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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: psychologist in San Diego

Anxiety in the Courtroom

Jill Stoddard

Witness Preparation Services

by Annabelle Parr

Have you ever felt especially nervous before a big presentation? Do you find your heart racing and palms sweating when you have to speak in front of a large group of people? You’re not alone. On average, people rate their fear of public speaking higher than their fear of death. Potentially one of the highest pressure, highest stakes public speaking situations is on the witness stand in a courtroom or during a deposition. Even the most experienced witnesses can feel anxiety, which left unaddressed can hinder their testimony. Anxiety is the number one communication obstacle in legal proceedings (Pitera, 2013).

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Witnesses typically have very specific fears related to testifying. Some common witness fears include, but are not limited to, a fear of letting people down, losing their job, making a mistake, looking incompetent, being embarrassed, judged or blamed, or having to reveal private, personal information. Witnesses also tend to take on more responsibility for the outcome of the case than is necessary or realistic (Pitera, 2013).

Though the source of a witness’s anxiety may be completely unrelated to their credibility or honesty, jurors tend to judge witnesses more on the basis of behavior than testimonial content (Afremow, 2011). Therefore, a testimony could be flawless and completely true, but if it is delivered poorly the concrete verbal content may not matter.

Typical anxious behaviors that jurors tend to interpret as signs of unreliability include non-verbal cues such as poor eye contact, fidgeting, appearing tense, and inconsistency of demeanor or tone (Afremow, 2011). Helping witnesses to become conscious of these subtle reactions as well as the sources of their anxiety before testifying can help them to manage the visible cues thus increasing their perceived credibility.

Meeting with a licensed psychologist who specializes in anxiety management is a great way to help prepare witnesses and allow them to address their anxiety before taking the stand. Using cutting edge, evidence-based, cognitive-behavioral techniques, the therapist can help witnesses modify their anxiety, bringing it into an optimal range for peak performance.

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Therapeutic techniques that can help prepare witnesses include:

  • cognitive reappraisal, which involves changing catastrophic cognitions that fuel anxiety and lead to poor performance
  • grounding, mindfulness, and relaxation
  • reduction of safety seeking, avoidance, or anxiety driven behaviors such as lack of eye contact, speaking too softly, fidgeting, talking too much or too little, or looking to the attorney for reassurance
  • video-taped feedback, which can help reduce anxiety by showing the witness that they don’t look as anxious as they feel, as well as helping them to notice and address visible safety behaviors

A therapeutic setting offers a safe space to practice testifying and receive non-judgmental, constructive feedback and tools that the witness can apply in court and during depositions. If you or your client are preparing to stand as a witness, know that feeling anxiety is normal, but that it doesn’t have to determine the tone of the testimony.


If you or someone you know might benefit from witness preparation services for anxiety or stress, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at


Afremow, J. (2011). Witness this: Behavioral science in the courtroom. Psychology Today. Retrieved from

Pitera, M. J. (2013). Witness tip: Anxiety is the #1 barrier affecting communication. Litigation Insights. Retrieved from

Let’s Talk About Anxiety

Jill Stoddard

by Annabelle Parr

Anxiety is a hot topic these days. It’s all over the news, and apparently it is on the rise. In the age of information and technology, we are constantly bombarded with doom and gloom news alerts, including reminders that on top of everything else, we are plagued with increasing anxiety. Eventually, these reminders can get exhausting and may even contribute to the anxiety that is apparently so prevalent in the first place.

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Of course, there are benefits to all this conversation around anxiety: we have a better understanding of what anxiety is and as a result we may be able to understand and empathize with those who are struggling better. But it’s important to be careful that we don’t pathologize all anxiety, and that we don’t lose sight of the strength that exists in those who truly do have anxiety disorders.

Anxiety: Natural Response to Stress or Disorder?

The way we talk about anxiety today, it is easy to believe that all anxiety is inherently bad and forget that it’s our natural response to threat or danger. We actually need anxiety to survive; it prepares our body to respond appropriately in the face of danger. However, our physiological experience of anxiety developed back when the regular dangers humans faced included running from large, sharp toothed predators. So when we are experiencing the fight-or-flight response before a big exam or presentation, it may not feel particularly adaptive. But despite the discomfort that comes with anxiety, it is natural when it is experienced as the result of a particular situation or problem, when it is proportional to the stressor, and when it only lasts until the situation is resolved (ULifeline, 2016). Anxiety, though often painful, is an important and adaptive part of the human experience.

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Though originally an adaptive response, anxiety does have the potential to be harmful when it manifests as “constant, chronic and unsubstantiated worry that causes significant distress, disturbs your social life and interferes with classes and work” (Active Minds, 2016). In other words, anxiety is no longer helpful when it begins to appear when there is no actual threat present. When a person experiences anxiety but has no threat to respond to, what happens? They begin avoiding situations that are actually safe. Their mind and body are telling them that safe situations are threatening, which can have a debilitating effect. When anxiety becomes disordered, it arises unexpectedly, is overwhelming, and, rather than catalyzing adaptive behavior in the face of a threat, often fosters avoidance of everyday situations (Here to Help, 2016).

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So what is the takeaway? Anxiety is uncomfortable, but it helps us respond to threat, uncertainty, trouble, or feelings of unpreparedness (Active Minds, 2016). Anxiety becomes a problem (and possibly a disorder) when it comes seemingly out of nowhere and in the absence of a stressor proportional to the response, and it interferes with functioning in some way.

Recognizing Strengths as well as Struggles

There is no denying that feeling anxious is not pleasant. It can range from uncomfortable to unbearable. For those with anxiety disorders, anxiety is unpleasant on a whole new level; it can be completely overwhelming and paralyzing. It is hard to describe how out of control one can feel in the middle of a panic attack, or how draining it is to go through the day (week, month, or year) flooded with anxiety.

But in the midst of this struggle, it’s important to remember that anxiety doesn’t own you. It may be a part of you, and it may influence your life in various and profound ways. But anxiety does not determine who you are. A diagnosis does not define you. You are not a disorder. You are not weak, powerless, or alone.

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Acknowledging the pain anxiety can bring is so important, but it can also be helpful to recognize that struggling with anxiety may also foster certain strengths. According to Dr. Tracy Foose (2013), trait anxiety is associated with being “highly conscientious, honest, detail oriented, performance driven, socially responsible, [and] self-controlled.” Furthermore, learning to cope with anxiety can push us towards an increased self-awareness and knowledge of ourselves. Because it is so uncomfortable, it can motivate us to grow and change parts of ourselves or our lives that may not be serving us. And once we learn that we can move through the discomfort of anxiety, we often feel stronger and more confident in ourselves knowing that we have the fortitude to move through something so profoundly difficult (Sutherland, 2011).

Finally, if you do feel like anxiety is controlling your life, you don’t have to stay stuck in this space. Not only can anxiety teach you to embrace vulnerability and reach out for support from loved ones, but therapy offers very effective treatment. Cognitive Behavioral Therapy and Acceptance and Commitment Therapy can teach valuable coping skills, and can help to change your relationship to anxiety. Nothing will ever take anxiety away completely, but we wouldn’t want that because without anxiety, we wouldn’t survive. But therapy can help us learn that even in the worst throws of anxiety, we will survive, and even thrive.


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


Active Minds. (2016). NSOD: Difference between normal anxiety and an anxiety disorder.  Retrieved from:

Foose, T. (2013, Feb. 19). Positive traits seen in anxiety disorders. SF Gate. Retrieved from:

Here to Help. (2016). What’s the difference between anxiety and an anxiety disorder?  Retrieved from:

Sutherland, M. (2011). The Benefits of Anxiety. Retrieved from:

ULifeline. (2016). Anxiety vs. anxiety disorders. Retrieved from:

The Importance of Clinical Research

Jill Stoddard

By: Sarah Bond

Clinical research is fundamental to the advancement and understanding of the field of psychology.  It is important not to underestimate the significance that clinical research has had upon the development and implementation of psychological interventions.  This is accomplished by randomly selecting a subset of the population to serve as a sample in which the potential effect(s) of a given variable are observed.  Clinical research provides practitioners and researchers with insight into the effectiveness of the associated variable(s) under study.  It helps us examine isolated factors that may not be clearly evident outside of a controlled setting.  For example, we may examine the clinical treatment outcome of a specific intervention to determine whether or not it is an effective treatment for a given disorder.

In order to further advance standards of care, we must compare current treatment options to novel interventions.  This challenges us to continuously advance our understanding of the most relevant and beneficial treatments available for our clients.  We have an ethical obligation to ensure that we understand how a given intervention will likely influence the treatment outcome prior to determining the best approach to utilize when helping a client.

Clinical studies provide findings that allow practitioners to analyze data and generalize interpretations to help their clients.  For instance, both cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) have been indicated by clinical research to be efficacious treatments for anxiety disorders as well as many other conditions (e.g., depression, chronic pain, eating disorders).  Clinical research provides a means for psychologists to determine the best type of treatment for their clients.

Most clinical studies utilize human participants.  There are strict ethical guidelines set forth by the American Psychological Association (APA) that must be ensured prior to and throughout administration.  For this reason, all academic research studies must submit a research proposal to be reviewed by the respective university’s Institutional Review Board (IRB).  In doing so, the IRB is obligated to determine whether or not a given study is ethical prior to implementation.  During the study, participants are asked to sign an informed consent, which is similar to a contract.  It thoroughly explains the intention and potential risks associated with the study.  If any deception is used, it is mandatory to debrief participants following administration.

In essence, clinical research is important to providing optimal client care.  It not only deepens our understanding of current practices, but it also helps us advance and learn about new treatment options that can potentially improve treatment outcomes.  We depend upon clinical studies to help us understand how different variables influence our daily lives.

If you are interested in being a participant in clinical research, you can visit

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Warning Signs of Mental Illness

Jill Stoddard

Living in a Western society, it is considered part of our yearly routine to visit our primary care physician, dentist, and optometrist for yearly check-ups. While the aforementioned doctors are important and play an active role in managing our health, it is crucial that we do not minimize the significance of other medical professionals, such as those in the field of mental healthcare. Unfortunately, there are many people who are living with distressing symptoms without an awareness that they are afflicted with a mental disorder.

A mental illness can be defined as a “health condition that changes a person’s thinking, feelings, or behavior (or all three) and that causes the person distress and difficulty in functioning” (NIH, 2005, p. 1).  According to the NIH (2005), approximately one in four Americans are known to be impacted by mental illness. Thus, it is likely that either you or someone close to you has suffered from the symptoms of a mental illness in some way. Data indicate that mental disorders account for four of the 10 most predominant causes of disability in America (National Institutes of Health, 2005).

While the symptoms vary in intensity from one person to another, ranging from mild to severe, they cause unnecessary problems for people that can be managed or treated with appropriate care. Thus, it is critical to raise awareness about mental healthcare, so that more individuals will take action and seek the care from mental health professionals that can alleviate unnecessary distress from their daily lives. Although mental disorders each have their own set of specific symptoms, the NIH (2005) has created a list of “general warning signs” that can be used as a guide to help you determine whether someone should seek professional help (p. 1).

“Warning Signs” from the NIH (2005):

  • Marked personality change
  • Inability to cope with problems and daily activities
  • Strange or grandiose ideas
  • Excessive anxieties
  • Prolonged depression and apathy
  • Marked changes in eating or sleeping patterns
  • Thinking or talking about suicide or harming oneself
  • Extreme mood swings—high or low
  • Abuse of alcohol or drugs
  • Excessive anger, hostility, or violent behavior

If you or a loved one has experienced any of the previously mentioned “warning signs,” or if you are interested in learning more about your current state of mental health, then contact a local mental healthcare professional. If you are in the San Diego area and would like to speak to a professional at CSAM who specializes in stress and anxiety problems, please contact us.



National Institutes of Health. (2005). The science of mental illness. Retrieved from

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