Dr. Lonette Belizaire works with young adults in our Anxiety Center, as well as with children and teens in our Children’s Center. Her primary treatment approach utilizes cognitive behavioral therapy (CBT). This is a modality which helps people recognize and change their negative thoughts and behaviors. Cognitive behavioral therapy can be effective in treating many mental health conditions, including anxiety and depression.
Do negative thoughts and behaviors really contribute to anxiety? “The brain has plasticity,” Dr. Belizaire says. “Trauma, anxiety, and distressing life experiences actually create structural changes within the brain.”
She explains that when we encounter something that worries or scares us, or puts us on guard, the amygdala – a small structure within the brain – responds with a nearly instant message to our hypothalamus. This activates the release of stress hormones and heightened physical responses, along with building new neural pathways.
This is designed to keep us safe. These responses help us take action during a dangerous situation or an imminent threat, such as making us leap out of the path of a speeding car. “The fight or flight response is protective and good,” Dr. Belizaire says, “but at times we apply this response when we’re not in danger.”
“For example, someone who is anxious and facing a work project may have the thought “I can’t get this done on time and I’m going to be fired,” she explains. “The distress response from this negative thought can lead to the person stalling or avoiding the project altogether. However, with cognitive behavioral therapy, this person would learn how to challenge their negative thought and replace it with a more positive one, such as “I can do my best to complete this project on time.”
Exploring Thinking Patterns
The longer we focus on and worry about something stressful, the more robust those neural pathways become and the stronger we respond. This is involuntary, of course, but it means the key to calming anxiety is through destroying those negative pathways and building more positive channels. In turn, our positive emotions support the building of new neural responses that suppress the old, negative reactions.
“I begin by having my clients look at their thinking patterns. I want them to explore how they see themselves, others, and how they operate within the world,” Dr. Belizaire says. “Part of our work together involves identifying these patterns and working to challenge those distortions.”
“When working with adults, we may explore how early childhood responses to early attachment figures may still be operating in adult relationships,” she says. “Are those messages still in place? How do these responses show up across relationships, in both the past and present?”
The answers to these questions can be illuminating. “Sometimes this is the first time the person has thought of it this way,” she says.
Along with traditional cognitive behavioral therapy, Dr. Belizaire often integrates self-care into her therapy sessions. Grounding techniques and mindfulness exercises help to refocus anxious responses and build positive neural pathways. “These techniques are aimed at the amygdala,” she explains.
“We know that self-care and self-regulating activities engage the physical to help the mental and emotional responses, so I try to find out what the client likes to do. What are their interests? Once I know, we incorporate regular self-care strategies in our work.”
For example, Dr. Belizaire may encourage yoga, diaphragmatic breathing exercises, meditation, or progressive muscle-relaxing exercises. When using visual imagery, “I may incorporate breathing exercises with visual imagery and have the client visualize breathing in calming white light or a calming word, phrase, or memory filling their body, and then exhaling black smoke, for example…or stress, anxiety and visualize it escaping their body with every breath.”
At times, she also gives “homework,” but it’s the kind that clients want to complete. “I’m not giving out actual homework,” she chuckles.
“Along with self-care homework, I may ask them to monitor their cognitive distortions between now and our next session, or implement a new sleep hygiene, or reward themselves after achieving a step towards their treatment goal.”
This self care work doesn’t have to be time-consuming either. “Something as simple as writing in a gratitude journal can help reframe your thinking more positively,” she says.
Just as with school-based homework or working out at the gym, Dr. Belizaire says that engaging in daily self-care exercises brings results.
“If you can learn to do them when you aren’t anxious, the habit kicks in when you are fearful, which helps ease your stress response. After all, when you are in those anxious moments, you are in fight or flight activated mode and you may not readily recall the strategies that will help reduce your stress response.”
In addition, a big step in reducing stress comes from being prepared for it. “If you can anticipate a trigger, such as an upcoming anniversary, exam, or anxiety-producing situation, you can prepare for it in advance, which can help reduce the stress during the actual event.”
We Are Here For You
Dr. Belizaire is primarily seeing clients through teletherapy right now. “There are advantages to telehealth, which includes scheduling,” she says.
One thing to keep in mind: “Teletherapy may not be appropriate for everyone and for every presenting concern,” she cautions, “but many people do benefit. Young children tend to do better with in-person interaction, but ‘tweens, teens, and adults all do well with teletherapy.”
If you are concerned that your child or teen is struggling emotionally or showing signs of anxiety or depression, we can help. To schedule an appointment with Dr. Belizaire or our other clinical team members, contact the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at (561) 496-1094.
About Dr. Lonette Belizaire, Ph.D.
Dr. Lonette Belizaire is a licensed psychologist with over 15 years of clinical experience working in a variety of treatment settings. She has worked with the gifted and talented child and adolescent school population, in college counseling centers, city hospitals and in private practice. She specializes in the treatment of anxiety, adjustment issues, interpersonal concerns, stress management, and bicultural identity. Dr. Belizaire’s approach is grounded in evidence-based treatment. She utilizes an integrative model that draws upon cognitive behavioral therapy and mindfulness-based interventions tailored to meet the client’s needs. She has found that building an awareness of the neurological basis of anxiety, how it is created and maintained in the brain, has also been particularly transformative for clients.
Dr. Belizaire earned her doctoral degree in Counseling Psychology from Fordham University, Master’s Degree in Mental Health Counseling from the University of Miami, and her Bachelor’s degree in Psychology from Stony Brook University. She has worked in some of the top institutions in the New York area including the Hunter College Campus Schools, Cornell University, and Pratt Institute. She is licensed in both Florida and New York.