Dr. Bourland provides cognitive-behavioral therapy to treat the following disorders.
Chronic pain is pain that persists despite medical intervention,
such as surgery or treatment with pain medication. It may be caused by
injury, such as damage to the back or neck, or by illness, such as
fibromyalgia, interstitial cystitis, diabetic neuropathy, or complex
regional pain syndrome (formerly known as reflex sympathetic dystrophy, or
RSD). Many people with chronic pain have been suffering for years.
Psychologically based pain management therapy includes
interventions that can directly reduce the severity of the pain itself,
such as relaxation and visualization. Therapy also addresses the many
negative emotional and social consequences of chronic pain, such as
depression, anxiety, frustration, irritability, boredom, difficulty
sleeping, social isolation, and marital distress. Because chronic pain
robs people of many rewarding and satisfying aspects of their lives, such
as work, social interaction with friends, and sexual intimacy, I often
refer to the goal of psychotherapy as “getting your life back.” As
patients gradually reintroduce activities they had been avoiding because
of their pain, many find that the pain itself actually decreases, because
their attention is distracted away from the pain by the pleasurable and
The American Psychiatric Association’s Diagnostic and Statistical
Manual of Mental Disorders – Fourth Edition (DSM-IV) describes several
anxiety conditions, including panic disorder, agoraphobia,
obsessive-compulsive disorder, posttraumatic stress disorder, specific
phobia, social phobia, and generalized anxiety disorder.
Panic Disorder is characterized by recurrent, unexpected panic
attacks. A panic attack is a sudden, very unpleasant rush of intense fear
or discomfort. Panic attacks include physical symptoms such as racing
heart, shortness of breath, and chest pain, and a person experiencing a
panic attack may believe that he or she is having a heart attack and is
about to die. Because panic attacks occur unexpectedly, a person with
panic disorder may live in constant fear of the next panic attack.
Panic Disorder may lead to the development of Agoraphobia, in which
the person begins to fear and avoid situations where escape might be
difficult (or embarrassing) in the event of a panic attack, such as
crowded rooms, driving, or being outside the home alone.
As its name implies, Obsessive-Compulsive Disorder is characterized
by obsessions and compulsions. Obsessions are recurrent and persistent
thoughts, images, or impulses, such as fear of being contaminated by
germs, fear that a loved one will be harmed, or unwanted and intrusive
sexual thoughts. Compulsions are recurrent behaviors or mental acts, such
as hand washing, checking, or counting, that the person feels driven to
perform to decrease the anxiety cause by an obsession, or according to
rules that must be applied rigidly.
Posttraumatic Stress Disorder can develop in response to a
traumatic event, such as violent crime, combat, or natural disaster.
Following the event, the person with posttraumatic stress disorder
develops symptoms such as intrusive memories of the event, nightmares,
difficulty sleeping, and irritability.
Specific Phobias are fear and avoidance of specific objects or
situations, such as heights, flying, animals, injections, or seeing blood.
Social Phobia is fear and avoidance of situations that involve
exposure to unfamiliar people or to possible scrutiny by others. The
person with social phobia fears that he or she will behave in a way that
will be humiliating or embarrassing. Commonly feared social situations
include parties, dating, and public speaking.
Generalized Anxiety Disorder is characterized by excessive and
distressing worry about a number of topics such as money, work or school
performance, one’s health, the health and safety of family members, and
minor matters such as household responsibilities or being late for
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