelong Type-A behavior at work and at home.  He never rested, he told me. He was always ON, working, strategizing, planning. He hadn’t vacationed in years and refused to ever consider retirement.  He had denied his family countless hours of quality time with him, while he went about driving himself,  never stopping to smell the roses.  After several hours of therapy it became clear that one of the motivators behind his inability to relax and stay in the moment was a profound fear of dying. By never quieting himself, he was able to continuously distract himself from anticipating his own demise.

This case is not the exception.  As Baby Boomers begin to experience the physical and mental effects of their aging, they are forced to consider the inevitability of their own mortality. While many are able to accept with grace that dying is a natural part of living, many others secretly live their lives with terror about dying, and develop mental and physical behaviors designed to DENY its reality. Obsessive compulsive behavior, cruel and sadistic personality styles, certain phobias, depression, severe anxiety, and even ironically, suicidal thoughts are often partially driven by unexpressed anxiety about dying.

Since we all are going to die eventually, we had better become as proactive as possible in de-horrorfying and de-catastrophizing our thoughts about our eventual demise. A sensitive and experienced cognitive behavior therapist can be helpful. Also I strongly recommend the best book on the subject of overcoming terror about dying….”Staring at The Sun” by Psychiatrist Sydney Yalom.  It should be required reading for all of us.  It is that good!”  As always feel free to email me at IBT104@AOL.com

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Available through Amazon

Available through Amazon

Where are the lines drawn between the disease-stricken hoarders, the messy clutterers and the over-enthusiastic collectors? Dr. Barry Lubetkin, Phd, ABBP offers us insight on the distinction between a diagnosed disorder and a hobby or personality characteristic.

Hoarders and Clutterers and Collectors Oh My!!!

The Psychiatric problem of hoarding had been under diagnosed for many years .But recently with increased media attention(see several New York Times articles in the past four months),the

wildly popular reality TV show “Hoarders” and recent major advances in the diagnosis and treatment of this mental affliction, many more people are getting professional help.
It is important to point out that while many of us may have lived with and accepted clutter in our homes for our entire lives, being diagnosed as a hoarder requires that the clutter must seriously interfere with the quality of our lives and risk our safety. Navigating through dangerous paths in our home with furniture and garbage piled on either side, shame of exposure leading to living lonely isolated lives, or irrational superstitious beliefs that cleaning up or throwing out certain articles will lead to terrible consequences………these all will confirm the diagnosis.

The etiology of hoarding is multi determined…….a previous diagnosis of obsessive compulsive disorder, prolonged depression, unkempt,and chaotic childhood homes, have all been implicated. Even the well intentioned collector who has enjoyed his passion for saving and displaying his collections is sometimes at risk if other psychiatric disorders emerge and create a vulnerability to depression and indifference to caring for themselves or their living conditions.

Treatment involves a variety of interventions :Anti depressant medication,engaging family support during the clearing process, Cognitive Behavior Therapy to reduce anxiety and panic and designed to educate the hoarder on the irrational and superstitious thinking elements of the disorder,and guided practice in controlling their environment post treatment.

With less serious clutter collectors who feel their mess has gotten difficult for them to control, I suggest starting with small portions of the affected areas (one corner of the bedroom,piles of books and papers on the floor,etc), and slowly progress over time to prioritize what to throw out. Dividing your “stuff” into A ,B and C groups………must keep, maybe keep, must dispose, is often very helpful. Feel free to contact me at ibt104@aol.com for further advice.

 Barry Lubetkin, Phd, ABBP is co-director of the Institute for Behavior Therapy in Manhattan.  Dr. Lubetkin has written two widely acclaimed books. Bailing Out (Simon and Schuster and Prentice Hall Press) and Why Do I Need You To Love Me In Order To Like Myself (Longmeadow and Borders Press). In addition, his 3-disc audio series on treating insomnia Dr. Barry’s Sound Asleep has recently been published. 

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One Fear illustration from Book of Fears

One Fear illustration from Book of Fears (Photo credit: Wikipedia)


By Dr. Barry Lubekin

Human beings experience hundreds of different phobias and overwhelming fears and anxieties. Many are deep rooted, and find their origin in long forgotten childhood traumas. Others develop more recently and are traced to reactions to frightening events or complex relationship dilemmas. When these phobic reactions actually interfere with normal daily functioning,professional intervention is the best course.

Here is an example of the 2 origins of an airplane flying phobia: the first patient was traumatized at age 11 when flying with her newly divorced parents,the plane hit very unsettling turbulence and she was very uncomfortable flying as an adult.  The second patient, panicked at the possibility that her husband was cheating on her,refused to fly to various job assignments, fearful that the husband would carry on his affair while she was gone! Note….the same fear with two very different origins, and treated in very different ways.

The most effective treatment for irrational simple phobias is called “flooding” and involves gradual exposure in imagery and in real life to the phobic object or situation. More complex phobias( eg. The fearful wife above) are best treated with cognitive behavior therapy(CBT) involving assertiveness training, meditation and relaxation techniques, and challenging irrational needs for dependence,and superstitious beliefs.

Do you have a phobia? Describe it to me in a private email. Send to IBT 104@aol.com and I will be happy to let you know the best treatment options available. Make your message attention to Dr. Lubetkin. Looking forward to hearing from you!

Dr. Barry Lubetkin is in private practice in NYC. He is the co-director of the Institute for Behavior Therapy.  He is a published author and frequent guest on TV and radio shows as an authoritative voice on mental health issues.


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Sorry I am posting this mental health tip from Dr. Barry Lubetkin so late in the day….clearly a sign that I didn’t get enough sleep last night.  Had an early important meeting so of course I didn’t get to bed till after midnight and then couldn’t sleep!!

“Insomnia or sleeplessness is occurring in epidemic proportions. Stress, unemployment,drug,alcohol, and internet addictions, and a variety of mental and emotional disorders make getting a good nights sleep more and more difficult to achieve. 
Here are some solid scientifically sound non medication tips to avoid tossing and turning for hours……..For 3 continuous weeks try the following:
1.Stop napping throughout the day
2.Wake up at the same time each morning, even on weekends and get into bed at the same time every night.
3.If not asleep within 30 minutes of lying down,get out of bed and sit and relax quietly in another room for 20 minutes before returning to bed
4.Bed is for sex and sleep! No reading,no visible clock,no eating in bed.
5.No caffeine or exercise within 2 hours of bedtime.
6.Challenge irrational ideas about sleep……eg.I MUST get 8 hours of sleep every night; My next day will be ruined completely if I don’t sleep enough.
Of course,consultation with a professional sleep specialist must be considered when sleeplessness persists despite self help efforts.”
Lubetkin is the recipient of several awards and honors within the profession of Psychology including The Annual Meritorious Service Award from The Association for the Advancement of Behavior Therapy (currently ABCT). He served as President of The American Board of Behavior Therapy for 12 years and has served on numerous editorial and review boards. He also served as the Editor in Chief of the Diplomate, the first journal published by the American Board of Professional Psychology. In addition to his 2 books, he has published over 50 articles in the fields of Cognitive Behavior Therapy and General Psychology.


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worried square

worried square (Photo credit: cathredfern) 

 A long time ago I read that two very useless emotions were worry and guilt; Prevalent among us all and hard habits to break!  The following words of advice are from Dr. Barry Lubetkin, Phd, ABBP.

” More about worry!
Remember ,worrying is a mental habit…….some thing that is repeated involuntarily without our being aware that it has started. So it will take frequent practice of actions that are incompatible with worrying to reduce the habit of worrying. Psychologists at Pennsylvania State University have developed a series of anti worrying steps.:

1. Write down the specific thoughts that you have when you worry..

2.Analyze each thought……is there evidence for it? What is its real probability of occurring? Have you handled such situations in the past without dire consequences.? A year after the event will it really make a major difference in your life.? Couldn’t you survive and move on even if the worst happens?
Write down your answers.

3.Use these new more adaptive thoughts whenever you notice a worrisome thought throughout the day. Remind yourself that they are more valid based on your logical evidence based analysis. With repeated practice they will begin to feel more true.

4.Designate a 15 minute period each day as your “worry time”. And only focus on your worries during this period. This will allow you to postpone worrisome thinking from other times,and do creative problem solving and rational thinking.

Dr Barry Lubetkin is the Director and founder of The Institute For Behavior Therapy in New York City. He is Board certified in both Clinical Psychology and Behavioral Psychology. He is the author of numerous academic and popular articles as well as two popular self-help books: “Bailing Out”and “Why Do I Need You to Love Me in Order to Like Myself”. He also has recorded the popular insomnia treatment CD set “Dr. Barry’s Sound Asleep.” The Institute for Behavior Therapy is the oldest privats.e Cognitive Behavior Therapy center in the United States founded in 1971. s have received treatment at the Institute.

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