Anxiety: Exposure Therapy Helping Teens Combat Anxiety

By Hannah Pierce

Exposure therapy is a cognitive-behavioral therapy technique in which a person is exposed to a feared object or situation to overcome their anxiety. A majority of researchers and clinicians believe that exposure therapy is the most effective treatment for many anxiety disorders. One study even found that people improved more using this technique than taking antidepressants.

Although exposure therapy is proven to be very effective, it is not frequently used with teens. Many teens suffering with anxiety are prescribed medication rather than receiving therapy. It is difficult for people to consent to exposure therapy because they do not want to do something that will make them feel even more anxious.

One article documented teens’ experiences with exposure therapy. A 14-year-old suffering from social anxiety, depression, OCD, and binge-eating agreed to tackle his social anxiety through exposure therapy. On a busy college campus he sat on a bench next to a stranger and initiated a conversation. To some people this may seem simple but to a teen suffering from social anxiety, the task is very daunting. He sat on the bench and tried to talk to the stranger but the stranger just kept texting and playing with his phone. Although the exchange did not turn into a conversation, at least the teen faced his fear and realized it wasn’t that bad.

Another teen’s exposure involved him holding a sign that read “I’ve been bullied. Ask me.” Thomas hoped to combat his anxiety while also educating people on bullying. Most students on the campus walked by him without giving him a second glance. After a while, a couple stopped to talk to Thomas. The man empathized with him, sharing that he had been bullied as well and the woman applauded Thomas for his bravery.  After the exchange Thomas was very pleasantly surprised and realized he did not have much to be so anxious about.

If you or someone you know may be experiencing anxiety, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Please contact our Bergen County, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment, or visit for more information.

Source: “The Kids Who Can’t” by Benoit Denizet-Lewis


OCD: What It’s Really About

By Miranda Botti

Obsessive-Compulsive Disorder, or more commonly referred to as OCD, is a psychological disorder in which those afflicted experience recurring distressing, intrusive thoughts, images or impulses (obsessions) and attempt to remedy and alleviate such thoughts with repetitive actions (compulsions).  Such intrusive, repetitive thoughts are often constant worries about one’s health or the health of family members or loved ones, as well as fears about bad things happening to loved ones. Common compulsions include but are not limited to: repeatedly checking things, such as if an oven is off or if a door is locked, excessively cleaning oneself and/or handwashing, and compulsive counting. Many OCD patients are able to understand that their thoughts are irrational and unlikely to be remedied by their compulsive actions but continue to struggle to control their obsessions. Most people are typically diagnosed with OCD in their late teens to early 20’s, although onset at any age is possible.

The knowledge of the causes of Obsessive-Compulsive Disorder is still yet to be discovered however, risk factors include: genetics, brain structure and functioning, and/or the environment. Treatments include medications that act to inhibit the reuptake of the neurotransmitter called serotonin (SRI’s and SSRI’s), as well as the less frequently prescribed antipsychotic medication; psychotherapy such as cognitive behavioral therapy (CBT); the approach of a combination of medication and psychotherapy. Research for treatment of OCD is up and running and clinical trials look to determine the effectiveness and safety of new treatments in order to help individuals in the future.


If you or someone you know is suffering from OCD, contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit


Information taken from:

What exactly is a “Panic Attack”?

by Sarah Moore

Panic Attacks: What are they?

We’ve all heard of panic attacks before, on television, in the movies and even in day-to-day conversation. In today’s age, people tend to use the term lightly, as an expression of a reaction to a stressful event or fearful encounter. One might say, “When I heard that the company was planning to downsize next year, I just about had a panic attack”. But to use the term this way does not describe what a panic attack truly is: a sudden, unexpected feeling of overwhelming and disabling anxiety, often with no premeditating cause.

So what exactly does a panic attack involve? The DSM-5 defines a panic attack as involving four (4) or more of the following symptoms:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • A feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Feelings of unreality (derealization) or being detached from oneself (depersonalization)
  • Fear of losing control or going crazy
  • Fear of dying
  • Numbness or tingling sensations
  • Chills or hot flushes

While it’s true that anyone can experience a panic attack, they are most commonly associated with Generalized Anxiety Disorder, Post-Traumatic Stress Disorder or Specific Phobias. Does this mean someone who experiences a panic attack has one of these conditions? Not necessarily. The DSM-V defines the diagnostic criteria for Panic disorder as suffering from frequent, often unexpected panic attacks. In addition, at least one attack must be followed by the fear that more attacks will occur, causing an individual to change his or her behavior in order to avoid triggering such attacks. It is important to note that other possible causes for panic attacks, such as side effects from drugs or medications must be ruled out before someone can be diagnosed with any of the above disorders. Panic attacks can be debilitating, but with the right treatment, recovery is possible.

If you believe that you or a loved one has or may be suffering from panic attacks, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Please contact our Bergen County, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment, or visit for more information.

Snapchat Culture

By: Emily Mulhaul

Lights flashing, music blasting, society Snapchatting.

Unbeknownst to many, an external appearance doesn’t always match up with an internal experience. To further explain, just because on the outside someone seems they are having fun, does not always mean internally they are having fun. This knowledge can act as a relaxant to combat the initial jealousy of binge watching other’s Snapchat stories; However, if you find yourself “doing it for the Snapchat” (we all have) and are sensing incongruity with the way you appear on Snapchat and feel in reality, it may be time to look inside yourself. If “the struggle is becoming too real” and you’re at the point where you want to feel the way you appear on Snapchat, or experience the perceived feelings of other’s but have absolutely no idea where to start, talking it through with a licensed professional could guide you towards genuinely feeling these positive emotions.

The experienced psychiatrists, psychologists, psychiatric nurse practitioners, social workers, and psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.




Anxiety, Depression, Isolation

By: Emily Mulhaul

Are you struggling to maintain relationships with a family member, friend or significant other? Does the idea of being connected to or trusting another person make you anxious or scared? Did something in your past cause you to have this reaction to others? Sometimes we find it easier to avoid a situation, opposed to acting upon a situation. After running a half marathon, I can attest that the effort and maintenance necessary for a meaningful relationship, is just that of training for a half marathon. Depending on your personality, the previous statement could have been viewed rewardingly because you compare the euphoric feeling of crossing the finish line of the half marathon to that of laughter with friends on a Saturday. The alternative reaction could have been that neither relationships nor half marathons are worth the effort, so you proceed with simply going through the motions of your work or school day, followed by isolating yourself in front of the TV at night. If the second scenario reminds you of yourself or someone you know, the avoidant behavior may potentially be a catalyst for anxiety and depression. People do not want to be alone all the time, but they may lack the motivation to continue otherwise due to an experience with a past relationship, lack of confidence, etc. As opposed to avoiding relationships, at Arista Counseling and Psychotherapy we want you or a loved one to avoid anxiety, depression, and isolation.

If you or a loved one are struggling with anxiety, depression, or isolation and are experiencing difficulty with the following:

Presence (both mentally and physically; may be feeling lethargic)

Maintaining or seeking relationships

Sleep (insomnia)


Daily Energy

The psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.

Trauma Turned Positive

How My Most Traumatic Experience Became My Most Humbling

By: Emily Mulhaul

When you go through a traumatic experience, the time it takes to recover is immeasurable and flooded with uncertainty. Overtime, everything around you begins to fade and you find yourself zoning in on your bedroom wall, for a leave of absence from reality. The previous night was spent in a pillow soaked with tears and the following night is expected to be the same. You are alone because you feel as though are burdening others with your pain, and now are trying to reassemble yourself on your own. You’re trying but right now you are physically and mentally exhausted. A couple of days pass by and maybe you’ve gotten up for something to eat or to take a shower, but in the end you always find your way right back to your bedroom. What you may be feeling now is numbness, opposed to the pain you initially felt.

Remember the pain that wasn’t ever going to go away? Although feelings inconveniently come and go as they please, they are only temporary. Happiness is not forever, but neither is pain and sadness. In the moment though, forever is exactly what it feels like.

Now that the initial, emotional pain has subsided you are left to feel nothing. Nothingness provides you with opportunity. This is the time to rewrite your story. The numb feeling is a blank slate and a new beginning; let’s celebrate this new beginning with an empty journal. It may be interesting to begin by writing where this emotional journey has taken you and where you would like to go. Write what you learned about life, about yourself, and about your emotions. You can even describe in detail the undeniable comfort your quilted blanket has provided you with throughout this emotional journey.

We’d love to help you rewrite your story and make this your most humbling experience.

The experienced psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.



Breakups: High School Sweetheart not so Sweet

By: Emily Mulhaul

To all of the silent sufferers out there who feel as though they are being dramatic for grieving a loss of a relationship for over a year now, you are not alone and you are not dramatic. Breakups can take an emotional toll on us that sometimes prolong for a year or more. Often times, our past experiences shape our present situation, meaning the termination of one relationship may affect our future relationships. Not only may it shape our present relationships with others, but it shapes relationships with oneself as well. Breakups may deprive us of the self confidence and hope we once had because it seemed to have vanished alongside the memory of the relationship.

Whether your break up is affecting your relationship with others or your relationship with yourself, experienced psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.


Post Traumatic Stress Disorder (PTSD): Making Sense of the Present

By: Emily Mulhaul

As an outsider, sometimes it’s difficult to understand what Post Traumatic Stress Disorder is and who gets to experience it and who doesn’t. To put simply, although we take in life’s moments with others around us, the emotional process is an individual experience, therefore anyone and everyone can at some point in their life experience Post Traumatic Stress Disorder even if others around them are not experiencing it. The variation in emotional experiences is so fascinating that it is the primary interest of social psychologists who study the way we process, store, and apply information to diverse situations. That being said, multiple individuals can be in the same place, at the same time, identifying the same series of events, but will interpret the situation completely differently. Individual interpretations may fall anywhere under the seven universal facial emotions noted by the American Psychological Association (APA): disgust, anger, fear, joy, happiness, surprise, and contempt. Diversity in emotional reactions to situations is normal, but there are times where it becomes an area of concern. For example, imagine it’s around the fourth of July, you’re at the beach and unexpectedly fireworks commence. One individual (twelve year old) may express the utmost joy, surprise, happiness or some combination of the three, whilst another individual (war veteran) darts to hide behind a bush in a trembling state, fearing for his life. The discrepancy between the reactions of these two individuals, the twelve year old kid and the war veteran, are not reactions one must brush off as varying personalities. Due to the war veteran’s time spent at war, he may be experiencing Post Traumatic Stress Disorder (PTSD), defined by the American Psychological Association (APA) as an anxiety problem that develops in some people after extremely traumatic events. His reaction (anxiety) may have been triggered by an association of the loud bang of the fireworks with that of a loud bang of a gunshot (traumatic event) he heard in the past.

Although the presence of PTSD in war veterans is the most commonly talked about, it is one form of PTSD, not the only. Other instances that have concluded with the diagnosis of PTSD include individuals who have experienced sexual assault, domestic violence, car accidents, crime, natural disasters, bullying, breakups, loss of a loved one, etc. Considering the following experiences do not necessarily mean that PTSD will be present, the APA highlights some recognizable signs in either yourself or others who may be at risk or experiencing PTSD: “reliving the event via intrusive memories, flashbacks, and nightmares; avoid anything that reminds them of the trauma; and have anxious feelings they didn’t have before.” If these signs sound familiar, it is to the benefit of the individual to seek therapy with a licensed professional because there is hope to diminish negative emotions for a resurgence of positive emotions!

If you or a loved one is experiencing signs of Post Traumatic Stress Disorder (PTSD), experienced psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.


PTSD: Post Traumatic Stress Disorder

By Anna Straus

What is PTSD and why does it occur? Two people may experience the same event, such as a car accident. One person is shaken up but recovers in a day or two; the other is consistently plagued with anxiety and stress at even the thought of getting in a car. Psychology supposes that something in the brain can get ‘stuck’ when a person processes a traumatic event.

PTSD is characterized by high levels of distress, insomnia, difficulty concentrating, flashbacks and bad dreams. As a result people may avoid anything that slightly reminds them of the traumatic event, become emotionally numb or depressed and withdraw from otherwise enjoyed activities.

People at high risk for PTSD are people who are likely victims or witnesses of traumatic scenes: war veterans and domestic violence victims being among the most prone, although people with otherwise happy lives can also experience PTSD. The type or nature of traumatic event does not necessarily determine whether someone will get PTSD, rather, PTSD happens because of a person’s way of reacting to and attempts to ‘get over’ the event.

When left untreated the symptoms of PTSD can cause a multitude of secondary psychological and behavioral symptoms. People may turn to drugs or alcohol to self-medicate their PTSD symptoms. They may experience severe depression because of the negative impact that their PTSD stress has on all other aspects of their life.

A variety of treatments have been shown to improve PTSD symptoms. The efficacy of the treatments depending on multiple factors. Some research shows that a chemical imbalance occurs in PTSD patients, and medication appears to stabilize this. Cognitive Behavioral Therapy and Exposure Therapies also show promising results. These therapies help a patient confront their traumatic experience in a safe setting and reprocess it in a more effective way.

If you believe that you or a loved one has PTSD, the psychiatrists, psychologists, psychiatric nurse practitioners and psychotherapists at Arista Counseling can help you. Contact our Bergen County, NJ or Manhattan offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment.



Relationships: Abusive Relationships: Why We Repeat the Past

“Why didn’t you just walk away?” “How could you let this happen to yourself again?” These questions are not uncommon for survivors of domestic abuse to hear. When a person has numerous maladaptive relationships, it leaves them and others baffled. Why on earth would someone put themselves in an abusive situation again? The answer to this lies in a psychological phenomenon called “repetition compulsion.” In repetition compulsion, a person either puts themselves into a situation where abuse is likely to happen again, or they reenact the past situation with another partner. Below are some theorized reasons why people repeat the past in their relationships.

  1. Change can be a scary or anxiety-provoking thing. Most of us stick to what we know, even if it means regularly dating partners who are physically and/or emotionally abusive.
  2. Some think that by putting themselves in the same situation, they can change the outcome this time. They think that they will be able to master this relationship, and this will make up for the last bad one.
  3. We might believe that if we act in just the right way, our partner’s behavior will change and they will treat us right.
  4. We begin to internalize the beliefs that we are unlovable and deserve to be mistreated.
  5.  Unconsciously or consciously, we seek out abuse from others due to conditioning.
  6. “Winning” an argument with an abusive partner may lead us to believe that we are able to do this again and the abuse will stop.

Despite how terrible the situation may be, know that you are not alone, there is help available, and there are resources to begin the healing process.

The psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling can help you. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.

Visit for more information.

Further reading: “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” by Bessel van der Kolk, M.D.

Source: Esposito, Linda. “Why Do We Repeat the Past in Our Relationships?” Psychology Today. Sussex Pulishers, 22 Mar. 2016. Web. 07 Apr. 2016

By: Scout H