Feelings of anxiety are something that all of us can relate to. People often struggle to establish whether anxiety is a normal emotion or an illness. Anxiety is an emotion which is an inherent part of human experience. All of us feel fear and worry when triggered by specific events. In such instances, anxiety is a normal emotion. However, for some, anxiety can begin to affect day-to-day functioning. Anxiety becomes a clinical problem when it is severe and persistent. Anxiety Disorders such as Panic Attacks, Social Anxiety and Generalised Anxiety Disorder are exaggerations of normal emotional reactions. Anxiety is associated with physical responses and avoidance and safety behaviours are normal reactions to the experience of anxiety. Anxiety can be treated through therapy, and CBT for anxiety is a very effective method.
Could CBT be helpful for Anxiety?
Yes, anxiety can be effectively treated by psychological therapy such as Cognitive Behavioural Therapy (CBT).
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) is a short-term, skills and solution focused treatment to change difficult emotional responses by modifying a client’s thoughts and behaviours (or both). It is helpful and effective for a wide range of mental health issues, especially anxiety disorders. CBT is a first line, empirically supported intervention for anxiety disorders. It has been shown to improve the functioning and quality of life in clients dealing with anxiety. CBT is as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.
Advances in CBT have been made based on research and clinical practice. Scientific evidence suggests that the methods produce change.
CBT is based on central principles such as:
- Psychological problems are partially based on flawed or unhelpful ways of thinking.
- Psychological problems are partially based on learned patterns of unhelpful behaviour.
- People suffering from psychological problems can learn better ways of coping with them, thus relieving their symptoms and becoming more effective in their lives.
CBT treatment involves changing thinking patterns. These strategies might include:
- Learning to recognise distorted thinking patterns that are causing problems, and then to re-evaluate them based on reality.
- Better understanding the behaviour and motivation of others.
- Using problem-solving skills to cope with difficult situations.
- Learning to develop a greater sense of confidence in one’s own abilities.
CBT treatment also usually involves changing behavioural patterns. These might involve:
- Facing fears instead of avoiding them.
- Using role playing to prepare for potentially problematic interactions with others.
- Learning to calm the mind and relax the body.
The therapist and client work collaboratively, to develop an understanding of the problem and to develop a treatment plan. CBT emphasises helping individuals learn to become their own therapists. Clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions, and behaviour. CBT therapists emphasise what is going on in an individual’s current life. A certain amount of information about one’s history is needed, but the focus is on moving forward in time to develop more effective ways of coping with life.
CBT Interventions for anxiety
Here are describe common and unique components of CBT for anxiety and related disorders (panic disorder, social anxiety disorder, generalised anxiety disorder, obsessive-compulsive disorder and posttraumatic stress disorder).
Cognitive Interventions
One of the main CBT approaches is cognitive intervention. CBT maintains that a person’s emotional experience is led by their interpretation of the events and circumstances surrounding that experience. Anxiety disorders are associated with negative cognitive distortions (“I think it’s 100% likely that I will fail my exam and will never progress to the next level”). The purpose of cognitive interventions is to enable more adaptive thinking through cognitive restructuring and behavioural experiments. Cognitive restructuring promotes more adaptive and realistic interpretations of events by identifying the presence of thinking traps. These cognitive traps are patterns of biased thinking that contribute to overly negative assessments. (For example, “black-and-white thinking” describes the interpretation of circumstances as either all good or all bad, without recognition of interpretations between these two extremes, and “over-generalisation” describes the making of sweeping judgments based on limited experiences).
By identifying thinking traps, cognitive restructuring can be used to promote more balanced thinking, encouraging clients to consider alternative interpretations of circumstances that are more helpful and less biased by anxiety (“Maybe thinking the chance of failing my exam 100% is overestimating the likelihood that it will actually happen. It’s not a forgone conclusion that even if I fail my exam, I will never progress to the next level for the rest of my life.”). Similarly, behavioural experiments can be used to facilitate cognitive change. Behavioural experiments involve encouraging clients to empirically test maladaptive beliefs to determine whether there is evidence supporting extreme thinking. Some combination of cognitive restructuring and behavioural experiments are often implemented in CBT for anxiety.
Behavioural Interventions
The main behavioural strategy in CBT for anxiety is exposure therapy. Exposure techniques rely on learning theory to explain how prolonged fear is maintained over time. Heightened anxiety and fear cause people to avoid experiences, events, and thoughts that they believe will lead to catastrophic outcomes. Continued avoidance of feared stimuli and events contributes to the maintenance of prolonged anxiety. Exposure exercises are designed to encourage a client to confront a feared situation without engaging in avoidance or subtle safety behaviours (doing something to make an anxiety-inducing situation less distressing). After repeated exposures to a feared situation (flying) without engaging in avoidance or safety behaviours (avoiding travel), the client will learn that such a situation is less likely to be associated with disastrous outcomes, and new experiences of safety will be reinforced. Exposure exercises offer the opportunity for clients to test their negative beliefs about the likelihood of a bad outcome by exposing themselves to whatever situations they have been avoiding.
Where and when can I avail of CBT for anxiety?
CBT can be used in face-to-face and also in online therapy. Our clinicians can use this method in a clinical counselling setting, or from the comfort of your own home. Appointments can be booked in advance and you can ask about CBT for anxiety upon booking. If you’re considering CBT and would like to avail of it with a therapist, you can book an appointment with Centric Mental Health by emailing us at [email protected] or by ringing us at 01 611 1719.
Written by; Amina Samee, Integrative Counsellor and Psychotherapist, MIAHIP