Скачать или смотреть 362 ‒ Understanding anxiety: defining, assessing, and treating health anxiety, OCD, and more

Josh Spitalnick is a clinical & research psychologist with expertise in treating a variety of anxiety conditions with cognitive-behavioral therapy (CBT) & other evidence-based approaches. In this episode, Josh unpacks the four layers of anxiety—psychological, emotional, cognitive, & behavioral—highlighting why avoidance is the key feature that transforms ordinary worry into disorder. He explains why he continues to treat OCD & PTSD as anxiety conditions despite their DSM-5 reclassification, & he draws important distinctions between worries versus worrying & thoughts versus thinking. The discussion explores health anxiety, illness anxiety, & the impact of modern contributors such as wearables, social media, & the COVID era, while weaving in real-world case studies & Josh’s structured assessment approach. Josh also breaks down evidence-based treatments, from exposure therapy & cognitive-behavioral therapy (CBT) to acceptance & commitment therapy (ACT), along with the role of medication, lifestyle factors, & how shifting from avoidance to committed action can build long-term resilience.

View show notes here: https://bit.ly/4n0tQm6
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0:00:00
0:01:19-Josh's background & approach to treating anxiety
0:03:19-Definition of anxiety/changes in the DSM-5
0:09:25-The psychological aspects of anxiety
0:16:20-Anxiety symptoms: triggers, fears, & hidden mental rituals
0:19:49-Thoughts vs thinking & worries vs worrying
0:24:24-Health anxiety & the limits of medical reassurance
0:37:30-Triggering events for health anxiety, symptom fixation, heritability, & the role of nature versus nurture
0:47:05-Historical & modern shifts in health anxiety, from HIV/AIDS in the 1980s to today’s heightened fears of cancer
0:48:59-Modern factors & recent events that have amplified societal anxiety levels
0:56:41-Josh’s approach to patients with excessive health-related rituals and/or OCD using CBT & exposure therapy
1:05:52-Hypothetical example of treating a person with a fear of flying
1:17:30-The 4 types of exposure therapy
1:24:48-Treating people with OCD that manifests in disturbing & intrusive thoughts
1:36:03-Acceptance & commitment therapy (ACT)
1:41:22-Mindfulness as a tool to cultivate presence, awareness, & healthy engagement with life
1:43:13-Hallmarks of successful therapy
1:50:07-Relationship between anxiety & substance use
1:55:30-Anxiety’s overlap with ADHD, OCD, autism, & physical health conditions
1:57:29-Debunking the harmful myth that health anxiety is “made up”
2:00:57-Prevalence, severity, & evolving treatments for health anxiety & OCD
2:08:21-Treating health anxiety is about providing patients with skills to improve quality of life
2:13:52-Balancing the benefits of abundant health information with the risks of fueling health anxiety
2:18:45-Finding a telehealth provider

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About:

The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 90 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.

Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.

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