Worry Off-Ramp

In August 2008, I had the privilege of attending the Behavior Therapy Institute in Palo Alto, California, which was conducted by the International OCD Foundation. A number of experts in the treatment of obsessive-compulsive disorder (OCD) and obsessive-compulsive spectrum disorders presented the latest information on treatment. The attendees received encouragement to follow validated treatment models. The opportunity for us to consult with experts in this field was most helpful.

Eda Gorbis, Ph.D., MFCC, who has a private practice and is an assistant clinical professor at the UCLA School of Medicine, led the breakout group I attended. Dr. Gorbis taught her group how to write out their worries and fears. She told us to take our pens and, for the next fifteen minutes, to write out all of our worst fears and worries. Skeptical about what this would do, I surprised myself when I wrote for fifteen minutes and did not repeat the same worries.

Since that experience, we have asked many of our clients to write out their worst fears. Virtually all of them have benefited from this exercise. Those with anxiety disorders who followed the prescription and wrote diligently experienced a dramatic drop in their overall anxiety. Other clients, those without a clinical level of anxiety, also benefited. Their experience was similar to my own. Even a relatively small amount of time spent writing out fears can significantly reduce the amount of time spent ruminating about stressful circumstances. Several clients have told me they have adopted the practice of writing out their worst-case scenario (WCS) fears as soon as a new concern develops. Many have found that facing the WCS early on reduces the strength of negative emotions. These emotions may have developed into worried rumination in the past.

I asked Dr. Gorbis where I could read more about her writing technique. She told me, “I’m telling you now how to do it.” I thought it would be helpful to create a guide for my clients and patients. I have used various iterations of this guide, and our clients and patients have found it a helpful reference as they complete their homework.

My current colleagues, Paul Bakke, MA, Heidi Miller, LICSW, Summer Scott, MA, and Haley Callahan, MA, and Christine Burgraff, MS participated in updating the original version of Write Your Fears Away to include more of the tools we use every day in our clinical practice as well as our Intensive Outpatient Program. Cognitive behavior therapy (CBT) continues to advance the treatment of many emotional disorders. We decided to title this update, Writing and Living Your Fears Away, in order to reflect the ongoing management and skill development we encourage in clients and patients to prevent relapse.

Thank you to Angela Weaver Barnhart for your patience and perseverance in editing the manuscript. Dr. Aparna Vuppala, my colleague and a child and adolescent psychiatrist, actively works in the community advocating for mental health especially in suicide prevention. Her openness and communication with her patients and parents is a model of caring and ethical professionalism. Mr. Marvin Kalachman works with a full range of patients providing psychiatric treatment. We are fortunate to have in our office professionals who encourage families to follow through with CBT while providing the psychiatric care they need. I love working with you all and collaborating with you on our client and patient care.

Thank you, Donna Barnhart, for your support during the last fifty-one years of marriage. You’ve run our offices, our home, reared a Ph.D. son and an MD daughter (David and Melanie), watched over my father’s terminal care and cared for my mother during a very difficult time. Now, you are also a devoted grandmother caring for and showing interest in our five highly intelligent, socially tuned-in, fascinating grandchildren. You are clearly the best person I’ve ever known. You bless my life every day with your presence.

Your interest in this workbook may come from simple curiosity about the subject, a desire to reduce your own everyday stress, anxiety, depression or maybe you have a friend or family member whose anxiety seems to be higher than that of most people you know. The techniques included are tools used by our clinical counselors to help clients with emotional disorders reduce anxiety to achieve long-lasting effects. I’m excited to present this information to you because we are able to see the long-term benefits that can be achieved in both the everyday stress people experience at work, at home, and in relationships as well as moderate and severe emotional disorders.

You don’t need to have an emotional disorder to benefit from this work. If you do suffer from an anxiety or mood disorder, I recommend that you consult with a clinical counselor, social worker, marriage and family therapist, or psychologist in addition to using this workbook. I believe the support, expertise, and accountability provided by an experienced therapist will tend to save you time, money, and discomfort in the long run.