Cognitive Behavioural Therapy for Anxiety: when anxiety requires treatment
by Dr Ascione
Anxiety and its impact
Anxiety serves a practical purpose in our lives. It alerts us to impending danger. We might feel uncomfortable and feel negative in a situation, but it is our in-built warning system telling us to act. The surge of cortisol simulates our desire to fight our way free or to run as fast as we can.
This inner defence system is highly effective, and some would say too effective for our modern world. Our brains have evolved in layers. The higher functioning portions of the brain layered over the more animalistic tendencies. This means our brain is still programmed to run away from a sabre-toothed tiger on our way to work on the tube – giving our body all the speed and strength required to scale the highest tree to assure our survival.
The problem? There is no sabre-toothed tiger and there is almost no day where there is a life or death need to scale a tall tree.
When anxiety requires treatment
Excess of anxiety can lead to a loss of appetite and a lack of interest in sex. It can cause muscle tension, headaches and insomnia. It can lead to panic attacks, which resemble the symptoms of a heart attack in some. These panic attacks can lead to a fear of anxiety itself and this can lead to a constant state of fear – and then can lead to depression.
Some anxiety might be normal; anxiety that anxiety might hit at any point is not. This would be categorised as a Generalised Anxiety Disorder and could require treatment from your GP or a mental health professional. There are also specific anxiety disorders that could require treatment. PTSD, panic disorder, OCD and social anxiety or phobias are all considered potential disabilities if symptoms persist for more than a year.
The role of CBT in treating anxiety
Cognitive Behaviour Therapy has been listed as an empirically supported treatment for anxiety. Studies have shown improvement in patients who would otherwise be on waiting lists in no treatment situations. The same studies show that CBT is also superior to attempts to control nonspecific or common factors in anxiety.
CBT works to address negative patterns of thoughts and distortions in the way that you perceive the world. The aim would be to stop the negative cycles by bringing awareness to how thoughts can lead to panicked or catastrophic thinking. CBT should help the anxious individual to intervene when thoughts are becoming uncomfortable and irrational, replacing the increasing fear with a new voice that challenges the fear and offers a realistic perspective.
The name of the therapy helps to reveal the underlying principles of the approach. Cognitive refers to the examination of negative thought patterns and how these contribute to anxiety. Behaviour examines how you behave in reaction to these thoughts. By raising awareness and challenging perceptions, the individual is empowered to reframe their approach to potentially anxious situations. Therefore, the premise of CBT is that it is our thoughts, and not the events themselves, that impact on how we feel.
What you can expect during Cognitive Behavioural Therapy
The fundamental approach of CBT with anxiety is therefore thought challenging – or cognitive restructuring to give it a clinical label. You will be encouraged to identify negative thought patterns, challenge these negative thoughts and then replace these negative thoughts with realistic thoughts.
Imagine if you are invited to a party with close friends. Your anxiety might encourage you to believe that this party presents a threat and you will feel awful. However, realistically, it is only that it has been called a party that causes fear. You are comfortable with these people in all other situations, as they are your close friends. Therefore, if you could replace the fear response to party with a realistic response of anticipation, then it is likely that anxiety will be reduced.
Why do you need the help of a CBT therapist?
Because this is easier said than done. Over a course of approximately 20 sessions, you will be shown how patterns emerge, to recognise them and to then to replace them.