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7860 Mission Center Ct, Suite 209
San Diego, CA, 92108


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: chronic illness


Jill Stoddard

by Annabelle Parr

Whether or not you struggle with an anxiety disorder, we have all found ourselves overwhelmed by stress or anxiety at some point.  We each have slightly different stressors that trigger our body’s natural stress response, but we all know what the response feels like: sweaty palms, racing heart, tense muscles.  This bodily reaction can feel overwhelming, as if it controls us.  It is easy to feel powerless to our biological response to stress, but we have more control than we think.


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Before we deem our biological reaction to stress bad, let’s talk about what happens and what purpose it serves.  When we get stressed out or anxious, our body begins preparing us to face threat.  Stress activates our sympathetic nervous system, triggering the fight-flight-or-freeze response.  This causes the sweaty palms, racing heart, panicky breathing and muscle tension (McGonigal, 2013).  We often look at the stress response as inherently bad, because it is not healthy to be in the fight-flight-or-freeze mode chronically (McGonigal, 2013).  However, it’s important to remember that when your heart starts racing or your palms get sweaty, your body is just trying to help prepare you.  Nevertheless, these sensations can feel overwhelming, and perpetuate our experience of anxiety.  So how can we calm ourselves down once this cycle is in motion?


Using our breath, we actually have the power to activate our parasympathetic nervous system.  The parasympathetic nervous system allows our body to “rest and digest” as opposed to the sympathetic nervous system’s fight or flight response (Hunt, 2016).  While “take a deep breath” is common advice, how we actually take that breath is important.  This is how to use the breath to calm down:

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  1. Find a comfortable, relaxed seated position with your feet planted on the ground; alternatively, you can try breathing laying down.  Now begin to bring your focus to your breath.
  2. With each breath, your belly should rise as you inhale and fall as you exhale
  3. Your shoulders and chest should remain still.  If you notice your shoulders rise, or your chest move, drop the breath down to the belly.  Breathing into your chest is reminiscent of hyperventilating, which will only further activate your sympathetic nervous system (Hunt, 2016).
  4. Now focus on breathing into your belly for four counts.  Hold your breath for a second or two.  Now exhale for five counts and relax (Hunt, 2016).  Repeat this process, focusing on your inhalations and exhalations, and making your belly rise and fall.
  5. You may notice that your heart rate speeds up at first.  Don’t panic or give up.  Your body is not used to calming itself down, and is simply adjusting.  After a few cycles of inhaling and exhaling, you should notice your heart rate begin to relax. 
  6. If you begin to get distracted or thoughts pop into your mind, simply notice they are there and then come back to focus on the breath
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See if you can practice doing four or five deep belly breaths a day.  Then see if you can work your way up to thirty seconds at a time.  Then maybe a minute.  Eventually, you will be able to sit in this space with your breath for a long period of time.

Being able to tap into your breath to find a calm, centered space, no matter where you are, is an invaluable resource.  This diaphragmatic breathing essentially turns off your sympathetic nervous system and turns on your parasympathetic nervous system (Hunt, 2016). 

This is not to say that you will never feel stressed again, or that you will never experience the fight-flight-or-freeze response.  But using deep belly breathing can help you to calm your body down and lessen the biological reaction to a stressful situation.


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


Hunt, M. G. (2016). Reclaim your life from IBS: A scientifically proven plan for relief without restrictive diets. Toronto, ON: Sterling Publishing Co., Inc.

McGonigal, K. (2013, June). Kelly McGonigal: How to make stress your friend [Video File].  Retrieved from:

Breast Cancer Awareness Month: Mindfulness & Cancer

Jill Stoddard

October is Breast Cancer Awareness Month

Written by Lauren Helm, M.A., B.C.B.


Cancer is incredibly common, and often leads to many difficult and frightening life changes. Studies have found that moderate to severe psychological distress occurs in 35-45% of all cancer patients (Carlson et al., 2004; Spiegel, 1996; Zabora, BrintzenhofeSzoc, Curbow, Hooker, & Piantadosi, 2001). Cancer is the most distressing diagnosis regardless of prognosis (Tacon & McComb, 2009), and anxiety can last even after treatment has been completed. Research has identified that cancer may lead to distress because of multiple factors, including the anticipation of suffering, and difficult treatment regimens (such as surgery, radiotherapy, chemotherapy, or hormone therapy). Some individuals experience great difficulty in coping with the life changes that cancer can bring about; in particular, the potential uncertainty and uncontrollability of illness is often formidable and distressing (Carlson, Ursuliak, Goodey, Angen, & Speca, 2001).  Additionally, when an individual is diagnosed with cancer, her quality of life may be profoundly impacted, and she may experience increases in stress, anxiety, depression, pain, fatigue, sleep problems, and nausea. The impact on one’s quality of life is not always easily “cured” by traditional Western medicine approaches. This is why some individuals with cancer also pursue supportive and complementary therapies, along with conventional medicine.




Some examples of supportive and complementary therapies for cancer patients include: support groups, interpersonal therapy, acupuncture, meditation, yoga, Tai Chi, hypnosis, massage, relaxation training, and mindfulness. When these therapies are used in conjunction with conventional medicine, studies have found that they may reduce stress, anxiety, depression, improve indicators of immune functioning, strengthen spirituality/religion, and improve coping skills, among other possible benefits.


Mindfulness is a potentially powerful tool that has been found to have a beneficial impact on the quality of life of individuals who are diagnosed with cancer. Mindfulness has been defined in many ways, but may be thought of as a “particular way of paying attention,” or “moment to moment” awareness where one adopts a non-judgmental, compassionate attitude towards one’s experience of the present moment. A mindful stance can be practiced by learning to accept, instead of resist or react to one’s thoughts, emotions, and physical sensations as they arise. It is all about changing the relationship to one’s thoughts and emotions so that a sense of equanimity is eventually achieved, even in the face of pain or distress (read more about mindfulness here).


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Mindfulness has been embraced by patients and behavioral medicine practitioners alike (Baer, 2003; Bishop, 2002), in large part because of the positive physical and psychological changes that tend to result from the regular practice of mindfulness. A substantial body of empirical evidence supports the use of mindfulness with cancer patients (Carlson & Garland, 2005; Carlson, Speca, Patel, & Goodey, 2003; Carlson, Speca, Patel, & Goodey, 2004; Carlson et al., 2001; Speca, Carlson, Goodey, & Angen, 2000). Most of the literature supporting the use of mindfulness with cancer patients has examined Mindfulness Based Stress Reduction programs (a program developed by Dr. Jon-Kabat Zinn for those with chronic illness or pain that teaches patients how to practice mindfulness) since they are more frequently available in medical settings. Mindfulness has also been integrated into other psychological treatments , including Mindfulness-Based Cognitive Therapy (created by Zindel Segal, Mark Williams and John Teasdale to help prevent relapse for those with depression), Dialectical Behavior Therapy (created by Dr. Marsha Linehan in order to treat those with borderline personality disorder), and Acceptance and Commitment Therapy (developed by Dr. Steven Hayes and Dr. Kelly Wilson and is often used for those with anxiety – indeed, this evidence-based treatment is offered by therapists at CSAM!). Mindfulness is applicable for a wide range of problems.


Some of the benefits of mindfulness training may include:

  • Improved general quality of life (Ledesma & Kumano, 2008)
  • Improved markers of physical health (Ledesma & Kumano, 2008)
  • Reduced anxiety and depression for patients, partners, and survivors (Ledesma & Kumano, 2008; Lengacher, Johnson-Mallard, Post-White, Moscoso, Jacobsen, Klein, Widen, Fitzgerald, Shelton, Barta, Goodman, Cox & Kip, 2009)
  • Improved sleep (Carlson & Garland, 2005)
  • Increased feelings of control, openness, personal growth, and spirituality and reduced feelings of isolation (Mackenzie, Carlson, Munoz, & Speca, 2007)
  • Improved psychological health


Mackenzie, Carlson, Munoz, and Speca (2007) found that cancer patients who underwent mindfulness training through an MBSR program reported five major themes:

  • Opening to change: Changes in how they think about and cope w/cancer and treatment
  • Self-control:
    • An improved control of attention and behaviors, including a reduction of reactivity to stressors and learning when to take action vs. when to let go
    • An improved physical and mental self-regulation and self-discipline
    • Living better with cancer
  • Shared experience:
    • Social support and camaraderie (sharing and listening; development of close and unique relationships; sense of community)
    • Reduced feelings of isolation, especially with cancer diagnosis
    • Instillation of hope (surrounded by other cancer survivors)
    • Improved coping skills (group problem solving, discovery of solutions together)
    • Meditation practice was reinforced
  • Personal growth: 
    • Mindfulness provided comfort, meaning, and direction
    • Mindfulness increased willingness to learn from difficult life experiences, such as cancer
    • Shifting from negative to positive mindset; seeing cancer as a motivator to live a full life
    • “The way I look at cancer is that once you get through the awfulness it’s a very powerful motivator to live your life. I’m grateful I can come up here and be reminded of that.”
  • Spirituality:
    • Exploration of spirituality (though a common theme that arose during interviews with study participants, though MBSR is secular)


In sum, the benefits of mindfulness are many, and can be potentially useful for those who suffer from cancer. If you or a loved one needs additional help in coping with the distress that cancer can bring, it may be worthwhile to learn more about additional resources that are available. Check out some of the resources below, or contact a qualified professional.




Breast Cancer Resources

Create an early detection plan

Beyond the Shock

Anxiety and Breast Cancer

Tips on How to Combat Anxiety


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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