Dr. Sara Denning Ph.D.

Sara Denning is a Clinical Psychologist in NYC and has been in private practice for over 16 years. She has developed a therapy approach called Adaptive Behavioral Therapy. This new method of changing behaviors around symptoms is based on neurological research which provides ample proof that the brain is a very adaptive mechanism using past and present experience to respond to stress.

The making of new neurological synapse connections has been used as a base for this learned, adaptive behavior approach to personal therapy. Adaptive Behavioral Therapy differs from Cognitive Behavioral Therapy in its emphasis on learned - primed - responses and the creation of new adaptive reactions to stress.

Dr. Denning completed a Ph.D. in clinical psychology from Southern California University for Professionals. Her dissertation emphasized a physical behavioral approach to problem solving. She also earned a Masters degree with a focus on classic psychology from the New School for Social Research in New York City. She was trained in psychodynamic therapy by Seymour Coopersmith of the National Institute for Psychoanalysis.

Fee Schedule: Adult and Students with insurance $ 175 - 180. Unemployed or uninsured student $80 - 120.00. Can't afford sessions? Go to www.myanxietynotebook.com and find a group.
Articles:
Creating Resilience - Understanding your brains reaction to stress
Chronic Anxiety causes changes in the part of the brain known as the Amygdala. Your daily dose of stress also causes fatigue in the Medial Prefrontal cortex. This information should sound frightening. So now that you are worried about all the things you usually are, you can add on worrying about what the worry is doing to your brain!
Goal: Creating resilience to stress

The good news from research is also that the brain has something called neural plasticity. Humans have ability to rethink and re experience the events which occur so you can mold the brain back into pretty good shape with new experiences. New Behavioral therapy is based on understanding the adaptation (s) that occurred due to stressful experiences and creation of new relevant experiences to the same stressor. In this treatment a combination of, developmental, interpersonal, social situations, or thinking patterns creates a platform for the reengineering of current behavioral symptoms.

Development of your response to stress was happening from birth till around age 21. Even now your style of stress response can be changed but only when you do something different in the moment when stress is triggered. Some stress triggers go way back in our history to very young ages when we, 'learned the way the world is'.

Your interpersonal stress is created when your brain gets signaled to play through a role that you think you know will lower the feelings of anxiety. When you step into being best friend because you care about someone, it doesn't mean that you can be 'used' for any purpose. You have a set definition of this role or else you need a better definition of this role. Endless texting over a crisis may make you feel resentful.

Social anxiety isn't always about being in the spotlight sometimes we just feel uneasy about a situation. All animals have a social role which gives us comfort. You know how to be at a birthday party but you may not feel comfortable if you are new in the group. You know how to be at a funeral. But you could feel odd if you were asked to speak about someone you barely knew.

These are all examples of your brain being fixed in one way and very plastic in another. The anxiety is triggered from a confusion of sorts. You have an identity but it is being taxed by the demands and behaviors of other people and situations.

Creating resilience to stress

You can gain flexibility in your response to stressful situations by using smaller everyday anxieties to practice. Adaptive behavioral therapy is also a preventive treatment as practice with smaller stressors creates familiarity with new healthy adaptive responses for future use. Today when you feel simply uneasy stop and ask yourself, "what just happened?". You may see that some small anxiety was triggered by a word, a thought, a sound, or a visual cue. Don't underestimate the sensitivity of your brain. When you practice with small stressors you will gain insight to the reason for anxiety and hen larger stress is at hand you can practice the same stop to gain greater control over your reactions.

Experience and training can modify the smaller effects of stress and bolster vulnerability to greater effects of stress.

References and further reading: This article is written from an excerpt of My Anxiety Notebook Part I. Sara Denning is a clinical psychologist and mental health counselor in New York City. For more information go to MyAnxietyNotebook.com, Saradenning.com or adaptivebehavioraltherapy.com. Cognitive flexibility, Dennis Charney Mt Sinai Hospital NYC., Stress Hormones Bruce McEwen Rockefeller Univ. NYC,. , Chronic Stress and Fatigue Medial Prefrontal cortex, Delaney.

Using Your Experience of Anxiety to Reduce Future Symptoms
Overview: As you are experiencing stress at lower levels (see Stress scale) you can use current symptoms to create behavioral change. Understanding the original confusion behind your stress response is a key to creating better resilience for future stress of the same type. Bettina is struggling with her job because she is overworked. When she can stop and look for the cause she realizes that she actually volunteers to do more than her share. Her old identity is the "helpful child" to her overworked parents.
Self-investigation functions as an educational path for change of the stress response in a pivotal moment. This moment is created by catching anxiety in action. When Bettina is at the office tomorrow she has to catch her response to help. When she does this she understands a second response; she is afraid that they won't think she is valuable.

The mechanisms for neurological plasticity seem to be the action of the brain in response to an experience. In this case choose the largest most dramatic reaction to stress you had in the past month to examine. Pay attention to the small signals as well as the very obvious larger behaviors which you experience.

Adaptive structural plasticity is the growth of neurons generated in the hippocampus. These are sensitive to experience as they participate in two functions; learning and modulation of the stress response. In Adaptive Behavioral therapy clients are educated on their own anxiety history in view of developmental adaptation to environment including interpersonal behavioral cues and memories. A stress scale is developed along with an identity and role review. Each client uses their own anxiety both historic and current to discover behavioral cues and triggers. Prevention of future high levels of anxiety may create resilience.

Bettina had a similar and dramatic example with her boyfriend a few months ago when he was leaving for a trip back to India. She was busy helping him pack his clothes and "running around like a crazy woman", when he asked her to stop. She broke down in tears with a feeling of uselessness and that he would not return. When he told he that she was worried for no reason she became angry and walked out. The key factor of adaptive behavioral therapy is the creation of a 'Pivotal Moment' a turning point in which the new awareness of the coping mechanism (known as the primed response) is in mind at the same time that the desire for a new outcome exists.

What she can do: Bettina needs to understand her confusion is coming from a previous experience. When she creates an investigation of the roles she has been in as a young girl she can see that she took on a lot of responsibility to maintain the attention and love of her very big family. Catch Anxiety symptoms in the lower end of the scale in the roles she is in throughout her week.

Resilience is created each time you undergo some stress. Like lifting weights you can train in the lower regions every day. Lifting the heavy (super stress) weight should be easier and hopefully less frequent.

Examples of the process: Below are some areas in which she can catch symptoms as they occur and use them to interrupt her behavior. Most of these originated when she was a teenager and have continued into her late twenties. With the interruption she can evaluate what to do with her feelings now as a grown woman.

Thoughts: Confused, I do and I don't feel appreciated.

Sleep: too much/ little, avoiding sleep due to need to worry, reorganize thoughts.

Body: too much/little exercise, thinking she is unattractive.

Social: talking less to friends, going out only with her boyfriend, or withdrawal.

Emotions: Overwhelmed, scared, confused, depressed.

Behaviors: Take charge of everything, sexually, erratic, isolating, crying.

With this information Bettina can begin to interrupt the process of her stress reactions. To get a step closer to permanent change she needs to understand where and when these behavioral reactions became her style of coping or avoiding anxiety.

This article is written from an excerpt of My Anxiety Notebook Part I. Sara Denning is a clinical psychologist and mental health counselor in New York City. For more information go to MyAnxietyNotebook.com, SaraDenning.com or AdaptiveBehavioralTherapy.com.