CBT and Anxiety

Anxiety describes a number of disorders that are associated with fear responses.  Panic Disorder, Obsessive Compulsive Disorder (OCD), Post-traumatic Stress Disorder (PTSD), and General Anxiety Disorder (GAD) are all types of anxiety disorders.  Various types of therapy including psychoanalysis, Gestalt, and even play therapy have all been used as treatment for anxiety.   Numerous studies have been conducted on various anxiety disorders.  Cognitive Behavior Therapy (CBT) has the greatest amount of evidence showing that it works for these issues.

Cognitive Behavior Therapy (CBT) views emotional responses as the combination of triggering events, biology, cognitive interpretations of the events, and the behaviors that occur.  CBT Therapists provide psychotherapy clients tools that help them to identify irrational beliefs that may exacerbate anxiety responses.  Once therapy clients can easily identify these irrational beliefs they learn to challenge or dispute them and then practice rehearsing rational beliefs, which help to reduce anxiety.

Irrational beliefs (IBs) are unhelpful, unrealistic, and or illogical.  They include cognitive distorted thinking that may exaggerate the magnitude of an event or draw a faulty conclusion.  The core irrational beliefs in one form of CBT called Rational Emotive Behavior Therapy (REBT) include four specific beliefs.

  1. Demandingness (DEM)
  2. Low frustration-tolerance (LFT)
  3. Awfulizing (AWF)
  4. Global Evaluations (GE)

For someone experiencing anxiety, in addition to worries, he or she also likely has conviction in the irrational beliefs listed above.  For example, someone with panic disorder may demand that he not experience such intense physiological arousal or fear.  He may also believe he can’t stand feeling that way (LFT), it is awful, and that the future is totally horrible (GE).  As you can imagine, these beliefs likely only intensify and lengthen the anxiety experience.

Other cognitive distortions from Cognitive Therapy (CT) another form of CBT include automatic thoughts and schemas.

  1. All-or-nothing thinking
  2. Overgeneralization
  3. Mental Filter
  4. Disqualifying the positive
  5. Jumping to conclusions
  6. Magnification and Minimization
  7. Catastrophizing
  8. Emotional Reasoning
  9. Shoulds
  10. Labeling
  11. Personalizing

Once again, an anxious person having thoughts from this group can also exacerbate the already uncomfortable feeling state of anxiety or panic.

Fortunately, many forms of CBT have been shown to be effective for anxiety.  In fact, one effective form of CBT for anxiety was modified to work for anger problems, since there are similarities in the kinds of irrational beliefs and the nervous system reactions in both anxiety and anger.

In time, treatments other than Cognitive Behavioral Therapy (CBT) may be proven to be effective.  But the good news is that as of now the majority of people with OCD, Panic Disorder, Phobias, or PTSD can dramatically reduce their anxiety symptoms if they receive CBT from a well-trained therapist.  Unfortunately, many therapists know people are looking for CBT therapists and are likely to report that they practice CBT if asked.  So, it is a good idea to ask how long and how the person was trained, what specific CBT therapy they studied and practice.

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