top of page
leaves 3.png
leaves 3.png

Cognitive Behavioral Therapy

If there is a silver lining in all the mess and chaos of the pandemic, it is that I have been reintroduced to my first love and true passion of medicine - which is to help children and teens navigate the treacherous waters of peer pressure, school pressure and parent pressure amid the torrent of self pressure, self doubt, self deprecation and self pity.  

FOR... Kids, Teens & Young Adults:

I will tell you a secret... growing up, school did NOT come easily to me.  I had to work harder than everyone else just to bring home Bs and Cs.  Some things came easier than others and some things just did not make any sense at all... until it did.  I remember sitting in the kitchen of my childhood home as FOUR different adults tried (and failed) to explain the concept of subtraction to me.  Yes, subtraction.  I was simply unable to grasp the idea of "taking away".  No one could understand why I was having this problem, I had zero issues with addition and multiplication,  even division I understood!  Then, one day it just all clicked; I don't even remember how I worked it all out.  From that day on, I was constantly trying to outsmart my own brain, which I was no longer able to rely upon, so I started living my life by mnemonics.  Such as: Righty tighty and Lefty loosey; eat to the left and drink to the right when setting the table (yes, even to this day, every time), I have several for spelling: there is a rat in separate, double the c and s to have success, 2 wrongs don't make a right but three lefts do... and those are just the ones I can think of off the top of my head!

So, subtraction is only one of my earliest memories, the other is from second grade when I repeatedly got in trouble for playing around in the bathroom rather than being in class - but I had been B-O-R-E-D in class.  This is how it went for me - either it was too easy and I got bored or it was overly difficult and I got frustrated.  Either way, I was NOT a fan of school, teachers, other students or learning!

I continued to struggle and work my way through middle and high school.  I even managed to score enough points on my SATs to be accepted to Brandeis University (this was the only school I had applied to, early decision.  I was admitted and accepted and did not even bother applying anywhere else).  In the middle of my second semester of my Freshman year of undergrad, my foreign language professor helped me identify the source of my frustration and trouble in school.  See, what was happening was that I spent 6 hours a week sitting in class and another 3-6 hours a week in the professor's office getting one-on-one help in her office hours as well as studying on my own; yet, I was still failing every exam, test and quiz that was given.  Because my professor knew first hand how much time and effort and work I was putting into the class, she finally suggested that I might have a learning disability.  This annoyed me at first, but I took myself over to the Health Services building on campus and asked for literature about Learning Disabilities.  On the page that listed out the symptoms of the various types of learning disabilities, I discovered that I had 99% of the problems and issues listed!!!

All at once I felt angry and relieved!!!

I had to wait several months for a testing date to become available, when I was finally able to be properly evaluated it was determined that not only was I ADHD (hyperactive) but that I also possess 7 (yes, SEVEN) different types of Dyslexia!!! There is the classic style dyslexia where I mix up letters like b and d or transpose numbers where 748 might become 784.  Then there is the type where I confuse "quarter of eleven" (which would be 10:45) for 11:15.  And the one where I add or subtract letters from words and/or words from sentences.  There is one where I know the word I want to say but I can't remember what it is so I have to describe it instead.  But the worst one of all is the one where I cannot pull the word up at all - it as if my whole brain has gone blank, and if I happen to be teaching a group or taking as an authority, this becomes embarrassing to me.  Even more so, than my dyslexic comprehension where I literally understand the opposite of the concept that was being offered to me, at least with that one I have an opportunity to ask if I have it correct or not.  

Why am I telling this all to you???

Because, that was a long time ago and I had to teach myself all these tools that are now widely available.  Sadly, not enough people are aware of these tools let alone HOW to take advantage of them.  I continue to tell people this story because if I am able to make it through grade school, university and post-graduate medical school, then anyone is able to!

I welcome patients of all ages and I am especially eager to provide tools to those who are actively looking for them.  Once you understand what your pattern is, it can be changed. Cognitive Behavioral Therapy is specifically designed to teach you how your brain works. Like fingerprints and snowflakes, no two brains are exactly alike! There is no one way that works across the board. By utilizing the Cognitive Model, we can literally create a unique to you User's Manual to follow to allow you to untangle your thoughts, get you out of the struggle and back to being your true self.  


My passion is to help children, teens and young adults to feel comfortable in their own skin and heads.  My mission is to empower people with tools and skills to make better choices.  

More FOR: Adults or Parents


CBT teaches us first to become aware of underlying patterns of thought that may exist, then to question the validity of this pattern of thinking and finally to change the pattern of thought and therefore behaviour. 

CBT is a structured, short-term, present-tense, goal-oriented psychotherapy which is directed toward solving current problems you are facing and modifying inaccurate or unhelpful thinking and behavior.  


By nature, CBT Therapy has a beginning, a middle and an end; depending on your underlying thoughts and emotions, you would be able to reach your goals in a just a few short months and once you achieve your goals, you are done with therapy.

The power of cognitive therapy lies largely in its focus on the automatic, distressing thoughts that fuel anxiety and depression. 

Working with Dr. Pihlgren:

  • You will learn to recognize, evaluate, and correct thoughts that may keep you up at night but fail to alleviate your worry. 

  • You will gain the ability to reduce and even prevent panic attacks. 

Anxiety has many faces, but for some people, anxiety becomes overwhelming, characterized by excessive and persistent feelings of apprehension, worry, tension and nervousness over everyday situations that most people face with little concern or thought.  

According to Kline (1964), more human suffering has resulted from depression than from any other single disease affecting humankind. 


Depression is second only to schizophrenia in admissions to mental hospitals in the US.  Furthermore, it is estimated that the prevalence of depression outside hospitals is five times greater.  This disease has been plaguing humans since the beginning of time.  In fact, the cardinal signs and symptoms used today in diagnosing depression are found in the ancient descriptions: disturbed mood (sad, dismayed, futile); self-castigations ("the accursed, hatred of the gods"); self-debasing behavior ("wrapped in sackcloth or dirty rags... he rolls himself in the dirt"); wish to die; physical and vegetative symptoms (agitation, loss of appetite, weight loss, sleepiness); and delusions. 


That is to say that depression can now be defined by the following attributes:

  1. A specific alteration in mood: sadness, loneliness, apathy.

  2. A negative self-concept associated with self-reproaches and self-blame.

  3. Regressive and self-punitive wishes: desires to escape, hide or die.  

  4. Vegetative changes: anorexia, insomnia, loss of libido.

  5. Change in activity level: retardation or agitation.  

​CBT has been well researched and has been found to be effective for a wide variety of disorders:

  • CBT is considered a reliable, first-line approach for anxiety disorders, which means it is the first approach that should be considered, or the gold standard, for treating anxiety disorders (Hoffman et al., 2012).  

  • While most research studies ues an adult population, CBT has also demonstrated to substantially improve symptoms of anxiety disorders in children and adolescents, where improvement was maintained when measured as long as two years after treatment ended (Ishikawa, Okajima, Matsuoka & Sakano, 2007). 

  • Because research studies often exclude individuals based on certain criteria, such as having a comorbid diagnoses, studies have also examined the use of CBT in real-world settings and found it to be an effective treatment under those circumstances, as well (Stewart & Chambless, 2009). 

  • Research has found CBT to be efficacious treatment for:

    1. Panic Disorder - with some research suggesting that it may be superior to medication (Mitte, 2005)

    2. Generalized Anxiety Disorder (GAD) - reducing the prominent symptom of worry (Hanrahan, Field, Jones & Davey, 2013)

    3. Social Phobia with patients experiencing better outcomes after treatment than compared to those who only received medication (Fedoroff & Taylor, 2001)

    4. Obsessive Compulsive Disorder (OCD) - highly effective for relief from obsessive thoughts and compulsive behavior (Olatunji, Davis, Powers & Smits, 2013)

    5. PTSD - superior to non-directive counseling and psychodynamic psychotherapy (Bisson & Andre, 2008)

    6. Generalized Depression - with significant impact on both short- and long-term effectiveness (Mark Reinecke and colleagues, 1998)

    7. Major Depressive Disorder is one of the most common and debilitating mental disorders. Cognitive behavioral therapy (CBT) for depression has received ample empirical support and is considered one of the most effective modes of treatment for depression. (Isr J Psychiatry Relat Sci Vol 46 No. 4, 2009)

bottom of page