Using CBT to treat Anxiety

The Cognitive Behavioural Treatment approach is slightly different for each of the anxiety disorder symptoms described here and it is therefore important to receive the right treatment. I specialise in the treatment of Anxiety disorders and I am experienced in treating all anxiety problems.

Anxiety is a normal human emotion which we all experience from time to time. It is usually triggered by a perceived threat either from our environment i.e. an external event or from within i.e. negative thoughts, emotions and physiological sensations. We all seem to deal with anxiety in similar ways by trying to control our environment or our internal processes: avoiding the perceived threat, reassuring ourselves, asking for reassurance from others, rationalising or trying to predict possible outcomes and so on.

However, sometimes the ways in which we respond to anxiety can itself become the problem as an excessive need for reassurance, a need for control, a need for certainty or a need for things to be going our way can quickly interfere with our lives, our day to day activities and our relationships. These problematic responses to anxiety are known as Anxiety Disorders.

“No amount of anxiety can change the future – No amount of regret can change the past”
Karen Salmasohn

Anxiety Disorders

Anxiety problems have been classified into different disorders according to symptoms, triggers and thoughts. It is common to have features of more than one disorder since they all share the same symptom: i.e. anxiety.

Anxiety may be a reaction to Stress.

Acute reaction to stress
Usually occurs after an unexpected life crisis: accident, bereavement, family problems, bad news, etc. Symptoms described above, settle quickly but can last a few weeks. One can also feel irritable, low in mood, sleep poorly, struggle to concentrate and experience emotional ups and downs.

Adjustment reaction
Similar to the above, but symptoms can develop days or weeks after the stressful situation as a reaction or adjustment to the problem. Other symptoms can include depression. Again these symptoms improve quite quickly.

Post-traumatic stress disorder (PTSD)
Usually followed by a severe trauma such as a serious assault or a life-threatening accident. Symptoms last at least a month and years if not treated. Anxiety is only one symptom of PTSD, the others are:

  • Recurring thoughts, memories, images, dreams, or “flashbacks” of the trauma which are extremely distressing
  • Avoidance of situations, thoughts, feelings, conversations, people or anything that may remind the person of the trauma
  • Feeling “numb”, “detached” from life and others
  • Loss of enjoyment, interests and plans for the future
  • Depression
  • Increased “arousal”: difficulties sleeping and concentrating and “increased vigilance”
  • Panic Attacks

Phobic Anxiety Disorders

Social Anxiety Disorder
Probably the most common anxiety problem, social Anxiety can be defined as a fear of negative evaluation. The anxiety a person experiences in social situations ranges from shyness to extreme panic and anxiety. The anxiety can be experienced in all social situations or in very specific situations such as public speaking.

People experiencing social anxiety often feel self-conscious and fear that others will judge them negatively, humiliate them, reject them and so on. They tend to avoid social situations, and if they cannot avoid social contact, they put in place a series of safety behaviours to protect them from others seeing what they fear could be true about them. They hold negative beliefs about themselves since childhood and/or adolescence which get reinforced by their avoidance of social situations, their self-focused attention and their safety behaviours.

Agoraphobia
Again this is a common problem, and best described as a fear of public places, open places and unknown places. People with this problem often feel safe at home and the further they go away from their place of safety the greater anxiety they experience. They fear that away from their safety zone, help will not be available, or they will not be able to escape. Hence, they often avoid shops, crowds, travelling in trains, tube, planes, being on a bridge or in a lift, being in a cinema, a restaurant and anywhere they feel trapped, unable to escape to safety. Again, when confronted by their fear, people will feel extremely anxious, panicky and have intense urges to get out.

Other phobias
There are so many other phobias of a specific thing or situation: claustrophobia (confined spaces), animal, insect and reptile phobias, fear of blood or injections, fear of vomiting, fear of being alone, fear of choking and many more.

Panic Disorder
It is better known as recurring panic attacks. A panic attack is a severe attack of anxiety which occurs suddenly, often without warning and for no apparent reason. The anxiety symptoms that accompany a panic attack are usually extremely uncomfortable and include: a thumping heart, trembling, shortness of breath, chest pains, feeling faint or dizzy, numbness or pins and needles. They usually last 5-10 minutes and can come in waves for up to two hours.

Generalised Anxiety Disorder (GAD)
It is best described as a general state of anxiety, feeling fearful, worried and tense most of the time for as long as one can remember. The anxiety tends to be about various life stressors, often minor. The symptoms which have been described in the above conditions often come and go and are persistent. People often describe GAD as always worrying about something: feeling restless, on edge, unable to concentrate, feeling irritable, muscle tension and poor sleep.

Mixed Anxiety and Depressive Disorder
Some people experience anxiety as a symptom of depression. Other symptoms of depression include: low mood, intense sadness, sleep disruptions, poor appetite, irritability, poor concentration, decreased sex drive, loss of energy, guilt feelings, headaches, aches, pains and finding no enjoyment in life. There is additional information you may find useful on my page CBT for depression.