Anxiety Disorders Association of Victoria, Inc.

Online Store

Dr Sallee McLaren - Registered Psychologist

Clinical Psychologist and author Specialist in Anxiety Disorders Registered Nurse Author of self help book: " Don't Panic you can overcome anxiety without drugs"

100 Leicester Street
Fitzroy. 3065.
Phone: 9416-1621

Areas of Specialisation

For many years I have specialised in recovery from anxiety and stress-related problems. I have extensive experience in panic disorder, agoraphobia, OCD, generalised anxiety, social anxiety, hypochondriasis and phobias. Much of my work also involves resolving problems often associated with anxiety such as substance overuse (alcohol, drugs, cigarettes), gambling, depression and relationship difficulties. I am the author of the self help book entitled Recover From Anxiety - Without Drugs.

Style of Therapy

My approach draws from many relevant sources, including cognitive-behavioural therapy (CBT) and Rational Emotive Therapy (RET), Acceptance and Commitment Therapy (ACT) and Narrative Therapy. I also use techniques from psychodrama, meditation and yoga in teaching people to overcome their fears.

The therapy process usually involves a thorough assessment lasting two sessions, followed by a feedback session given by me about the cause of the problem, what is maintaining it, and how to correct the problem so that recovery can occur.

SPECIFIC FEATURES:

1. I have a clear preference for working with people without using medication, as my approach requires active mental engagement, alertness and curiosity.
2. My approach takes account of the whole person (physical, emotional, intellectual and social context). It involves a strong element of personal coaching with the aim of helping people to attain their personal best in all areas of their lives.
3. Although people often consult me after symptoms have arisen, my approach is nonetheless preventative in that it identifies likely future difficulties and aims to correct these prior to their occurrence.
4. Therapy is systematic, providing weekly tasks and goals within the framework of an overall timeline for recovery.

---

Almost always people come to see me after they have experienced some sort of distressing event. It might have been recently or it might have been many years ago and they have never really recovered. I cannot remember ever treating someone where this has not been the case. The event is not always a discrete event, nor is it necessarily an obvious event, as in cases of ongoing childhood criticism or insufficient love or care. At times, the distress may arise due to over-protection and the imposition onto a child of a world view about the 'dangers' to be encountered in the outside world, leading to restricted exploration of the world.

While the specific nature of these events vary, it seems they must somehow threaten the stability of a person's sense of self. While events may often be concerned with loss, I have observed that it is ultimately the threat to self (the consequences of the loss on the person) that seems to give rise to the psychological distress encountered in anxiety. Over the last couple of years I have conducted three large-scale studies into anxiety conditions. The preliminary results strongly suggest that people are more likely to develop psychological distress following uncontrollable life events.

It appears that when our brain detects a threat of sufficient magnitude a number of biochemical changes come into play. There is much evidence to suggest that corticotrophin releasing factor (CRF) is one of the main players in this response. CRF initiates the release of other hormonal responses within the body, such as the release of stress hormones like cortisol, as well as causing some brain changes consistent with increased mental agitation, hyper-arousal and fear. This reaction, applicable to a physiological threat, is being utilised in response to a psychological threat.

When we experience these types of threats to self we often feel profoundly destabilised for a period of time, finding ourselves ruminating, scared of almost everything, inclined to panic, unconfident, self-conscious, hyper-aroused, unable to sleep, and sometimes without appetite. These 'symptoms' as they are called, probably arise directly from the excessive release of CRF and other stress hormones. This stress response is a NORMAL response to a significantly threatening event.

Some people become overly afraid by these body and brain changes. This is probably not surprising since many of them can feel quite extreme. It also seems likely that some people become particularly afraid. It is not known why this might be the case, but it is possible that people who have had less security in their earlier years (probably on account of more threats to self) might feel more vulnerable.

When we feel particularly fearful it might seem reasonable to start to avoid the things that scare us. At these times simple things that are not usually particularly fear-provoking, like driving in the car, or going on the tram, or going to the movies, or meeting people, or going to work, or catching germs, can lead to strong feelings of fear. We may want to avoid these experiences. Sometimes we may not want to experience even our own thoughts as they have become frightening, so we try to push them away. We may be afraid of the 'feeling' of fear. Sometimes we might attach to substances, such as alcohol, in order to annihilate these thoughts and feelings. It is normal to want to avoid coming into contact with distressing events (like retracting your hand from a burning flame) and we have learnt to escape danger in order to survive.

The problem arises when we try to avoid events that are not objectively dangerous. In other words, avoidance when there is no real risk to our lives. CRF and other chemical changes that occur in our bodies and brains at times of threat, make us FEEL as though we are in a catastrophic situation, when really we are just catching the bus or going to the shops.

It is important NOT to avoid these now-fearful experiences. So long, as you do not avoid them you are likely to recover. If you ensure that you do not turn to alcohol or other 'numbing' substances, and ensure you do not avoid the things you fear (including thoughts and feelings) you will come through. Over the months, the chemical changes will generally resolve and you will gradually lose your fear and recover as normal. If, on the other hand, you avoid fearful experiences you can get into all sorts of trouble, prolonging and complicating your recovery for years.

Remember, distressing events happen to almost everyone at some stage in life. Accept the fears (they are just part of the chemical response to threat). The fears will go away so long as you do not avoid them. If you avoid them, they get worse. Find some help if you are struggling.