Clinical Services

The focus of the The Anxiety & OCD Clinic Melbourne is the provision of psychological therapies on referral from GP’s, Consultant Psychiatrists and other medical specialists. These sessions have a Medicare rebate based on obtaining a Mental Health Plan from a Medical Practitioner. Some attend for Psychological Therapy when referred through Workcover, the Transport Accident Commission or other health insurance agencies. Patients with the appropriate private health cover may apply for private health insurance rebates on Psychological Therapies.
Further information on Medicare  for Psychology is available from the Australian Psychological Society (www.psychology.org.au).

About Anxiety

The Anxiety & OCD Clinic Melbourne seeks to help people who develop problem responses to what are otherwise normal and adaptive responses to threatening or novel social situations. In fact, anxiety is an important and necessary adaptation for normal functioning. When maladaptive, anxiety can lead to symptoms that exaggerate the normal stress response. Anxiety Disorders can result when anxiety is triggered too easily, lasts too long, reaches high intensity and interferes with normal functioning. Over-anxious people can become highly sensitized to their surroundings because of various factors - a genetically inherited component, critical incidents or ‘out-of-the-ordinary’ experiences, attachment issues, unresolved inner conflicts and other learned factors.
 

The following questions can point to problematic anxiety:

• Do you worry all the time? Does worry interfere with day-to-day life – your work, your hobbies, or your sleeping?
• Do you notice increased irritability and annoyance in daily living?
• Do you avoid parties, meetings or mixing with others because you are concerned that other people might think critically about you?
• Do you have rushes of fear or anxiety that cause your heart to race, to feel sweat running, to fear you might faint?
• Are you bothered by intrusive upsetting thoughts, the need to check things or to wash your hands frequently?
• Are you so fearful of very specific things – spiders, lifts, flying, or dogs – that you try to avoid them completely, or feel overwhelmed if you can’t?
• Have you had experiences that have become focal points of fear and loss in your life – the unexpected loss of a loved one, an experience of war or natural disaster, a life-threatening circumstance, a trauma or shock– causing flashbacks, periods of disconnection and emotional distress?
• Do you feel as if something bad or awful is about to happen?

If you answer YES to any of these questions, you may be dealing with disabling anxiety. You can find out further information by first checking with your doctor or The Anxiety & OCD Clinic Melbourne on 03-9420 1424.

There are specific groupings of symptoms and behaviour that are characterized as specific anxiety disorders:

• Panic Disorder describes recurrent unexpected panic attacks bringing intense emotional disturbances, thoughts that misinterpret the experience and set off a chain of concern about more attacks, worry about the implications of the attack, and the use of escape, avoidance and other safety behaviours. The misinterpretation that bodily sensations present imminent danger leads to constant self-monitoring looking for an early sign of a feared catastrophe.
• Agoraphobia is a strong fear or anxiety about being in situations from which a person feels they are trapped and cant escape. This feeling of being stuck brings on panic like symptoms for which no help seems available. It can occur in open places, in trams, aeroplanes or whilst standing in a queue. Agoraphobic situations are often avoided or overcome by having somebody as a companion.
• Generalised Anxiety Disorder describes the born worrier with excessive anxiety and worry about day-to-day events or activities – family, finances, work, and health. Such worriers see their worry as excessive but difficult to control resulting in restlessness, easily fatigued, poor concentration, muscle tension, sleep problems and poor coping ability. Over-estimation of threat, intolerance of uncertainty and persistent rumination are key factors.
• Social Anxiety Disorder is described by a persistent fear of social or performance situations with people, especially those not known to you, fearing the scrutiny by others and anxious about acting in a way that could be humiliating and embarrassing. The underlying fear is of being rejected, and the person so fears situational panic or humiliation that they avoid social settings, any centre-of-attention occasions, and develop intense internal self focus and safety behaviours that distort interactions with others (alcohol use, avoid conversation or eye contact, on edge of group, grip cup tightly, rehearse sentences in your head, put on a good front).
• Phobias relate to very specific issues that lead to marked fear, avoidance and interference in the lives of the sufferer. Examples are fear of flying, spiders, snakes or animals, heights, enclosed spaces, or crowded places, blood, needles, lightning or thunder are some of many examples of this commonly experienced anxiety state. The most common way of dealing with phobias is to avoid the situations where they present (like crossing the road when someone walking a dog approaches) or similar escape mechanisms arising from negative predictions about the feared thing (‘the pain of the needle will be unbearable’). These do not work overall, and more adaptive strategies are available.
• Post Traumatic Stress Disorder (PTSD) is a response to an overwhelming event that brings involuntary surges of anxiety owing to re-experiencing of the original trauma that was life-threatening, or extraordinary in its occurrence. This can be through flash-backs, persistent thoughts about the original event that bring a sense of being presently under serious threat’. The accompanying responses of heightened anxiety, sense of numbness, attempts to suppress or avoid the experiences disable the sufferer from being able to properly process the threat and distress in their current living.
• Health Anxiety is a fear and preoccupation that something is physically wrong and may in the future result in a more serious illness. People with Health Anxiety scan their body for signs of illness or misinterpret physical changes as signs of serious health issues. Health Anxiety results in either frequently seeking medical advice or avoiding consultation incase an illness is detected.
• Obsessive Compulsive Disorder (OCD) symptoms arise from attempts to avoid or escape from the heightened anxiety that I could be responsible for harm to myself or others. The anxiety triggers include various unwanted thoughts or impulses that 'intrude' persistently leading to attempts by the person to suppress or neutralize the anxiety by another thought or action that become repetitive, ritualized and compulsive. Such attempts at blocking, stopping or controlling our thoughts do not work, rather they lead to an increase in such thoughts. Research shows that people with OCD think differently from those without OCD. Key differences include the OCD sufferer placing high importance on having a particular thought and the need to keep control over the thoughts in your mind. Everyone can identify with the idea of an unwanted and surprising thought popping into mind, and then popping out again, without any distress or impact. The OCD person has qualities of perfectionism and intolerance of uncertainty that does not enable them to just let go of a thought. (‘bad thought = bad mind= bad person' is a common process in OCD). Further, the person with OCD feels responsible for the implications of such a thought and needs to do something to prevent the feared thing from happening.
  The most common manifestations of OCD relate to
  1) Contamination fears leading to RITUALIZED cleaning and avoidance as compulsive behaviours;
  2) Doubt and uncertainty that something bad will happen if they do not check their actions, do things in a 'just right way';
  3) Intrusive thoughts or images that a person feels are immoral, evil and reprehensible that could lead to some inappropriate and harmful behaviours.

Hoarding Disorder

Hoarding Disorder is a formal psychiatric disorder defined in the DSM5 (APA, 2013). Hoarding can occur independently of other conditions, but is usually associated with other co-morbidities. In the coming years, it is expected that education and research will lead to greater recognition of hoarding disorder and the development of appropriate treatments for a condition that is estimated to affect up to 5% of the population.

Treatment

The Anxiety & OCD Clinic Melbourne utilizes the platform of Cognitive Behavioural Therapy (CBT) that has an impressive body of research and clinical practice to support its effectiveness. Therapy provides strategies for settling physical symptoms, managing distressing worry and fear, and challenging the underlying distortions in thinking that lead to emotional distress. With practice, these CBT strategies enable people to gradually confront situations they have been avoiding due to anxiety, opening up possibilities of better managing their lives. CBT treatments are evidence-based, are applied in a collaborative way, with graded tasks appropriate for the individual context. The clinic encourages contemporary therapies utilizing mindfulness, hypnosis and CBT strategic interventions to complement established therapeutic models including dynamic therapies and pharmacotherapy.