Dr. Rotter is a licensed clinical psychologist who works with children, adolescents and adults to address a wide variety of issues and problem areas. She is experienced in helping clients with trauma, past abuse, anxiety, depression, adjustment issues, behavior problems, parent-child conflict, stress management, self-esteem issues, health anxiety, and those seeking personal growth. She realizes that no one treatment approach will work for every person; each new client’s needs and strengths are reviewed to help build a successful plan for treatment.
Dr. Rotter’s education includes a Bachelor’s degree from the University of Illinois at Urbana, and Master’s and Doctoral degrees from Wayne State University in Michigan. She has worked in both mental health and primary care settings with clients of all ages. After practicing in Iowa for four years, she moved to Illinois where she has been licensed as a clinical Psychologist since 2002. She is a member of the National Register of Health Service Providers in Psychology, and a member of the American and Illinois Psychological Associations. In order to remain up-to-date on treatment and practice issues she regularly attends continuing education conferences. She has developed a special interest in working with those on the autism spectrum, particularly those with Asperger’s Syndrome.
Click to learn more about Dr. Ann’s Areas of Specialty:
Abuse and other Traumas
Depression
Anxiety
Additional Areas of Interest and Information:
The Decision to Seek Therapy
What is Therapy?
Autism-Spectrum Disorers
Childhood Hyperactivity, Defiance, and Peer Relation Problems
Abuse and other Traumas
A trauma is any extremely stressful event or set of events that involves a threat to the safety of oneself or someone else, or to one’s sense of self. Typically, a traumatic reaction to such an event involves intrusive memories of the event, a sense of helplessness both at the time of the event and later, and attempts to avoid reminders of the event. Trauma affects a person’s mood and life in long-lasting ways. Often, abuse or other traumas break a person’s basic sense of trust in others or beliefs about who they are as a person.
If you’ve experienced a trauma, your whole life might seem to be defined by that one very bad thing that happened. It might feel like life will never be normal again, and that you’re vulnerable to more bad things happening – without any way to stop it. Over time, this sense of helplessness and vulnerability can lead to depression, a very restricted life as you avoid reminders, and other problems (for example, addictions).
The desire to avoid memories and reminders of what happened is normal, but can be counterproductive. There are treatments that can help reduce the intrusive memories and strong feelings that often are associated with trauma. These treatments can help you feel safer and more in control of your life and future. Dr. Rotter’s treatment philosophy puts the client in charge of the pace of therapy, especially in cases of abuse or other trauma. In working with clients, she reviews the treatment choices and what each involves. Deciding what type of treatment you are ready for will be your choice. Sometimes just identifying how your life is impacted by what happened in the past, and building ways to reduce that impact, is helpful. The important thing is that you consider taking charge of how you’ve been affected, rather than feeling powerless or out of options.
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Depression
Many things can cause depression, including loss, a series of negative events, the break-up of an important relationship, trauma, abuse, or even a biological predisposition (family history of depression). It is even possible to be depressed without fully realizing it. Some people will complain about feeling tired and restless, feeling dull, having trouble sleeping or concentrating, or experiencing significant appetite change or extreme irritability. These can all be signs of depression, but often are overlooked or attributed to stress and pushed aside. Others might believe that acknowledging depression means that there is something wrong with them, that they are defective, or “crazy”. None of these fears is true, but depression can make them seem very real. Depression affects how we think about things, how we view the world, how events affect us, and our motivation. A depressed person will see the negative side of things quite easily, but has a lot of trouble seeing the positive side. Small setbacks and normal daily hassles can be overwhelming. A depressed person often isolates, leading to relationship problems or a sense of being alone, which can help maintain the depression.
Fortunately, there are good treatments for depression. Cognitive-behavioral and interpersonal therapies have been shown to be effective with depression, either alone or in combination with medication. There is some evidence that the effects of cognitive-behavioral treatments are longer-lasting after treatment ends, in comparison to medication alone. Studies also show that regular activity (for example, walking 30 minutes five days a week) can help depression symptoms in some people. If you think you might be depressed, it is important to get help. Talk with a psychologist, your doctor, or contact a crisis line if you’re having thoughts about death or dying (800-273-8255). Depression is treatable and you don’t have to fight it alone.
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Anxiety
There are many forms of anxiety and different people will have different patterns of symptoms. Anxiety symptoms can include dry mouth, hot or cold flashes, increased heart rate, difficulty breathing, intrusive worries, restlessness, and in some cases fear of dying. As you might notice, many of these symptoms are physical, which can make it difficult to recognize them as symptoms of anxiety. The most dramatic example of this is a panic attack, in which a person might actually believe that they are having a heart attack or otherwise dying. In reality, stress hormones are activating a “fight-or-flight” response in the body and creating physical reactions that are meant to help us deal with a potential danger. However, most of the things that cause us anxiety in modern days don’t require fighting or fleeing. Therefore, the physical changes don’t help us deal with the stressor -- they just add confusion and more things to worry about. Cognitive-behavioral therapy focuses on the triggers of the anxiety reaction, the anxious thinking patterns, and the physical symptoms of anxiety. This type of treatment has been shown to be effective for many people and types of anxiety. Of course, it is important to first see your doctor about physical symptoms to rule out a medical cause. Then, if your doctor suggests the symptoms are caused by anxiety or stress, cognitive-behavioral therapy is a good option to consider.
One specific type of anxiety, commonly referred to as “health anxiety”, occurs when a person becomes so focused on physical sensations that they become convinced that they have a physical illness. Often, these individuals are not reassured even when their doctor says that there is no medical cause for their symptoms; then the person feels alone and even more worried. Cognitive-behavioral treatment strategies can be very helpful with this form of anxiety, and often a person’s working relationship with their doctor will improve as well.
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The Decision to Seek Therapy
The decision to seek therapy can be a difficult one. Some people might have felt for a long time that something wasn’t right and just suffered in silence instead of asking for help. Some believe that it isn’t okay to get help, that it is a sign of weakness or means there is something wrong with them. Often, those who’ve been abused or traumatized have coped by hiding or denying their feelings, and the idea of getting help feels very risky. If you are considering therapy for yourself, Dr. Rotter commends you on taking this step. It takes courage to open up to a new person and share personal information and uncomfortable feelings. Feeling somewhat uncomfortable is normal, but typically this feeling will ease with time. Keep in mind that setting one appointment does not mean you are obligated to continue in therapy or to continue seeing the same therapist. Dr. Rotter recommends seeing a therapist for three to four appointments before deciding if it is a good match. She encourages clients to let her know if there is something about therapy that is making them uncomfortable. Sometimes a change can be made to increase their comfort. Other times the way something is affecting them gives the therapist information that will help treatment. If you are unsure whether something is okay to bring up in therapy, it is important to ask. A good therapist-client fit is important for therapy to be effective, and open communication will help establish a good fit.
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What is Therapy?
One way to think about therapy is as a confidential, ongoing consultation about private feelings and issues, with the goal of improving how you feel about your life, both now and in the future. Therapy involves talking about personal thoughts, feelings, and issues that you might never have talked about before – so at times it can be uncomfortable because you experience feelings you have avoided. Most people feel a sense of relief at being able to share things they have kept to themselves for so long. Talking also helps the therapist identify what is keeping these feelings or problems with you. From there, we can figure out what needs to change in order for you to feel better or for the issue to be resolved. You are in charge of whether you take steps to make changes or not – no one else can make those decisions for you. The benefit of making changes is that you can often experience relief from emotional symptoms and feel more able to focus on enjoying and expanding the positives in your life.
Through her years of training and professional practice, Dr. Rotter has learned and used many types of treatments. She has found that a combination of Cognitive-Behavioral, Interpersonal, and Supportive approaches works well with most clients. Depending on the type of problem or issue a client comes in with, Dr. Rotter emphasizes variations of each approach in therapy. Client preference is also very important. Therapy will not be helpful if you don’t like how it is being done. A flexible approach helps to improve the fit between therapist and client.
Cognitive-Behavioral therapy focuses on the interaction between our thoughts, feelings, and behaviors. Certain patterns tend to develop in these interactions when a person has depression or anxiety. The patterns can become a vicious circle so that it can feel like any change is impossible. Cognitive-behavioral therapy helps to break into that cycle and reverse the pattern so that the anxiety, depression, or other issue can be addressed. This type of therapy can be used with most issues and problems, and treatment is customized to each person. In recent years, research on specific treatments has found cognitive-behavioral therapy to be quite effective in treating many problems, including depression and various forms of anxiety.
Interpersonal types of therapy focus on how your feelings and issues interact with the world and people around you. Whether we are introverted and shy or extroverted and social, we all interact with other people and the world every day. We have an effect on the world and the world affects us. Sometimes we can get so used to those effects on us that we can no longer tell how much something is bringing our mood down or worrying us. Or, we might feel helpless to make any changes even if we can identify the source of the problem. Interpersonal therapies can help identify what influences your world is having on you, and vice versa, and then increase the positive and reduce or change the negative. The goal is to have a more balanced and positive interaction between you and your world, and to feel more empowered and aware of just how much you can influence that interaction. Research tells us that our social support networks are important not just to our emotional wellbeing, but also to our physical health. Interpersonal therapies can help to optimize that connection between us and our social world.
Just as it sounds, Supportive therapy helps by providing a safe and comfortable place to share difficult feelings, thoughts, worries, and memories. Often, a person who has had their trust broken in the past, or has been let down by people they thought would be there for them, has trouble opening up again. Since humans are by nature social, pulling back from the world can make us vulnerable to feelings of anxiety, sadness, loneliness, and isolation. Supportive treatments can help to rebuild the capacity to trust and open up; to air out painful feelings or memories without being worried about rejection or judgment. Growing the ability to be safely vulnerable seems to build emotional strength and resilience, and makes it possible to let go of things that have weighed us down. When we can reconnect more fully with the important people in our life, we reap the benefits of improved mood and health from having such a solid support network.
Hopefully these descriptions of the types of therapy Dr. Rotter uses have given you an idea of what therapy can be like. The truth is that there are many forms of therapy and no one form is best for every person. She believes that one of the most important treatment factors is to find someone that you believe understands your difficulties and what you want out of treatment. It is also important that you feel comfortable with whomever you see for therapy; otherwise you won’t get the full benefit of treatment. When Dr. Rotter works with a client, the therapy techniques she uses depend on what the client is most comfortable with and whether there are specific treatments that have been shown to be particularly effective for the client’s symptoms.
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Autism Spectrum Disorders
Autism is a developmental disorder that affects every aspect of a child’s life. There are various types of developmental disorders along the spectrum of Autism, including
”high-functioning autism” or Asperger’s Disorder (AD). In this syndrome, individuals typically have intact speech and language, but are different from typical peers in how they perceive, think, and relate to others. In some ways this has been a silent and invisible disorder that is only recently being fully recognized. Many have suffered silently, unsure of why it is so much more difficult for them to relate to people and understand what people mean when they say or do something. Often, a diagnosis of Asperger’s Disorder can bring relief because it explains the cause of the person’s frustration for so long, and it gives the direction for improving a person’s life. This type of disorder cannot be cured per se, but there are many ways that treatment can help reduce the impact of AD on a person and their life. Often, the social and job-related difficulties a person with AD experiences have led to depression, anxiety, social isolation and low self-esteem. Learning about AD and how to adapt can help reduce these secondary effects and lead to a happier and more productive life.
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Childhood Hyperactivity, Defiance, and Peer Relation Problems
When a child has one or more of these problems, their education, mood, peer relations, and overall well-being can be affected. It is important to take action and prevent the problem from getting worse.
Hyperactivity
All children are hyperactive at times and as they grow, this generally diminishes. If a child is significantly hyperactive when compared to other children the same age, then he or she could have Attention-Deficit/Hyperactivity Disorder (AD/HD) or another problem that causes hyperactive behavior. Simply put, AD/HD is a disorder of self-control – control of attention/concentration and behavioral impulses. Because a child with AD/HD is more hyper than peers, and more impulsive, he or she can end up alienating peers and adults by being annoying, intrusive, and seemingly oppositional. Children who act this way are at risk for being rejected by their peers, which can make them vulnerable to problems with self-esteem, anxiety, sadness, or even depression. In school, AD/HD can significantly interfere with learning, and school failures can add to the problems of low self-esteem and mood.
Not every child who is hyperactive has AD/HD. Because children don’t have fully-developed language skills, they will sometimes channel emotional distress into acting-out behaviors. In addition, some medical conditions and medications can cause hyperactive behavior in children. Therefore, it is important to get a thorough assessment to make sure that your child’s hyperactivity doesn’t have another treatable cause.
Defiant
It is normal for every child to be oppositional or defiant at some point. At some ages, it is normal for this to occur many times a day. As they grow, one of the ways that children learn is by exerting their will onto the world and monitoring the results. This is normal and adaptive for the child – and often frustrating and stressful for the parent! When a child is routinely oppositional and routinely defies adult authority figures, more so than peers of the same age, then they might be diagnosed with Oppositional-Defiant Disorder or another behavior disorder. There are treatments that work to reduce these behavior problems, and these treatments require the active participation of the parents. ODD is often seen in children who also have AD/HD.
However, just as not every hyper child has AD/HD, not every child who is willful and oppositional has primarily a behavior disorder. Developmentally, children are still learning and building their abilities to recognize their own feelings, what caused those feelings, and how to tell someone about the problem. Think about a recent time that you were stressed out and how difficult it might have been to put into words, without yelling, what was bothering you. You have many more years of practice at this than a child does. So, it isn’t too surprising that sometimes a child’s behavior problem might be a symptom of another problem – such as anxiety, sadness, or a relationship difficulty. Since they don’t have the skills to realize that and tell you, their distress comes out in their behavior. When a child’s behavioral problems stem from communication and emotional issues rather than willfulness, there are treatments that can help. Often, treatment is focused on the child initially and later on improving the child-parent communication.
Peer Relation Problems
Most children will be rejected by their friends and peers at some point in their life, but when the rejection happens regularly and outweighs their positive peer relations it is important to take action. Peer rejection can occur for many reasons, including AD/HD and ODD. No child will have fun playing with another child who is impulsive, intrusive, bossy or always negative. Addressing the cause of these behaviors can often result in improvements in peer relations over time.
Less straightforward is the case of a child being rejected because the way they interact is somewhat odd or different. Sometimes this is the result of poor social skills – the child needs to be told and shown what to say in social situations and with practice is more successful socially. Other times, the social awkwardness and difficulty come from something like an autism-spectrum disorder such as Asperger’s Disorder, or is related to certain types of Learning Disability. In these cases, it is not just a simple skills deficit that is causing the social problems – it may be an inability to recognize social cues and social norms. Learning Disabilities are most often diagnosed through a formal assessment in the school system, after a child has experienced significant difficulty with learning.
When a child has social problems, it is important to find out what is at the root of these problems in order to find a solution. In some cases, the social problem might be one that will continue long-term, but that can be helped so that it is less severe and impacts the child less.
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