Anxiety Matters

Why You Can't Sleep and How CBT-I Fixes It with guest Dr. Jesse Spiegel

The Bonnies introduce Dr. Jessie Spiegel, a licensed clinical psychologist who treats children, adolescents, and adults. This episode focuses on insomnia and on cognitive behavioral therapy for insomnia, or CBTI, which they discuss as a first-line treatment. Dr. Jesse explains how insomnia is distinguished from short-term sleep problems. He describes chronic insomnia as difficulty falling asleep, staying asleep, or waking too early, occurring at least three nights a week for at least three months, with clear distress or impaired functioning. They discuss the main ideas behind CBTI and talk about sleep drive, circadian timing, and arousal, and how these factors interact with chronotype. Dr. Jesse notes that morning and evening types may have different sleep patterns, and we discuss that chronotype is largely biological. Dr. Jesse also covers the behavioral parts of treatment. He explains stimulus control, including going to bed only when sleepy, getting out of bed if unable to sleep, using the bed only for sleep and sex, waking at the same time each day, and avoiding naps when possible. He then describes sleep restriction, where time in bed is adjusted to better match actual sleep time in order to improve sleep efficiency. Finally, they talk about the thoughts and habits that can keep insomnia going. Also mentioned is worry, catastrophic thinking, safety behaviors, and the way sleep tracking devices can become unhelpful for some people. The goal with treatment is that it aims to reduce pressure around sleep and make it feel more effortless. HIGHLIGHTS: 6:03 Meet Dr. Jessie Spiegel 7:38 What Is CBT-I? 12:02 Sleep Drive and Body Clock 19:40 Bed Becomes a Battleground 23:48 How CBTI Treats Insomnia 30:09 The Core Sleep Debate 34:20 Calming Sleep Anxiety 39:10 Reframing Sleep Thoughts 43:23 Wearables and Sleep Logs connect with Dr. Jesse website: https://www.drjessespiegel.com [https://www.drjessespiegel.com] CONNECT WITH THE BONNIE ZUCKERS: Bonnie Zucker Ph.D.(west) website: https://www.bonniezuckerphd.com [https://www.bonniezuckerphd.com] Newsletter sign-up: https://bonnie-zucker-ph-d.kit.com/d44b57fcdf [https://bonnie-zucker-ph-d.kit.com/d44b57fcdf] Books by Bonnie West: https://a.co/d/04aNJFDZ [https://a.co/d/04aNJFDZ] Bonnie Zucker Psy.D. (east) website: https://www.bonniezuckerandassociates.com [https://www.bonniezuckerandassociates.com] Books by Bonnie East: https://shorturl.at/MxvRZ [https://shorturl.at/MxvRZ] The content of Anxiety Matters Podcast is for informational purposes only and does not constitute mental health or medical advice, nor is it a substitute for professional mental health or medical advice, diagnosis, or treatment. If you are experiencing a mental health crisis, call emergency services or a local crisis line.

A Day in the Life of an OCD Psychologist (part 2): The Effectiveness of ERP for OCD

In this part 2 BZE and BZW discuss anxiety and OCD through their clinical work and personal experiences, including a recent visit in Maryland and time spent together in person. They talk about exposure work at Whole Foods, contamination fears, and how exposures can be broken into smaller steps while still helping retrain reactions to triggering situations. They also discuss social anxiety, selective attention to negative events, and the body’s physical anxiety response, including adrenaline, cortisol, shortness of breath, and a faster heartbeat. Along the way, they share a few personal moments from the visit, including the BZE's dog, a train delay, and a mix-up over continuing education credits. HIGHLIGHTS: 2:54 OCD Exposures Explained 6:45 Anxiety and Threat Perception 10:24 Unattended Drinks and Safety 17:34 Cassidy’s Warm Welcome 19:20 Train Ride Troubles 21:24 Mixed-Up CEs CONNECT WITH THE BONNIE ZUCKERS: Bonnie Zucker Ph.D.(west) website: https://www.bonniezuckerphd.com [https://www.bonniezuckerphd.com] Newsletter sign-up: https://bonnie-zucker-ph-d.kit.com/d44b57fcdf [https://bonnie-zucker-ph-d.kit.com/d44b57fcdf] Books by Bonnie West: https://a.co/d/04aNJFDZ [https://a.co/d/04aNJFDZ] Bonnie Zucker Psy.D. (east) website: https://www.bonniezuckerandassociates.com [https://www.bonniezuckerandassociates.com] Books by Bonnie East: https://shorturl.at/MxvRZ [https://shorturl.at/MxvRZ] The content of Anxiety Matters Podcast is for informational purposes only and does not constitute mental health or medical advice, nor is it a substitute for professional mental health or medical advice, diagnosis, or treatment. If you are experiencing a mental health crisis, call emergency services or a local crisis line.

A Day in the Life of an OCD Psychologist: Bonnie West Visits Bonnie East in Maryland

East meets West in this special episode of Anxiety Matters as Bonnie West travels to visit Bonnie East. After an excitedly heartwarming welcome, the two enjoy good food and drink as they discuss exciting new plans for Anxiety Matters. The two hit up Bonnie East's local Whole Foods to do a live exposure exercise. They leave tea on a shelf, walk away for a while, and return to drink it and describe the purpose of these exercises as helping people tolerate uncertainty, discomfort, and the anxiety that rises and then falls. They discuss several kinds of exposure work, including asking for help, interrupting someone, leaving items unattended, and handling contamination fears including a more direct contamination exposure involving a chip that is placed on a shelf and then on the floor before being eaten. BZE describes how some people need repeated practice before they are willing to do it, and notes that doing the feared action often reduces anxiety more than expected. Later, BZW visits BZE's office and home, where they talk about the workspace, the artwork created by Bonnie East's mom, and family-made gifts. They wrap up by discussing BZE's home, the dog, the Christmas decorations, how they each work and the surprising place Bonnie East records episodes of the podcast. You'll want to listen in, not only for valuable information on exposure exercises, but for the fun these two share when they're together. HIGHLIGHTS: 1:18 Whole Foods Exposure 5:17 Challenging Contamination Fears 7:49 Tolerating Uncertainty 9:49 Eating the Floor Chip 14:08 Flooding Exposures 17:05 Visiting the Office 20:24 House Tour and Gifts 24:21 Cozy Home Reflections CONNECT WITH THE BONNIE ZUCKERS: Bonnie Zucker Ph.D.(west) website: https://www.bonniezuckerphd.com [https://www.bonniezuckerphd.com] Newsletter sign-up: https://bonnie-zucker-ph-d.kit.com/d44b57fcdf [https://bonnie-zucker-ph-d.kit.com/d44b57fcdf] Books by Bonnie West: https://a.co/d/04aNJFDZ [https://a.co/d/04aNJFDZ] Bonnie Zucker Psy.D. (east) website: https://www.bonniezuckerandassociates.com [https://www.bonniezuckerandassociates.com] Books by Bonnie East: https://shorturl.at/MxvRZ [https://shorturl.at/MxvRZ] The content of Anxiety Matters Podcast is for informational purposes only and does not constitute mental health or medical advice, nor is it a substitute for professional mental health or medical advice, diagnosis, or treatment. If you are experiencing a mental health crisis, call emergency services or a local crisis line.

A Perfectionist's Guide to Not Being Perfect

In this episode BZE and BZW talk about perfectionism through their own habits and experiences, from the pressure to make the “right” choice to the way rigid standards can show up in everyday life. They discuss BZE's book *A Perfectionist’s Guide to Not Being Perfect*, written for middle and high school readers, and how it was shaped by her writing routine and the disruptions of early 2020. They explore how perfectionism can lead to inflexibility, repeated checking, procrastination, and avoidance in school, work, and relationships. They also discuss treatment approaches that focus on flexibility, including exposure exercises, small acts of spontaneity, and learning to tolerate mistakes. The two then look at perfectionism in students and families, including test anxiety, social media, college decisions, and parental pressure. They close by emphasizing practical ways to respond to perfectionism, such as time limits for avoided tasks and reducing harsh self-criticism, with flexibility presented as more helpful than perfection. HIGHLIGHTS: 3:06 Eye Exam Epiphany 5:33 Writing Through Perfectionism 8:43 Flexibility Over Control 12:03 When Perfection Hurts 13:21 Building Flexible Habits 16:26 Social Media Pressure 19:01 Success Beyond Grades 23:27 Parenting Through Mistakes 27:41 College Choices Matter Less 30:05 Break the Avoidance Cycle mentioned in the episode: A Perfectionist's Guide to Not Being Perfect by Bonnie (East): https://a.co/d/0ajFPyrp [https://a.co/d/0ajFPyrp] The Obstacle is the Way book: https://a.co/d/01abU2GT [https://a.co/d/01abU2GT] CONNECT WITH THE BONNIE ZUCKERS: Bonnie Zucker Ph.D.(west) website: https://www.bonniezuckerphd.com [https://www.bonniezuckerphd.com] Newsletter sign-up: https://bonnie-zucker-ph-d.kit.com/d44b57fcdf [https://bonnie-zucker-ph-d.kit.com/d44b57fcdf] Books by Bonnie West: https://a.co/d/04aNJFDZ [https://a.co/d/04aNJFDZ] Bonnie Zucker Psy.D. (east) website: https://www.bonniezuckerandassociates.com [https://www.bonniezuckerandassociates.com] Books by Bonnie East: https://shorturl.at/MxvRZ [https://shorturl.at/MxvRZ] The content of Anxiety Matters Podcast is for informational purposes only and does not constitute mental health or medical advice, nor is it a substitute for professional mental health or medical advice, diagnosis, or treatment. If you are experiencing a mental health crisis, call emergency services or a local crisis line.

Panic Attack or Heart Attack: Treatment Strategies That Work

In this episode, BZW and BZE revisit Ireland Baldwin's journey with health anxiety and panic disorder, examining how trauma, genetics, and environmental factors intersect to influence anxiety. They explore the cycle of fear and heightened sensitivity to bodily sensations, advocating for cognitive behavioral therapy (CBT) as a key intervention. Their discussion highlights interoceptive exposure techniques to confront discomfort and stresses the importance of supportive relationships with established boundaries. Ireland’s story illustrates that, with effective strategies, individuals can manage anxiety and reclaim control over their lives, empowering listeners to understand their own experiences with anxiety. Be sure to listen to episode 64 with Ireland Baldwin to understand the foundation of her health anxiety. HIGHLIGHTS: 1:09 Follow-Up on Ireland Baldwin interview (ep 64) 4:13 Exploring Health Anxiety 5:36 The Role of Cognitive Behavioral Therapy 7:52 Personal Stories and Panic Buttons 9:42 Addressing Trauma and EMDR 11:09 Understanding Family Support 15:34 The Importance of Tolerating Uncertainty 17:17 Interoceptive Exposure Explained CONNECT WITH THE BONNIE ZUCKERS: Bonnie Zucker Ph.D.(west) website: https://www.bonniezuckerphd.com [https://www.bonniezuckerphd.com] Newsletter sign-up: https://bonnie-zucker-ph-d.kit.com/d44b57fcdf [https://bonnie-zucker-ph-d.kit.com/d44b57fcdf] Bonnie Zucker Psy.D. (east) website: https://www.bonniezuckerandassociates.com [https://www.bonniezuckerandassociates.com] The content of Anxiety Matters Podcast is for informational purposes only and does not constitute mental health or medical advice, nor is it a substitute for professional mental health or medical advice, diagnosis, or treatment. If you are experiencing a mental health crisis, call emergency services or a local crisis line.