Validation Without Reassurance


Written by Hadar Naftalovich

[Note: Details have been changed to protect patient privacy]

When I started working at the Center for Anxiety, I quickly learned that some of the inquiries we receive are rather different from the typical phone calls I’d been used to. In some cases, I was surprised by the amount of clinical information that one could gather from a simple conversation. Here is one telling exchange I had with one of our patients who suffered from Obsessive Compulsive Disorder (OCD).

H: Center for Anxiety, Hadar speaking. How can I help you? P: Hello? Is this Hadar? H: Yes, this is Hadar. How can I help you? P: I am a patient at your center. What time is my appointment next week? H: It’s on Wednesday at 12:30 P: What? (rather loudly) What? H: It’s on Wednesday at 12:30 P: Thanks. Wait… What time is my appointment? I couldn’t hear you. H: Your appointment is Wednesday at twelve-thirty in the afternoon. P: Okay. See you then. Actually… Did you say it’s at noon???

Even more interesting, this patient called me one day before her next appointment the following week, and we had more or less the exact same conversation. At that point, I approached her therapist to tell her about the burgeoning pattern, and was surprised to learn that at each of the past two sessions, the patient had been given her appointment time in writing on a business card. We therefore realized the patient was engaging in compulsive checking – in other words, the phone calls were actually a symptom of her OCD.

The question for me thus became how should I handle such calls in the future. I wanted to convey to the patient that I cared about her without giving into her compulsions, which would ultimately make matters worse for her. With guidance from the Center for Anxiety directors, I learned a key skill that I like to call Validation Without Reassurance. I now use this approach every day in dealing with patients and their families. Here’s what it involves:

When patients call our office, it means that either they, or a loved one, are experiencing a problem. Often times, they have tried to find help elsewhere to no avail. I therefore try my best to validate their pain. I reflect back to them what they say to me – to make sure that I have the correct information, and also convey to them that I understand what they are going through. I also try to help them make some sense of their situation. For example, many OCD sufferers call our office after years of non-CBT treatment, which only made their symptoms worse. Validating their experience provides some degree of immediate relief from the pain they are carrying. I also try to instill hope, by conveying what our office can do for them and the results we’ve achieved in similar cases.

However, once I have provided this validation many patients are left wanting more, and will ask questions or make statements geared towards getting me to repeat what I have said. This is called “reassurance-seeking” and consistent research from around the globe shows that, for individuals with anxiety and related symptoms, it is associated with worse outcomes and prolonged suffering. I therefore had to learn to not repeat information that has already been discussed, just to provide temporary relief. If you call my office, you will not hear me say things like “You’ll be fine!” or “Everything will be okay!” This is not because I lack confidence in our services – every day I see patients whose lives have been changed by our clinical team. But telling this to patients serves no benefit, and in fact can cause more problems over time. It’s important for patients – like all people – to learn to accept uncertainty, and providing reassurance doesn’t allow for that to happen. Especially for people with OCD, shortly after receiving reassurance they will start to experience new intrusive thoughts, their doubts return with a vengeance, and they will feel the need to be reassured once again.

While I learned how to validate without reassurance primarily to help our patients, I have found that the same skill has also helped me communicate better with my friends and family. I am able to support my loved ones better than ever, because I realize subtleties in our communication patterns and understand that what they truly need may not be exactly what they say or think they need. Getting into the habit of validating without reassurance did not come without its challenges, but once I was able to integrate these skills into my regular speaking patterns I have found that my ability to listen and communicate has greatly improved.

Inspirational Message

The Way of Mastery is to break all the rules—but you have to know them perfectly before you can do this; otherwise you are not in a position to transcend them.

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What Clients Say

In a recent survey of our patients, 94% would recommend our practice to a friend.
Calmer in the Face of Hardship
I came to the Center for Anxiety for help in dealing with a family member who suffered from extreme anxiety. But I ended up getting a serious illness two months later and started having my own sessions. With the help of my therapist I got through my illness, learned to understand my habits that were making my major life stresses worse, learned to communicate better, taper my anger, and surprisingly I became more calmer even though my hardships in life worsened. Therapy is a lot of work and not easy, but nothing in life comes easy! I became a better and softer mom and (when I practice what I learned) and my kids and home are calmer and happier. I am still a work in progress and have more to work on, but I know I am on the right path. I wish I knew before how my communication style and anger were really impacting my life, how being softer you can accomplish way more then being harsh. I have been to other therapists in the past and I can hands down say that the Center for Anxiety’s approach is really effective. I have even referred a bunch of people to the Center and they have been really happy with the therapists and how much they really care for their patients.
I Tackled a Long List of Fears
When I first came to the Center for Anxiety, my list of anxieties/fears was long! I was scared of getting sick, getting stranded, driving, flying and more. With the help of my therapist, I immediately got to work and tackled every one of my fears. Now the world is open to me and I feel free! I can dream big and accomplish whatever I set my mind to! I am especially grateful that I was able to do all this without having to rely on medication. It was hard work – grueling at times! – but now I have the coping tools within me for life. In fact a family member recently said to me “You are awesome. You can accomplish anything you set your mind to because you don’t let fear stop you! ” Thank you Dr. Rosmarin and the Center for Anxiety staff for helping me get here. My fears no longer limit me and I love my life. Try it, it might turn your life around too!
Highly Skilled and Professional Treatment
When I sought treatment at the Center for Anxiety, the clinic was is in its incipient stages. However, by the time I successfully finished treatment, the Center for Anxiety grew and flourished into a world-class treatment center, offering cutting-edge, evidence-based treatment to countless individuals. The continued success of the Center for Anxiety comes as no surprise to me, with a team that contains such highly skilled professionals who display clinical acumen, empathy, and compassion. When I first entered treatment I was concerned that therapy would be similar to the experiences with past psychologists: a seemingly bottomless pit with no reductions in my anxiety symptoms, but was so relieved when I started to feel less anxious after only a handful of sessions. My therapist created a treatment plan that was tailored exactly to my needs and taught me practical skills to help me work through my anxiety that I still use and practice to this very day.
No More Panic
When I first came in, I was struggling with panic disorder and didn’t even know it, which only made dealing with it that much more difficult. After my first time sitting down with my therapist, however, I instantly started to gain perspective and look at the difficult situation in a different light. Our meetings helped me conquer the issue step by step and get my life back on track. I’d strongly recommend that anyone dealing with anxiety in a way that impacts their day to day life should visit the Center for Anxiety! I know it helped me tremendously.
Free of Obsessions
When I woke up one morning last June and didn’t want to get out of bed, I knew I needed help. The thought of getting through another day with all my anxieties, obsessions and rituals was just too overwhelming. After feeling stuck for years, I just couldn’t anymore. Thankfully, that’s when I found the Center for Anxiety. Dr. Rosmarin and his staff are experts at what they do, kind and professional. After just several weeks I accomplished my initial targets. The change I experienced in such a short amount of time was astounding that I stayed on for a while longer to work on more complex goals. I soon achieved those too. Now, I am free of my obsessions, know how to manage my anxiety, and love my life. My only regret: not having done this sooner. I wish I had known that you don’t have to wait to hit rock bottom to get help.
Depression Lifted
I’m 26 years old and I’ve been suffering from terrible depression for 7 years. In the throws of my sadness I literally wanted to die. Soon after starting therapy at the Center for Anxiety, my depression lifted. My suicidal thoughts began to dissipate. I remember the feeling that came over me as soon as the dark cloud above me left. It was the most liberating feeling I have ever experienced. I actually shouted to my friends, family and anyone nearby me “I’m Happy! I am Happy!” I felt free.
From EXISTING to LIVING
Over the course of four years I developed anxiety-like symptoms (tightness in chest, gut, back) that slowly but surely increased in duration and severity. The EXTREMELY uncomfortable nature of the symptoms notwithstanding, I still continued and managed to function. The effort required to do so, however, left me utterly drained. Having always been a very spiritual person I strongly felt that a course of therapy incorporating a spiritual component could potentially work well for me and decided to give the Center for Anxiety a try. Happily, I have achieved significant symptom reduction, tremendously improved emotional/mental health, and above all, Connection. Medication free. I’m no longer just existing, I’m LIVING. I’ve been given a second chance to become the unique human being that I was meant to be.
No More worries
I have wormed in healthcare for 36 years in many different settings, and I have been overwhelmingly satisfied with the Center for Anxiety. When staff says they are going to call, I get a call. From the first contact, I have been very impressed with the professionalism and efficiency. I had a situation and needed to have sessions more than once per week, and my clinicians worked out a schedule to accommodate my needs. I was astounded that they attended to me so quickly and effectively - they made my priority their priority. My clinicians were also excellent at what they do - they have a plan for me each session, and it's clear that they have thought in advance about each session, and that they are listening to what I say and observing what I do, even though our sessions have been conducted via Telehealth. Compassion is a quality that I have all too often found to be lacking in my experiences as a healthcare professional and patient, and this is not the case with the Center for Anxiety. Of all the websites I found on Google, I am so thankful that God guided my hand to yours.
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