Dealing with doubt: North Tahoe psychologist’s clinic focuses on anxiety, OCD, other phobia-related disorders

Tim Hauserman | Special to the Sun
Anxiety makes it too hard for some people to perform the simple tasks that everyone needs to be successful in life — and often, avoiding things that make people nervous is common.
Courtesy | iStockphoto

When does anxiety become a disorder?

Dr. Barmann, as well as other experts within the field of anxiety disorders, say it depends upon five primary factors: frequency, duration, intensity, interference with daily activities, and avoidance.

The normal anxiety all people face can become a disorder if these five factors are present, Barmann said.

Therefore, Barmann recommends people who feel they may have a disorder ask themselves the following questions:

1. Frequency: How often do you feel anxiety — every day, or just once in awhile?

2. Duration: How long does your anxious arousal last on any given day — just a little, or throughout much of the day?

3. Intensity: Is your anxiety causing physical symptoms such as chronic headaches, fatigue, chronic indigestion or IBS (irritable bowel syndrome) that is not caused by exercise, injury or diet? Do you have trouble sleeping, but still wake up wired? Do you carry anxiety medication with you at all times?

4. Interference: Does your anxiety stop you from performing important everyday activities? Are you worried constantly about making mistakes or not meeting your rigid standards of what should be happening in your life? Do people say you are a perfectionist, or that you have irrational fears or compulsive behavior?

5. Avoidance: Are you avoiding engaging in certain behaviors as a result of your anxiety? Barmann gives the example of a client of his who would fly from Oakland to San Francisco to avoid going over the Bay Bridge, or someone whose fear of flying makes him or her drive 10 hours for work once a week instead of taking a short commuter flight. Or, do you feel that all eyes are on you in a social setting, thus causing you to avoid going to various social functions? Barmann gives another example of a client of his who turned down a lucrative job promotion because it would require him to give staff presentations at work each week.

According to the National Institute for Mental Health, more than 40 million people in the United States suffer from anxiety disorders. That’s roughly 18 percent of the population — or nearly one in five Americans.

While most people experience some level of anxiety, those who suffer from anxiety disorders can become overwhelmed and have difficulty dealing with day-to-day life.

To help those who are challenged by these types of disorders, Dr. Barry Barmann and his wife, Mary, created the Center for Anxiety and Chronic Worry in Incline Village, the only such clinic in the North Tahoe area.

“Within two months of opening our clinic, we had a six-week waiting list for those who needed to be treated for some type of anxiety condition,” Barry Barmann said.

The Barmanns, who have operated an anxiety clinic in Westlake Village, Calif. (Ventura County) for 27 years, have owned a second home in Incline Village for the past 17 years.

For years, their Tahoe friends have been suggesting they open a clinic in Washoe County, and after determining the demand was here, they opened the center last year on Village Boulevard.


We all need a bit of anxiety in our life to getting us out of bed in the morning and working toward accomplishing our goals. It’s that little juice that gets us to work on time and reminds us to call our parents.

But for many people, harboring too much anxiety makes it hard to perform the simple tasks that everyone needs to be successful in life.

Barry Barmann, Ph.D., a Licensed Clinical Psychologist in Nevada and California, said those who suffer from an anxiety disorder tend to “overestimate the probability of encountering danger, overestimate the severity of the outcome, and underestimate their ability to be able to handle any danger.”

Often, those who suffer from overwhelming anxiety, Barmann said, follow a rule that, “whenever you feel uncertain about something, you get really anxious. People who are anxious hate uncertainty; they cannot deal with doubt.”

These disorders can start fairly early in life, he said. The average age for women to develop an anxiety disorder is 22, while men usually develop it even sooner, in their late teens.


Anxiety disorders include Obsessive Compulsive Disorder, Panic Disorder, Generalized Anxiety Disorder, Social Anxiety and various types of Phobia.

Barmann uses a technique known as cognitive behavioral therapy, which begins with a thorough assessment of the patient, to determine if he or she has a disorder that needs treatment.

Once he finds out what the patient is suffering from, he said, “I begin with education, teaching them everything there is to know about that disorder. I want them to know their condition.”

Then he develops a “very specific, individually based treatment protocol” for each patient.

A big part of this protocol is the patients have to commit to work hard to overcome the disorder.

He assigns homework they need to accomplish between sessions, which in most cases means practicing the techniques he has taught them to deal with their anxiety issues.

“People who are anxious avoid what makes them anxious,” Barmann said. “With cognitive behavioral therapy, we are changing their misinterpretation of what the reaction would be.”

This is done by gently exposing patients to what triggers their anxiety, so they learn that what they fear is actually not likely to happen — or, if it does, they can handle it.

For example, if you have people who have a fear of social interaction so severe they haven’t been able to leave the house for four years, Barmann would tell them to go to a grocery store once a day for an hour and ask five people what time it is.

Later, as they gain confidence, he will teach them to speak to a small group of people for a few minutes, and then to a larger group for a longer period of time.


The goal with all this is for people to discover that things are not as bad as they think.

“I see people rarely more then 12 sessions,” Barmann said.

He wants patients to leave with a skillset they didn’t have when they came in, which will enable them to deal with anxiety on their own.

After initial sessions, Barmann usually sees patients once a month for a few months, then once every six months.

“They learn how to shift their reaction to everyday events, from feeling threatened to being able to handle it,” he said.

The Center for Anxiety and Chronic Worry is located at 120 Village Blvd.

In addition to comprehensive cognitive behavioral therapy available by appointment, the center hosts free seminars on chronic worry and anxiety disorders.

The Barmanns also provide continuing education courses for Nevada nurses on how to deal with anxiety disorders seen in the medical setting, and assessments for ADHD (Attention Deficit Hyperactivity Disorder) in children and adults.

To learn more, visit, call 805-379-2800 or email Barmann at

Tim Hauserman, a nearly lifelong resident of Tahoe City, is a freelance author and cross-country ski instructor. He may be reached at

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