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Crazy-Makers: Dealing with Passive-Aggressive People

Why Are People Mean? Don't Take It Personally!

When You Have Been Betrayed

Struggling to Forgive: An Inability to Grieve

Happy Habits: 50 Suggestions

The Secret of Happiness: Let It Find You (But Make the Effort)

Excellence vs. Perfection

Depression is Not Sadness

Conflict in the Workplace

Motivation: Intrinsic vs. Extrinsic

20 Steps to Better Self-Esteem

7 Rules and 8 Methods for Responding to Passive-aggressive People

Promoting Healthy Behavior Change

10 Common Errors in CBT

What to Do When Your Jealousy Threatens to Destroy Your Marriage

Rejection Sensitivity, Irrational Jealousy and Impact on Relationships

For Women Only: How to Have the Relationship of Your Dreams

What to Do When Your Partner's Jealousy Threatens to Destroy Your Relationship

Making Attributions for a Healthier Attitude

Happiness is An Attitude

Thinking Your Way to a Healthy Weight

Guide to How to Set Achieveable Goals

The Effectiveness of Cognitive-Behavioral Treatment for Anxiety Disorders

Co-Dependency: An Issue of Control

The Pillars of the Self-Concept: Self-Esteem and Self-Efficacy

Catastrophe? Or Inconvenience?


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Audio Version of Article: Crazy-Makers: Passive-Aggressive People

Audio Version of Article: Why Are People Mean? Don't Take It Personally!

Audio Version of Article: Happiness Is An Attitude

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Kindle Books by Dr. Monica Frank


Emotion Training: What is it and How Does it Work?

How You Can Be More Resistant to Workplace Bullying

Are You Passive Aggressive and Want to Change?

When Your Loved One Refuses Help

The Porcupine Effect: Pushing Others Away When You Want to Connect

What if You Considered Other Peoples' Views?

5 Common Microaggressions Against Those With Mental Illness

What to Expect from Mindfulness-based Cognitive-Behavioral Therapy (MCBT) When You Have Depression and Anxiety

Does Cognitive-Behavioral Therapy Lack Compassion? It Depends Upon the Therapist

When Needs Come Into Conflict

What to Do When Anger Hurts Those You Love

A Brief Primer On the Biology of Stress and How CBT Can Help

50 Tools for Panic and Anxiety

Coping With Change: Psychological Flexibility

Breaking Up is Hard to Do: Ending a Bad Relationship

I'm Depressed. I'm Overwhelmed. Where Do I Start?


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5 Methods to Managing Anger

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Change Yourself--Don't Wait for the World to Change

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Thinking Your Way to a Healthy Weight

Lies You Were Told

Probability and OCD

Choosing Happiness

Magic Bubbles for Children

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Cloud Castles for Children

Hot Air Balloon Motivation

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January 10, 2017       

Perception of Family Criticism Impedes Recovery from Panic Disorder

by Monica A. Frank, Ph.D.
person standing against emotional whorl
Clinical treatment often varies from research protocols. When participants are selected for research the process usually involves meeting criteria such as no co-existing conditions. As a therapist I've frequently felt frustrated that my clients did not recover as quickly as the research showed with cognitive-behavioral therapy (CBT). However, I also recognized that most of the time the clients who sought me out as a CBT specialist with anxiety disorders didn't meet the criteria for a simple condition but presented with much more complex situations.

In particular, many of them experienced childhood trauma as well as current criticism or abuse by their families of origin. Frequently, such a history created a self-fulfilling prophecy focused on me or on those current family members who were trying to be supportive. In other words, their past history taught them to expect criticism which meant they were more likely to perceive criticism even when it was not present. This perception created another hurdle that therapy had to overcome.

Recent research by Dr. Dianne Chambless and colleagues (2017) confirms my experience. The research showed that when perception of criticism was high the CBT treatment outcome for Panic Disorder was worse. They concluded that family members should be included in the treatment process when perception of criticism is high.

Unfortunately, I've found that when perception of criticism is accurate family members are less likely to agree to involvement in treatment. Sometimes clients, even as adults, continue to experience mistreatment at the hands of parents or siblings. In such cases, treatment has to involve changing their self-concept so as to not accept the criticism and methods to protect themselves from the ongoing abuse.

Chambless, D.L., Allred, K.M., Chen, F.F., McCarthy, K.S., Milrod, B. and Barber, J.P. (2017). Perceived Criticism Predicts Outcome of Psychotherapy for Panic Disorder: Replication and Extension. Journal of Consulting and Clinical Psychology, 85, 37–44. DOI: 10.1037/ccp0000161


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