Big Apple Counseling
NYC / NYS Psychotherapy
Dr. Matt Paldy
"When I look back on all these worries, I remember the story of the old man who said on his deathbed that he had had a lot of trouble in his life, most of which had never happened."
— Winston Churchill
NYC Anxiety Disorders Therapy

Anxiety disorders are among the most common mental health conditions globally. According to the World Health Organization (WHO), approximately 7.3% of the global population is affected by anxiety disorders in any given year. In the United States, the National Institute of Mental Health (NIMH) estimates that around 19% of adults experience an anxiety disorder in a given year. This makes anxiety disorders the most common mental health issue in the U.S. The prevalence of anxiety disorders can vary by age, gender, and other factors. For instance, women are more likely to experience anxiety disorders than men, with studies indicating that women are about twice as likely to be affected. Anxiety disorders also tend to begin early in life, with 50% of cases typically emerging by the age of 11. It's important that you seek help if you believe you have an anxiety disorder. I will help you learn the skills you need to manage your anxiety and enjoy a full and rewarding life.

NYC Obsessive Compulsive Disorder (OCD)
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Obsessive-Compulsive Disorder (OCD) is a mental health condition where a person experiences recurrent, unwanted thoughts (obsessions) and feels the need to perform certain behaviors or rituals (compulsions) to reduce the anxiety caused by these thoughts. For example, someone with OCD might constantly worry about germs or contamination (an obsession) and feel compelled to wash their hands repeatedly (a compulsion) to feel safe. The obsessions and compulsions can take up a lot of time, sometimes interfering with daily life and making it difficult to focus on work, school, or relationships. While the person may recognize that the thoughts and actions are excessive, they feel unable to control them. OCD affects people of all ages, and the severity of symptoms can vary. With the right treatment, many people with OCD can manage their symptoms and lead fulfilling lives.

NYC Panic Disorder
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Panic disorder is a type of anxiety disorder characterized by recurrent and unexpected panic attacks—sudden, intense episodes of fear or discomfort that often include physical symptoms like rapid heartbeat, sweating, shaking, shortness of breath, chest pain, dizziness, or a feeling of losing control. These attacks can occur without any clear trigger and may happen at any time, even during relaxation. Over time, people with panic disorder often develop fear of having another attack, which can lead them to avoid places or situations where they previously experienced an attack, limiting their normal activities and affecting their quality of life. Normal fears, on the other hand, are temporary emotional responses to real-life stressors or potential dangers. For example, feeling nervous before a big presentation or being scared when watching a horror movie are typical experiences that are generally not overwhelming and don't interfere with a person’s daily life. Unlike panic disorder, normal fears are situational and proportional to the event at hand, and once the situation resolves, the fear usually fades. In contrast, panic disorder involves unexpected and intense feelings of fear that can happen without an obvious cause, and the anxiety tends to persist.

NYC Phobias

Phobias are intense, persistent fears of specific objects, situations, or activities that are out of proportion to the actual danger posed by them. Unlike normal fears, which are common and temporary responses to things like heights, spiders, or public speaking, phobias cause significant distress and can interfere with a person’s daily life. For example, someone with a phobia of flying (aviophobia) may experience overwhelming anxiety just thinking about getting on a plane, leading them to avoid air travel altogether, even if flying is necessary. Phobias often trigger physical symptoms like a rapid heartbeat, sweating, and dizziness when confronted with the feared object or situation. These symptoms can be so intense that they disrupt social, occupational, or other important areas of functioning. Normal fears, on the other hand, are a natural response to potential dangers and usually don’t last long or cause major disruptions in a person’s life. For example, feeling anxious about an upcoming exam or a first date is a common experience that tends to fade once the situation is resolved. Phobias tend to be more persistent and irrational, while normal fears are often temporary and proportional to the situation.

NYC Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after a person experiences or witnesses a traumatic event, such as a natural disaster, serious accident, military combat, sexual assault, or other life-threatening situations. People with PTSD may experience flashbacks, where they feel as if they are reliving the traumatic event, and nightmares about the incident. They may also experience intense emotional reactions, such as anxiety, anger, or guilt, and may avoid situations or people that remind them of the trauma. Other common symptoms include feeling detached or numb, difficulty concentrating, and being easily startled or feeling on edge. These symptoms can be severe enough to interfere with daily life, affecting relationships, work, and overall well-being. PTSD can develop soon after the traumatic event, or it may emerge months or even years later. With appropriate treatment, many people with PTSD can learn to manage their symptoms and lead fulfilling lives.

NYC Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable worry about a wide range of everyday situations, often lasting for six months or more. People with GAD experience constant, persistent anxiety that is not limited to specific triggers, and they find it difficult to control their worry, even when there is little or no reason for concern. Along with the worry, they may experience physical symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. This level of anxiety is disproportionate to the situation and can interfere with daily life, affecting work, relationships, and overall functioning. In contrast, normal anxiety is a natural and temporary response to stress or danger. Everyone experiences anxiety in response to challenging or unfamiliar situations, such as preparing for an exam, a job interview, or a big presentation. Normal anxiety tends to be situational, fading once the event or stressor has passed. It does not typically cause persistent worry or significant impairment in daily activities. While normal anxiety may cause some discomfort or distress, it is proportional to the situation, whereas GAD involves excessive and uncontrollable worry that is ongoing and not tied to specific circumstances.

NYC Social Anxiety Disorder

ocial Anxiety Disorder (SAD), also known as social phobia, is a condition characterized by an intense fear of being judged, embarrassed, or humiliated in social or performance situations. People with SAD often experience overwhelming anxiety at the thought of interacting with others, especially in unfamiliar or group settings. This anxiety can be so severe that it leads to avoidance of social situations, such as parties, public speaking, or even casual conversations, which can interfere with daily life, work, and relationships. Common symptoms include rapid heartbeat, sweating, blushing, trembling, nausea, and difficulty speaking or making eye contact. The fear is usually out of proportion to the actual threat, and individuals with SAD may worry excessively about being negatively evaluated by others, even in situations where no judgment is likely. Social anxiety is more than just shyness or occasional nervousness; it is a persistent condition that can cause significant distress. can be understood as a reflection of deep-seated feelings of emotional isolation and disconnection. Social anxiety is not merely an issue of fear of judgment or embarrassment but often stems from early relational experiences where an individual’s self-experience was not adequately validated or attuned to by caregivers or significant others. As a result, individuals with SAD may develop an internalized sense of self-doubt, worthlessness, or shame that they fear will be exposed in social interactions. These fears manifest as intense worry about being negatively evaluated by others, and the individual may experience overwhelming feelings of vulnerability or rejection when engaging socially. The anxiety becomes a defense against the perceived threat of emotional disintegration or exposure of an inadequate self. Healing occurs when individuals can experience empathic attunement in a therapeutic relationship, where their inner emotional world is deeply understood and validated. Through such attunement, individuals with social anxiety can begin to form a more cohesive, authentic sense of self, leading to greater confidence and comfort in social interactions.

NYC Stress Management and Personal Growth

approach to stress and personal growth is deeply rooted in his self-psychology, which focuses on the importance of emotional attunement and the relational experiences that shape one's sense of self. Stress often arises from experiences of emotional misattunement in early relationships, leading to a fragmented or underdeveloped sense of self. When a person feels misunderstood, disconnected, or invalidated, they may experience heightened stress as they struggle to make sense of their inner world and cope with life's challenges. This stress can manifest as anxiety, depression, or other emotional distress, which occurs because the person feels disconnected from their true self or is unable to process their emotions in a supportive, validating way.

For personal growth, I believe in the healing power of empathic attunement, which occurs in therapeutic relationships where the therapist deeply understands and resonates with the client’s emotional experience. Through such an attuned relationship, the person can feel safe to explore and integrate parts of their self that may have been repressed or denied due to past emotional wounds. True personal growth happens when individuals can move toward self-cohesion, meaning they develop a more integrated sense of identity that is not fragmented by internal conflicts or unresolved relational traumas. Growth involves acknowledging and accepting difficult emotions, gaining self-understanding, and cultivating a sense of self-worth that is not dependent on external validation but instead emerges from the acceptance of one's true, authentic self.

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