Anxiety Specialists Of Los Angeles

Now offering online therapy And telephone sessions

Receive therapy at home online or by telephone.

Our Practice

Anxiety Specialists of Los Angeles, is a concierge practice specializing in the assessment and treatment of anxiety disorders and related conditions. Our licensed mental health clinicians treat adults and adolescents utilizing the latest evidenced-based therapies. In 1989, Dr. Lynne Freeman founded Open Doors Institute, a statewide network of licensed anxiety specialists while training and supervising interns at the flagship office in Beverly Hills, California. Over time, Dr. Freeman dissolved the network to focus on her book, Panic Free: Eliminate Anxiety/Panic Attacks Without Drugs and Take Control of Your Life, and to deliver services directly to clients. Eventually, she relocated her practice to Encino, California, where she earned a reputation for successfully treating resistant cases of anxiety and obsessive- compulsive disorders . Subsequently, she developed an extensive waitlist of clients.

Dr. Susan Holt, a specialist in anxiety disorders and trauma, joined as a partner in 2018 to form Anxiety Specialists of Los Angeles. Doctors Holt and Freeman have combined their unique expertise to provide effective treatment for all types of anxiety disorders, OCD and related conditions. Clients are seen by licensed professionals and appointments can be arranged within a reasonable period of time.

Anxiety disorders afflict approximately 40 million Americans over the age of 18 and affect 25 percent of all teens. Obsessive- Compulsive Disorder afflicts 2.2 million individuals – approximately 1% of the population. However, according to a recent study in the Journal of Obsessive-Compulsive and Related Disorders, researchers found that nearly all of the people in the study — about 94 percent — reported experiencing at least one unwanted thought in the previous three months. The average amount of time to receive an accurate diagnosis of an anxiety disorder is 15 years. This is because many mental health professionals are not specifically trained in the assessment and treatment of symptoms associated with these conditions.

Treatment Approaches

What to Expect

When you contact Anxiety Specialists of Los Angeles, you will be asked a number of questions to determine which of our therapists would be most appropriate to treat your symptoms. You will receive assessment forms to complete that you will bring to the initial consultation. The initial consultation is one hour in duration and, during this appointment, you will be provided a diagnosis and treatment plan. Depending upon your symptoms and history, your therapist will discuss the various approaches and recommendations that will most benefit you. This may include a recommendation for an evaluation for medication. The treatment approach and decision to pursue medication is a collaborative decision between you and your therapist. Some of the treatment approaches utilized include the following:

Mindfulness-based Cognitive Therapy

Mindfulness-based Cognitive Psychotherapy is a form of cognitive therapy derived from mindfulness based stress reduction. MBCT teaches the client how to remain in the present and focus on their experiences in real time. It is a practice that has its origin in meditation and has evolved into a form of psychotherapy emphasizing acceptance of uncomfortable states of mind. MBCT exercises can help with symptoms of depression and has recently gained popularity in treating anxiety disorders, OCD, and related conditions.

Acceptance Commitment Therapy

Acceptance Commitment Therapy uses acceptance and mindfulness, not to eliminate bad feelings, but to reach levels where the client no longer reacts to these feelings or goes to lengths to avoid them. This form of therapy can be used to treat a wide range of problems; however, it is growing in popularity as an effective treatment for OCD particularly when certain symptoms may remain unchanged for a period of time.

Exposure Response Therapy

Exposure Response Therapy (ERP) is a subset of CBT and is premised on recognizing that anxiety will improve when it is confronted rather than avoided and assists patients in facing their fears. This form of therapy requires specific training and there are a limited number of clinicians qualified to use it. It is considered the mainstay of treatment for Obsessive –Compulsive Disorders and is evidenced based. ERP may include writing a story or “script” detailing a worst case scenario and rereading it until the anxiety is eventually extinguished. Other forms may include Imaginal Exposure, or In Vivo Exposure Therapy.

Imaginal Exposure Therapy

This is a form of Exposure Response Therapy. However, it tends to be less threatening than live (in vivo) exposures. The client is asked to focus on the scenario they are trying to avoid and the therapist guides them through it in conjunction with CBT and/or mindfulness.

Challenging Superstitious Thinking

When someone with OCD engages in magical thoughts, they worry that, if they do not comply with certain rituals or control their thoughts, they will incur a negative consequence. Without debunking the magical thinking, the behaviors may seem to improve; however, the individual may still be experiencing anxiety. Utilizing psychoeducation and ERP, superstitious thinking is challenged so that, over time, it no longer seems logical.

Panic Disorder

Agoraphobia

This term, which literally means “Fear of the Marketplace”, can be misleading. Agoraphobia is more accurately characterized by an avoidance of certain environments, activities and situations which are likely to precipitate a panic attack. Common places and situations that agoraphobics may avoid include:

• Theatres
• Car washes
• Driving (especially red lights, left turns, freeways, and traffic)
• Elevators
• Indoor shopping malls and large buildings
• Underground parking structures
• Dental or other appointments which require an extended period of sitting
• Ingesting a new medication
• Planes, trains, buses, and/or subways

An individual with agoraphobia usually feels more comfortable with someone who is familiar and may experience increased anxiety when alone.

Panic Attack

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD)
GAD is characterized by chronic worry frequently occurring initially in adolescence. The worry is typically focused on the health and safety of oneself or a loved one and/or financial stability or employment- related concerns. Individuals with GAD are sometimes misdiagnosed with Obsessive- Compulsive Disorder because they entertain certain thoughts that may become obsessive. The emotional and physical symptoms of GAD include:

• Trembling, twitching, or feeling shaky
• Muscle tension, aches or soreness
• Strong fatigue and depression
• Palpitations or an accelerated heart rate
• Feelings of being on edge or agitated
• Exaggerated startle response
• Difficulty concentrating

Experiencing at least three of these symptoms for a period of six months may indicate GAD.

Specific Phobia

A phobia is an irrational fear of a non-threatening object, place or situation. For example, if a woman lives alone and frequently checks to make sure her doors and windows are locked because she is anxious that an intruder may enter her home, she does not necessarily have a phobia. (One in three women may be sexually assaulted in their lifetime.) However, if the same woman continually patrols her doors and windows with a can of insecticide fearing that a spider might enter, she probably has a phobia – specifically, arachnophobia. Most spiders are not a threat to her survival so her fears are not warranted.
Phobias develop for a variety of reasons. Panic disorder with agoraphobia may include certain phobias such as claustrophobia (fear of small enclosed spaces) and acrophobia (fear of heights) among others.

Social Phobia

Social phobia is characterized by anxiety in social situations and/or social interaction with others. It can result during and/or from the following:

• Anxiety during public speaking (circumscribed or limited)
• Anxiety when using a public restroom
• Writing in the presence of others
• Sexual activity or undressing in front of others
• Reviewing conversations and scrutinizing one’s responses
• Gatherings or situations that require engaging others

Physical symptoms associated with social phobia may include:

• Blushing
• Sweating
• Shaky voice
• Racing heart
• Shaky legs
• Dry mouth
• Nausea or vomiting
• Sexual dysfunction

Social phobics may be able to socialize and can appear outgoing and engaged. However, social anxiety often initiates feelings of being scrutinized, diminishing the pleasure of social interaction. Typically, those with social phobia have been considered consistently shy since childhood.

Obsessive -Compulsive Disorder

Obsessive -Compulsive Disorder (OCD) and Primary Obsessional Disorder

Although Obsessive- Compulsive Disorder does cause anxiety, it was removed from the anxiety disorders category in the latest Diagnostic & Statistical Manual and has received its own classification in that publication.

The symptoms of OCD can be broken down into two distinct features: obsessions and compulsions. Obsessions are unwanted and intrusive thoughts that occur repeatedly. Compulsions are behaviors which are performed in an attempt to minimize anxiety. The symptoms can range from mild to severe and the obsessions and compulsions can be limited or inclusive of multiple themes. Obsessions can include dirt and contamination, sexual themes, religious themes, illogical obsessions, fear of causing harm to oneself or to another person or animal, superstitious thinking, and health anxiety. Sensorimotor OCD focuses on bodily sensations such as the worry that one may stop breathing in their sleep or that, if they start to sneeze, they may not be able to stop.

Ritualistic behaviors may include obsessive cleaning; repeatedly checking that doors are locked or ovens are turned off; counting; an overwhelming need to make lists; adhering to a specific sequence of tasks a specific number of times, and more. These ritualistic behaviors are often performed to avoid perceived harm and the fear of negative consequences (superstitious thinking). OCD is often referred to as the “doubting disease”. Even though the individual has taken an action such as locking the door, they may doubt that it was completed or fear that the door was not actually locked. Obsessive- Compulsive Disorder is often accompanied by depression. Similar to Generalized Anxiety Disorder (GAD), it is frequently misdiagnosed and even confused with GAD. Engaging in these obsessions and compulsions for at least an hour every day, or if they significantly impair social or occupational functioning, may indicate the presence of OCD. Obsessive- Compulsive Disorder should not be confused with OCD spectrum disorders or Obsessive Compulsive Personality Disorder which is characterized by rigid behaviors. Compulsive nail biting, skin picking, hair pulling, Olfactory Reference Syndrome (fear of giving off a bad odor), and Body Dysmorphic Disorder (irrational perception and preoccupation with physical appearance), are examples of OCD spectrum disorders which may occur independently of OCD.

Primary Obsessional Disorder

This disorder consists of intrusive thoughts that may accompany OCD but can occur exclusively. These thoughts may include a fear of harming oneself or others, a fear of acting on a sexual impulse toward a child or a pet, a fear of blurting something inappropriate in the presence of others, or fear of acting out homosexual behavior when the individual is not gay or lesbian. The thoughts may be attended by images and even physical urges and, the more one tries to stop them, the more convincing the worry of acting out these behaviors becomes. These represent only a small example of the various manifestations of intrusive thoughts. They can cause severe distress and clients are often frightened to disclose their symptoms to therapists, particularly in cases such as OCD fear of harming, out of concern that they may be reported to law enforcement. The fear of harming is referred to as “the silent epidemic” for this reason.

Illness Anxiety Disorder

Illness Anxiety Disorder (also known as Health Anxiety and formally referred to as Hypochondriasis.)

This is classified as a somatoform disorder although it is commonly associated with OCD , Panic Disorder and GAD. It is characterized by chronic worry about one’s health. This condition may occur as a result of an individual experiencing a history of chronic illness and, therefore, becoming hypervigilant that they may become ill again. It may also develop as one of the symptoms associated with an anxiety disorder or on its own. Individuals suffering from Illness Anxiety Disorder will fall into one of two categories: either care avoidant or care seeking. They are often misunderstood by their physicians and family members who believe that they want attention for being ill. This is because they seek reassurance that they are not ill. There is a rise in health anxiety because many baby boomers are now at an age where they may be developing symptoms and feel vulnerable that they will be diagnosed with a serious disease or chronic illness.

Emotophobia

Emetophoia is a fear of vomiting. It often presents as a related disorder or part of OCD. The individual is triggered into feeling nauseous and anxious by various circumstances or images of others becoming sick. They will usually avoid being exposed to situations or individuals they fear are more likely to vomit in their presence. This may include small children; being in an environment where people are consuming alcohol; being on a boat where people might experience motion sickness; and being in an environment where they fear they may hear the sound of vomiting or be exposed to the smell associated with it. Even if a family member is sick, a person suffering from Emetophobia may find it very difficult to care for that person because the anxiety is acute. There is often a fear that they will vomit in the presence of others and, if they are predisposed to social anxiety, this will exacerbate the disorder.

OCD Perfectionism

OCD perfectionism may exist in the context of OCD or exclusively. Symptoms include unrealistic expectations of oneself and, oftentimes, unrealistic expectations of others. There is an inherent fear of making a wrong decision and individuals with perfectionism may have difficulty making decisions resulting in procrastination and/or develop an over-dependency on the opinions and reassurance of others. This can have a significant effect on work performance and interpersonal relationships. OCD perfectionism may result in Social Anxiety Disorder, eating disorders, Body Dysmorphic Disorder, and a belief that there is a right and wrong way to do things. Subsequently, the individual suffering from OCD perfectionism can often be controlling with specific and significant others or children. In teenagers, there has been a rise in perfectionism which may be associated with greater pressures for academic and scholastic performance in pursuit of scholarships. No matter how hard an individual works to achieve competency, there is always a sense that it is not good enough and depression can often accompany the perfectionism.

Featured Article

15 Aug. 2018

Treatment for Health Anxiety (also known as Illness Anxiety Disorder)

For most people, experiencing a headache is uncomfortable but not anxiety producing. However, when an individual suffers from health anxiety, previously known as “hypochondriasis,” a headache can trigger panic. An assumption may be made that the cause of the headache is a life threatening disease or condition such as an aneurysm or brain tumor. The individual may visit her/his