We are excited to announce that Dr. Clarissa Gosney will be speaking at The Coalition for Physician Well-Being 11th Annual Conference next Wednesday! In addition to owning and operating Pinnacle Counseling and Testing Center and serving as Wellness Director for various Graduate Medical Education (GME) programs, she is now serving as a Wellness Consultant for GME programs across the nation. At the conference, she will be speaking on a personalized approach to improving Resident Physician Well-Being.

Thank you to Shoutout SoCal for interviewing Dr. Gosney for their new Local Stories article! Shoutout SoCal allows many local businesses and creatives the opportunity to share their stories, inspiring important conversations within our communities.

Click here to learn more about Dr. Gosney’s insights and passions.

We are so excited to be featured in the City of Murrieta’s “Back to Business” newsletter in the “Murrieta Pivots” article! Local businesses discussed how COVID-19 changed the way we do business, and what lasting effects this pandemic has made. To read the article, click here.

Food and Anxiety… What’s that About?

Anxiety not only can affect how you function in your daily life, but it can also initiate unhealthy habits with food. Many people struggle with food anxiety, which can stem from body image issues, social anxiety, or food security. The issues you face may not necessarily classify under a disorder, but it is still important to be aware and find the root of the problem, in order to make the first step and create a healthy relationship with food.

There are several different ways your anxiety could flare up involving food and eating. Individuals with social anxiety may have a fear of eating around others. The social situation, people you are surrounded by, and environment can potentially all be triggers for anxiety. It is possible that you are fearing how difficult the food will be to eat, or how messy it is. All of this stems from the fear of being negatively evaluated by others, and it is treatable through therapy and controlling your thoughts. Try to stay grounded and remind yourself that you are your own worst critic, and it is likely that no one will judge you the way that you judge yourself.

The societal pressures of body image also can play a role in your anxiety about food. Social media frequently broadcasts and celebrates skinny bodies, and body-shames those who may be overweight. This can lead to negative self-talk about your own appearance, leading you to obsess about your weight. Media could regularly influence the way you might see yourself, even if it is not a conscious thought. Try to practice positive thoughts about yourself while also being aware that the media regularly warps your perception of body image. 

You may also experience anxieties around not having enough food! If you are going to be busy for a period of time, it is possible that you may fear not having enough food to last through it. This can lead to overeating, or the anxiety may make your stomach feel uneasy which leads to not eating enough. If you feel yourself falling into this pattern, try packing plenty of healthy snacks to ease your mind. Planning sustainable meals can also be a key element in combating this anxiety. 

If you are experiencing uneasiness regarding food, remember that you do not have to keep it to yourself because it is not physically apparent. Food anxiety does not have to manifest physically in order to hinder your mental health and daily life experiences. Seeking professional help is crucial if you feel your anxieties about food becoming more frequent or more distracting. Being open with a therapist about these habits will allow you to start making healthy decisions both mentally and physically.

We are excited to announce that our Outside Voice camps for children with Selective Mutism have confirmed dates! Our 4-day camps will be held from July 21st-July 24th in Murrieta, California and from August 4th-August 7th in Poway, California. If you are interested, feel free to fill out out our interest form! For additional details and information, contact us.

Pinnacle Counseling and Testing Center’s Dr. Clarissa Gosney wrote an article on Selective Mutism (SM) in teens and adults, which was published on Anxiety.org! Feel free to give the article a read and share it to help educate others.

Pinnacle's Partnership with UHS SoCal Medical Residency Program

Pinnacle Counseling and Testing Center is excited to announce our faculty partnership with Universal Health Services Southern California Medical Education Residency Consortium (UHS SoCal MEC).  This partnership offers superior graduate medical education (GME) residency programs to Riverside County, California.

Starting in September 2019, Pinnacle’s Licensed Psychologist Clarissa Gosney, Psy.D. has been serving as core faculty for the two residency programs: Family Medicine and Internal Medicine. Carissa Douglas, Psy.D. is serving as adjunct faculty.  Dr. Gosney and Dr. Douglas provide direct clinical supervision to the Family Medicine Resident Doctors at Rancho Family Medical Group’s Makena office in Temecula, CA, as well as providing training didactics for Behavioral Health integration for the two programs. Dr. Gosney and Dr. Douglas also direct the Wellness Support Team for medical residents and core faculty, ensuring that both faculty and residents maintain proper physical and emotional well-being.

This is UHS’s first year of their Internal Medicine and Family Medicine residency programs.  Chief Academic Officer and Designated Institutional Official, Dr. Michael N. Nduati, stated that “Our residency programs are integrated into the core mission of the hospitals: to provide our community superior quality care that patients recommend to family and friends and physicians prefer for their patients, while offering unique training opportunities to the next generation of healthcare providers.”

The Resident Doctors will be providing behaviorally-trained services to patients at Temecula Valley Hospital, Rancho Springs Medical Center, Inland Valley Medical Center, Corona Regional Medical Center, Palmdale Regional Medical Center, and Rancho Family Medical Group.

We are so excited to be involved in such a rewarding partnership with UHS in providing quality Behavioral Health clinical supervision and training to the medical resident doctors of Riverside County.

Read Dr. Gosney’s Family Medicine Residency Core Faculty profile.

Learn more about UHS SoCal Medical Education Residency Consortium.

Trick or...?

I will admit... I remember telling children "Say Trick-or Treat or you don't get candy" before encouraging them to say "Thank you" for the delicious treat. This was before I learned about Selective Mutism.

Selective Mutism (SM) is an anxiety disorder that causes children, teens, and adults who have it to be unable to speak in certain situations such as at school, at the store, or... you got it... while trick-or-treating.  Have you heard about the 4 F's in response to stress: flight-fight-freeze-fawn?  Perhaps you haven't heard of the latter two.  We'll talk about "fawn" another time.  But what about "freeze?"  In a stressful state, many people have a natural reaction not to fight or flee, but to feel as if they are cemented in one place.  Their minds go blank, or perhaps their minds are rushing thoughts around at a million miles a minute, yet they are frozen.  They cannot move.  Now imagine this happening to your mouth.  This is what happens to individuals with SM.  While they want to engage with others, and may be able to do so physically, they find it difficult to speak.  In elementary school, this might look like a child playing with her peers at recess but not speaking to them.  In adolescence, this might look like a teen staring blankly at his teacher when asked a question in front of the class.  In adulthood, this might look like someone who doesn’t talk to anyone at work and often doesn’t attend social gatherings.  SM isn’t shyness, though that is often how it is explained to others by those who don’t know how to explain it any other way.  SM is an anxiety disorder that causes the mouths of those who have it to “freeze,” unable to speak.

This Halloween, please keep in mind that the child or teen who extends their hand for a treat but does not verbalize anything, may be a child who wants to say “Thank you” but is frozen.  Coaxing them to speak (no matter how sweet and calm or how direct and demanding your approach) will not help but is likely to make them more anxious and thus, even less likely to speak.  Instead, flash a smile and tell them “Happy Halloween” while passing out goodies.

Thank you for making Halloween fun for everyone!

Anxiety in the Classroom

Your child is experiencing anxiety in the classroom. This experience can make your child feel frozen, which in turn decreases your child’s ability to learn the information being taught.  While we never want our children to experience high levels of anxiety, the classroom is one of the last places we would want our children to be anxious.  

So, how do we identify anxiety in the classroom? Unfortunately, identifying anxiety in a child at school is not always a straightforward task. Symptoms of anxiety often mimic symptoms of other difficulties, such as ADHD, learning disorders, and oppositional behavior. In order to provide the best care to a child, we need to observe behaviors closely and try to identify the root to the behaviors.

What are some behaviors to look out for that may be a result of anxiety?

Here are a few common ways that anxiety presents itself in the classroom: 

1.     Attendance problems/Trips to the nurse. Anxious kids may protest going to school due to the anxiety that arises when they are there. They also may frequently ask to go to the nurse once they are at school. Children experiencing anxiety may express that they feel sick due to experiencing stomachaches or other physical symptoms. If this is happening on a regular and consistent basis, these physical symptoms may be a result of anxiety rather than actual illness.

2.     Inattention and restlessness. While we often think of attention difficulties and restlessness as being related to ADHD, these behaviors may also be a result of anxiety. Anxious children may have difficulties attending to the lesson or sitting still when they are preoccupied with worries swarming in their heads.

3.     Not answering questions or asking for help. Children experiencing anxiety may be overly concerned with their answers being exactly right, and therefore may not share information with the rest of the class. Children experiencing social anxiety may be acutely concerned with what their peers and teachers think of them. When children are experiencing difficulties with Selective Mutism, they often “freeze” up and are unable to provide verbal responses to questions.   

4.     Unfinished work/Difficulties in certain subjects. If a child has not been completing work that was assigned, this could be a sign of anxiety. The same goes if a child is struggling in a certain subject at school and having difficulties completing the work in a specific subject. The child may either not want to turn in work that isn’t “perfect” or may be overwhelmed by intrusive, anxious thoughts that are distracting him from getting his work done.

By no means is this list exhaustive, as anxiety has many different expressions. However, if you notice your child exhibiting any of the above behaviors or others that are concerning, you might consider the possibility that the issue is stemming from anxiety. Ultimately, anxiety can be extremely disruptive in multiple areas of a child’s life, and the classroom is often one of these areas. The good news is this: if we are able to pinpoint anxiety as the root to the difficulties that our children are experiencing, we can provide the appropriate care in order to help our children conquer the anxiety that’s hindering their success. 

- By Dr. Lindsay Haig, PsyD -

The word “mindfulness” is popping up everywhere today. Maybe because I am in the field of psychology and I practice mindfulness myself, but it definitely feels as if no one can get enough of mindfulness. But how does this translate to kids and anxiety?

John Kabat-Zinn defines mindfulness as, “Paying attention in the present moment without judgment.” Fair enough, but what does this mean and how does this help kids struggling with anxiety? Mindfulness can feel simple and, at the same time, totally out of our comfort zone all at once. For kiddos (and other ages alike), mindfulness can be practiced by paying attention to the senses. When children are anxious, they are very much stuck in their thoughts and not aware of what is happening in the present moment.  By coming back to what is happening in the here-and-now (which can be extremely difficult no matter how old you are), children and adults can refocus their attention to what’s happening in the present instead of thinking about the past or future.

One exercise that I love to do in therapy is called the “5-4-3-2-1” grounding exercise. In essence, this is how it goes. Look around the room that you are currently sitting in and identify 5 things you can see (i.e. I see a cup, I see a computer), 4 things you can feel (i.e. I can feel my back on the chair, I can feel my feet on the floor), 3 things you can hear (i.e. can hear the traffic outside, I can hear my dog making silly noises), 2 things you can smell/like the smell of (i.e. I can smell mom cooking in the kitchen OR I love the smell of chocolate), 1 thing you can taste/like the taste of (i.e. toothpaste from brushing your teeth OR I love the taste of chocolate).

Why is this exercise or using mindfulness in treating kids with anxiety important? It helps them return to the here-and-now. With anxiety, it is so easy to get inside your head and be out of touch with the reality of the present moment.  Using mindfulness, we can return to what’s actually happening and leave behind those things that we think are happening. 

~ Dr. Lindsay Haig ~

We are thrilled to announce the dates for our summer camp for children with Selective Mutism, ages 3 to 9. Camp registration will be open to the public, as well as to current clients. This is the first time that Pinnacle Counseling and Testing Center will be opening its doors to offer treatment to children who are not already registered clients! Our 4-Day camp, Outside Voice, will run June 23-26 in Murrieta, California. For more details, Contact Us.

*Stay tuned for dates on our “older” kids SM camp, which will be held at the end of July!

Doubt and Dysfunction in OCD

Johns Hopkins Medicine recently highlighted Gerald Nestadt, Psychiatrist, who has studied and treated patients with OCD for the past 30 years. He has found strong evidence for a biological basis for OCD, while he acknowledges that one’s environment also plays a role. Recently, Gerald Nestadt has been studying the role of doubt in OCD. He has found that the more self-doubt one has, the more dysfunctional their OCD tends to be. For instance, one does not simply act on an obsessive thought (compulsion) for the sake of performing the act, but out of their own self-doubt that they had performed the act correctly or thoroughly enough.

We know that with OCD, the behaviors (compulsions) are performed in an effort to reduce one’s own anxiety. This may work for the short-term, but anxiety is not decreased overall unless the person is able to resist acting out on their compulsions. At Pinnacle CTC, we guide clients through this process by using Exposure with Response Prevention (ERP). ERP is not only effective in the treatment of OCD, but for many anxiety disorders as well.

Learn more about the Conditions We Treat and other information on the Evidence-Based Treatment modalities we offer at both our San Diego and Murrieta, CA offices.

Read the full article.

Trauma-Informed Teaching

As we approach a new school year, it is important for all teachers to look deep into the needs of each child who sits in their classroom.  Trauma is something that can scream so loudly in a voice that can be easily mistaken as oppositional, inattentive, hyperactive, and angry.  

In a recent post, Ransom for Israel painted a vivid picture of a child who has experienced trauma as a goldfish that has been mistaken as a shark.  "...our children often present with behaviors that look like the shark, but if we look below the water, we will realize they are really just scared goldfish trying to have a need met.  Their behaviors might communicate anger and hostility, but below the surface is fear and a hurting child."

School can be a fortress for the hurt and the weary.  For teachers, you have the honor of being able to "provide a safe space and help them regulate.  This might mean sinking down to eye level and saying, 'You are safe.' and then simply step away for a while.  The cure for trauma is a safe relationship and you are going to give the child space and environment to feel safe."

When you see a child who is struggling, find the need that has yet to be met.  Be their safety.

Secondary Emotions

Anger is often considered a secondary emotion because it is used as an attempt to protect ourselves against feeling or showing primary emotions such as sadness, grief, fear, and anxiety.  We may unintentionally hurt others as a form of self-protection.  Only when we decide to take off the mask of anger can we allow ourselves to begin to heal.

The next time you find yourself angry, I challenge you to look beneath the surface.  Are you feeling embarrassed?  Disrespected?  Undervalued?  Afraid?  Open yourself up to learning more about the real you, and let the healing begin.