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At The Center for Stress and Anxiety Management, our psychologists have years of experience. Unlike many other providers, our clinicians truly specialize in the diagnosis and treatment of anxiety and related problems. Our mission is to apply only the most effective short-term psychological treatments supported by extensive scientific research. We are located in Rancho Bernardo, Carlsbad, and Mission Valley.

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Read our award-winning blogs for useful information and tips about anxiety, stress, and related disorders.


Filtering by Tag: act

My Horcrux Diary

Jill Stoddard

guest blog post by Dr. Nic Hooper

Have you read the quote below by T.E. Lawrence?

"All men dream: but not equally. Those who dream by night in the dusty recesses of their minds wake up in the day to find it was vanity, but the dreamers of the day are dangerous men, for they may act their dreams with open eyes, to make it possible.”  


I’m a dreamer. Always have been. Ever since I could remember, I wanted to do remarkable things that would make the world a better place. Over the years, I’ve had lots of ideas for how to do this but often I would ‘wake up in the day to find it was vanity’. In other words, the ideas remained just that; ideas. On a recent project, I became a ‘dreamer of the day’.

I research an approach to human suffering named Acceptance and Commitment Therapy (ACT). The pitch of ACT goes something like this: if we can be willing to experience all of our thoughts and feelings, both positive and negative, whilst continuing to move in valued directions, then we will do a decent job at this game of life. One night, after delivering an ACT intervention to teachers, I had this thought: “It is really easy to forget our values; I need to create something that will remind people of what is important to them.” In the following weeks I came up with the idea of an annual diary. For the most part, this diary would be like any other diary i.e. it would have days and dates and spaces to record meetings. However, it would also provide an opportunity for the user to record what is important to them at the beginning of each week.


Ok, so there was the idea. Now I had to do something with it. The first step was easy; I loaded Microsoft Word and spent hours and hours and hours (with my co-author Dr. Freddy Jackson Brown) shaping the words and lines that would make up the inside of the diary. The second step was more difficult. I had to figure out how to take that file and turn it into a product. First question: a publisher or a printing house? No publisher was interested so we went with a printing house. Then, more questions. What sort of spine to go for? How thick should the paper be? How many copies should we buy? How should we sell it? What are the best postage and packaging options? How should we advertise it? How should we accept payment for it? How do we pay tax? Who is going to post them? How should we grow the product over time?

During the first and second steps I faced a fair bit of discomfort (i.e. seemingly powerful negative thoughts often crossed my mind: “this is a waste of time”, “nobody will like it” or “you should be spending this time with Max”). However, the third step of making my idea a reality brought the most discomfort: once I had the completed product, I sent it out there into the scary world. And given that success or failure has implications for how I feel about myself, my diary is a bit like a Horcrux in the Harry Potter story. In that story, the bad guy (Voldemort) poured his soul into a number of items and placed them out there in the world. Those items were called ‘Horcruxes’. His thinking was that this strategy would make him more difficult to kill.

Like Voldemort, I poured my soul into this Horcrux. And like Voldemort, any attack on the Horcrux feels like it kills a part of my soul (‘attack’ is an extreme word that is possibly misplaced here. By ‘attack’, what I mean is any evidence I see that the diary is not worthy, whether it be a lack of sales, little interest on social media or negative feedback). My Horcrux diary is now out there in the world fending not just for itself but, in some ways, for me also. A bit of my soul is unprotected; it can be scrutinized, criticized or ignored. It can fail. And if it fails then it will hurt like hell.

The feeling of vulnerability that comes with trying to do something remarkable is tiring, and it often makes me question whether it would have been better to stay a ‘dreamer of the night’. If my Horcrux is inside my mind then nobody can see it; nobody can hurt me. However, every time I think about this I come to the same conclusion. Although being a ‘dreamer of the night’ comes with built-in safety, if I didn’t do something with my dreams then I’d be living a life out of step with my value of making the world a better place, and consequently, I’d feel empty.


Why am I telling you all this? For two reasons. Firstly, I want you to see how ACT is in my blood. Just in this blog you will spot how I used important ACT processes (willingness, defusion, self-as-context, values). Secondly, and more importantly, I want you to see that having ACT in my blood helped me to chase my dreams, and that it can help you to do the same. Chasing dreams will bring vulnerability but if you know what to do with vulnerability then you will be free.

Interested in checking out Dr. Hooper’s Annual Diary for Valued Action? Check it out here.


If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, stress, PTSD, insomnia, or chronic illness, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at

Anxiety in Children

Jill Stoddard


Have you noticed that your child seems to be experiencing a significant amount of anxiety? Learn more about the anxiety disorders that can develop at a young age and the support that is available. If you would like to seek the help of a professional, contact us to schedule an appointment with our child anxiety specialist now.


Childhood Anxiety Disorders


Generalized Anxiety Disorder

Learn more about GAD.

Things to look out for:

·      Excessive worry about a variety of things in your child’s life

·      Perfectionism and self-criticism

·      Constant need for approval or reassurance


Obsessive-Compulsive Disorder (OCD)

Learn more about OCD.

Things to look out for:

·      Obsessions: Experiencing unwanted and intrusive thoughts

·      Compulsions: Repeatedly perform rituals and/or routines in order to ward off anxious feelings


Panic Disorder

Learn more about panic disorder and panic attacks.

Things to look out for:

·      Panic/anxiety attacks that come on for no reason or out of the blue

·      If your child is concerned about or afraid of having another panic attack in the future


Posttraumatic Stress Disorder (PTSD)

Learn more about PTSD.

Things to look out for:

·      Experiencing or witnessing a traumatic or life-threatening event

·      Intense fear/anxiety

·      Emotional numbness

·      Easily irritable

·      Avoidance of places, people or activities



Separation Anxiety Disorder

Learn more about separation anxiety disorder here.

Things to look out for:

·      Your child is slightly older (common in ages seven to nine)

·      Unable to be separated from loved ones or takes significantly longer to calm down compared to other children

·      Experiences extreme homesickness/misery at being separated from loved ones


Social Anxiety Disorder

Learn more about social anxiety disorder.

Things to look out for:

·      Intense fear or anxiety related to social interactions

·      Anxiety about performance and activities

·      Extreme shyness or inhibition

·      Difficulty making new friends or speaking with peers


Selective Mutism

Visit online: Selective Mutism Group

Things to look out for:

·      Refusing to speak in situations that make your child anxious

·      Standing motionless/expressionless

·      Avoiding eye contact, chewing/twirling hair, turning heads


Specific Phobias

Learn more about phobias.

Things to look out for:

·      Intense irrational fear of a specific object or situation (such as animals, storms, blood, needles, medical procedures, etc.)



Treatments Offered at CSAM


Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is an empirically supported treatment that focuses on modifying problematic thoughts & behaviors that contribute to & maintain emotional problems like anxiety, stress, & depression. Like traditional forms of therapy, CBT emphasizes a warm, safe, & empathic therapeutic environment. CBT is different from some approaches in that it focuses on present-day problems & learning skills to overcome symptoms. It teaches children to identify thoughts & behaviors that are keeping your child stuck, so your child may develop more adaptive ways for navigating life.


Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy is an empirically supported treatment that focuses on reducing experiential avoidance and accepting internal experiences (thoughts and feelings) in the service of living a valued, vital, meaningful existence.  Mindfulness, metaphors, and experiential exercises play a central role in ACT.



Biofeedback is an empirically supported treatment that focuses on balancing the nervous system. Biofeedback is shown to be extremely effective at helping patients reduce anxiety and stress, lower blood pressure, reduce chronic pain (including migraines), increase focus and attention, and reduce hyper-vigilance commonly experienced after trauma.


How Can I Respond to My Child?


ADAA provides the following suggestions in their article “Tips for Parents and Caregivers”



Here are things you can do at home to help your child manage his or her anxiety disorder:


Pay attention to your child’s feelings.

Stay calm when your child becomes anxious about a situation or event.

Recognize and praise small accomplishments.

Don’t punish mistakes or lack of progress.

Be flexible and try to maintain a normal routine.

Modify expectations during stressful periods.

Plan for transitions (For example, allow extra time in the morning if getting to school is difficult).

Keep in mind that your child’s anxiety disorder diagnosis is not a sign of poor parenting. It may add stress to family life, however. It is helpful to build a support network of relatives and friends


The Anxiety and Depression Association of America, ADAA


Are you interested in scheduling an appointment with our child specialist? If you'd like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety, please click here.

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Setting Intentions for the New Year & Using ACT to Guide the Way

Jill Stoddard

Written by Lauren Helm, M.A.


Setting Intentions for the New Year & Using ACT to Guide the Way



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As you set out into the new year, you may have already identified and begun practicing taking steps towards your New Year’s resolutions. The road towards various forms of transformation or self-betterment can often be long and arduous, and you may face challenging moments as well as rewarding ones. In order to set yourself up for success, consider learning about and applying some of these tips based on an interpretation of Acceptance and Commitment Therapy (ACT) principles. Hopefully, this will help you to continue to evolve in the direction of your choosing this year!

Set intentions that are rooted in your values

Make sure to give yourself enough time to adequately reflect on what is truly important to you. Too often, we may choose to “better” ourselves in ways that may be important to others, but not ourselves. This is a great time to discover your authentic, deeply held desires for yourself, if you have not already done so. What we value speaks to who we want to be in this life, and what gives our lives the greatest sense of richness and meaning. Our values can range various domains, including health, family, friendships, career, spirituality, etc. Clarify for yourself WHY you have selected a certain New Year’s resolution, and determine if it is truly aligned with your authentic values. When we set an intention to fulfill a values-driven goal, we are more likely to be intrinsically motivated to achieve it than if the goal we have set is solely reliant upon the approval of others (or any other reason we think that we “should” be doing something).

Create a SMART values-guided plan of action

Once you’ve selected your New Year’s resolutions or intentions, set yourself up for success by creating an action plan. Dr. Russ Harris created a worksheet that is geared towards helping individuals create a specific plan that is based in their values. You can find the SMART goal worksheet here. SMART stands for specific, meaningful, adaptive, realistic, and time-bound. In other words, you may select a New Year’s resolution that is specific (define exactly what it is that you hope to achieve, and the specific steps that you believe may need to be carried out in order to get there), meaningful (make sure that the resolution is based on something you genuinely care about), adaptive (is setting this goal truly supportive for you and will it improve your life?), and time-bound (be specific and identify the times and dates that you plan to complete certain steps that move you closer to your goal). These are guidelines (not rules) that may support you in successfully working towards your resolutions throughout the year.

Make contact with the present moment

Practice mindfulness of both pleasant and unpleasant aspects of what you are working towards (the FULL experience of the moment), instead of struggling or resisting the discomfort that you may encounter (say, if you were working towards living healthfully by exercising, you may practice mindfulness of the sensations experienced during exercise). Our experience of working towards our desired goal may be dramatically shifted by whether we adopt a mindful, open attitude, or a judgmental, resistant attitude. Excessively trying to “omit” the uncomfortable aspects of your journey will be unlikely to work, can waste your time and energy, and possibly sour your chances to stretch yourself or rise beyond what you may have previously believed you could not do.

Check in with yourself as the year progresses. Adopt a nonjudgmental, objective viewpoint as you observe whether your current actions are in alignment with your original resolutions or intentions. Allow this information to inform any modifications that may be made to the SMART plan that you created. Have you learned that certain strategies help you keep on track, and others don’t? Does just the action-plan need to be revised, or have your priorities shifted over time, and thus your original intentions need to be re-committed to or revised?

Be flexible

We are ever-evolving human beings in an ever-changing world. We cannot always predict or control what will happen in the future. Even if you have created a plan using the SMART guidelines, planning for your future can either work for you or against you, depending on how you relate to your plan. When we hold too tightly or rigidly to an idea of how “things are supposed to go,” the plan begins to unravel us, instead of supporting us. Be honest with yourself when this happens (without judging yourself), and practice flexibility.

Practice acceptance AND commitment

When we feel blocked or unable to achieve the outcome we desire, there may be suffering. Given that unexpected life events may happen that interfere with the plan you have in place to reach your goals, loosening our fixation or attachment to only one way of achieving your values-based resolutions may be helpful. ACT suggests that we can have lives full of meaning, even when we are thrown off course or encounter pain or difficulty. The key is committing to your values, and letting them guide you as you reset your course as needed. Just because you do not achieve a specific outcome (or goal) in a specific way does not mean that you aren’t able to live a valued, meaningful life. We can live in alignment with our values in so many different ways in different situations. Though it can be tough to not obtain a specific outcome that we hoped for, with a flexible, accepting attitude, we can discover another way to embody our values. We may often find that it can be equally as satisfying, even if it doesn’t look like we originally had imagined it.

From the team at CSAM, we hope you have a Happy New Year!

If you'd like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety, please click here.

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SMART goal worksheet:

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.