About Our Approach

"The first step toward change is awareness. The second step is acceptance." [Nathaniel Branden]

Our Approach

MSAM is proud to be on the cutting edge of empirically based treatment for OCD, Trauma and the full range of anxiety disorders. We employ the best practice and effective treatment approaches available including CBT, DBT, EMDR, mindfulness. Our groups include; Anxiety Support Group, Certified Grief Recovery Method Group and Certified Mindfulness Training Group.

All people are unique. The complex nature of each person guides our assessment and inquiry for using the most effective treatment strategies. Here are some thoughts on how people develop difficulties and become stuck. Finally, a few thoughts on how we can learn to escape the suffering of our history and find a life worth living.


Developing how we see ourselves as unique and individual people is influenced by genetics and temperamental propensities. We are, of course, also shaped by our caregivers, and further molded through exposure to diverse experiences.  Perception and conditioning are important factors in forming our unique idea of self. Learning is also influenced by our developmental abilities.

Think about this, if you will. From the moment you became aware of your existence usually somewhere between ages 4 to 6, you started to view your life day by day.  Your experiences turned into memories that built one on the other.  This moment-to-moment learning formed the groundwork for instructions for how to live your life. This learning constructed “facts” or “truths” about who you are, the meaning you attach to others as well as your understanding of the world. These “truths” become instructions for figuring out how to cope, adapt and survive.  Although early on, it wasn’t likely that you gave a lot of thought to this idea of survival, because you were concerned about being cared for and being loved. Survival when we are young meant staying attached to a caregiver, fitting in and staying attached.

Being Present

In each present moment you experience day to day existence and you are watching this process. You have been watching your life unfold since your earliest memory. You have also arrived at conclusions about your experiences and have become “conditioned” about what living means in each moment.  No matter the range of diverse things that have happened, there you were watching and learning.  In fact, as mentioned a moment ago you are here now watching yourself read-Cheers!

It is important at this juncture to point out that learning is in the eye of the beholder.  We are similar and also unique. In other words, many people can have the exact same experience and perceive the experience differently.  If perceived differently, what is learned will also be unique. Learning, as mentioned earlier, is influenced by our developmental abilities.

Integrated Information

Once we have learned something important, it becomes resistant to adjustment or change.  The basic way in which we learn often makes what we learn feel permanent and unchangeable over time.  As a result of this resistance to change and of beliefs about oneself we can forget that we have choice.  We go on autopilot, so to speak. As a result we start “being” what we believe we are rather than seeing things as they are. We in large part see the world as we are rather than how the world is.

Without being able to objectively see our patterns we remain stuck repeating them. The first step is to be able to see your pattern instead of “being” the pattern. This is the path leading to regaining the ability to first understand and finally make different decisions and new choices in the areas that you are stuck.


We become “stuck” because of the way in which our minds learn. (If you need help seek a comprehensive treatment that has skill with CBT, DBT EMDR, Mindfulness) By nature of design our brains love summarizing information. Having what we sense and observe and experience into usable bits of information beliefs or “truths” about living, being and surviving. Sometimes we call these information files habits, conditioning, schema, beliefs, concepts or stories.  What ever we call them they are very useful indeed.

I joke with my clients about how much energy it would take to relearn everything if we didn’t have previous learning and habit. In order to tie our shoes we would need to. find the shoe-tying video each morning after putting my shoes on, that is after looking for shoe tying video search instructions on google, but first using the dictionary to understand what google is after being told what a dictionary i…you get the idea.  Habit/ learning/conditioning are vital. They can, however, be problematic if the resulting habit./learning /conditioning is creating problems in living.


So learning, forming habit, conditioning, and the beliefs that are developed are a very good thing.  The functional problem is finding a method to break away from a non-helpful or dangerous pattern. Once our brains have come to a conclusion and summarizes that a thing has happened enough times and “works,” (good or bad) not considered questionable.  We just accept it as truth.  The longer we identify with this “truth,” the more its maintenance is ensured.  Whatever is practiced strengthens, negatively or positively.  In fact, this “truth goes on autopilot” and is generally out of our conscious awareness.  It becomes part of our story of self, so to speak.


What if, however, some of the learning was integrated from the perception of a six year old that may still be your “truth.” What if it gets a free pass because we don’t see it?  By free pass, I mean is never reexamined for usefulness or accuracy. 

The useless uncontrolled pattern can become a source of suffering.  This conditioning, habit, or belief will longer serves you well. It is out of your immediate conscious awareness and is on automatic?  I am not talking about the mysterious unconscious.  The kind of information I’m discussing here is like “your software,” for shoe-tying, if you will. You don’t usually have to remember each step of shoe tying to tie your shoes. You just “know” how to tie your shoes.

Distorted “Facts”

Problems occur as our early conditioning becomes inadequate to address our current need. Problems can occur when conditioning was shaped by emotional invalidation, neglect, abuse or even simple misinformation. If so, this may cause problems interpreting life as we are rather than how life is. This learning or pattern will not not serve us well in navigating life in the present.

Having negative patterns to address is normal and natural for all humans. If you think about it, it is very difficult if not impossible to make it too adulthood without getting somethings wrong, getting hurt or worse. Attention needs to be placed on misperceptions that negatively effect your ability to achieve a life worth living .


We continue to act in ways that are not in our best interest without being able to change them or “will them away.”  Stuck in old “facts” or “truths” that have outlived their usefulness and are less sophisticated than life now demands. Being stuck in life make us suffer and creates its own negative information about living. Imagine a person was often bullied and developed an idea that they were “less than others” or that “life is completely dangerous.” Most of us would believe that being bullied does not mean the he is not as good as other people. But he believes he is even if we told him what we think.

This example shows how a distorted conclusions in learning without the benefit of reality adjustment can still be presented as “fact” or “truth”.  Do you believe that being bullied as a child makes an adult intrinsically “less than” other people or completely weak? Most likely you don’t, but the person who was bullied might.

From Misunderstanding to the Moment

We can and do continue to depend on old learning that has lost its usefulness as our guide for living now.  Most of this learning is out of our immediate awareness and creates repeated suffering.

“There is that moment in time where you have to realize you have to let go of the rope…”
― K. Farrell St. Germain-Goodreads

It is healthy to learn to build the skill to become aware of your internal world of thoughts, feelings, and emotions.  By doing this you gain skill to become less reactive to non-useful or hurtful patterns of thinking and behaving learned earlier in life.  You also learn to be with the moment in a way that allows you to observe with clear eyes and begin gaining the skills needed to build a life that is worth living now.  You can learn to be mindfully present in such a way as to see your internal world rather than reactively be the pattern.


We all repeat mistakes even in the face of our best rational judgment and in the face of real and painful negative consequences. Often we become stuck by choosing to continue to avoid hurt that occurred early in life. What was seen as too big for you to handle as a child may not be too big for you to handle as an adult. But with years of practice it may have become your habit to avoid. You are not looking through the lens of the present moment when stuck in a pattern, but instead you are on autopilot looking through the lens of early learning and conditioning.

The first step to any change is recognizing the problem and its nature and finding effective means to change what needs to be changed. We won’t be changing your old experience, that is not possible. You can work on changing your relationship to the old experience and begin to live from what you want now.



“The most fundamental aggression to ourselves, the most fundamental harm we can do to ourselves, is to remain ignorant by not having the courage and the respect to look at ourselves honestly and gently.”
― Pema ChödrönWhen Things Fall Apart: Heart Advice for Difficult Times-Goodreads

A good individualized collaborative therapy can help you learn how to become your own therapist.  Remember you have been observing yourself your whole life, even though you may never notice that you have. You are much bigger than your what you have learned and have become conditioned to believe and act upon.

We are committed to providing you with the tools that lead to learning to live a life you value. Rather than being dragged through life on autopilot trying to avoid a life that you don’t want begin thinking about building a life that you do want. 

Getting Started

I have provided a “disorders” section in this website. Before you look it over please understand that you are infinitely greater than any description of your problem.  The criteria in each of the categories helps us (you and your therapist) to identify the specific here-and-now issue that is affecting your quality of life.

We also use these categories for research purposes to look at problems that are presented with similar symptom profiles in order to continue to find better ways to help.  You may feel relieved knowing that what is hurting you has a name, but remember that the symptoms are what you have but they never describe who you are.  You can contact us at www.anxietyocdbala.com. We look forward to working with you. Contact us.

Kind Regards,