Understanding why you think what you think and what causes you to act in a certain way is the most important step in learning how to change negative and unproductive behaviors and replacing them with positive, fulfilling behaviors. Anxiety is a condition that often affects more people than we can imagine. Many people who suffer from anxiety think that they are a minimal group of people who suffer from this but in actuality, there are many. In USA alone, there are over 4 million people who suffer from anxiety.
Anxiety can be caused by a variety of reasons and psychological treatments are the most popular and preferred modes for anxiety. They form the initial treatment and can be categorized under two approaches:
- Techniques to decrease physiological arousal: Relaxation techniques and biofeedback are used for this purpose.
- Cognitive Techniques to help the patient view their worries more realistically, enabling them to make better plans to manage their anxiety:
Cognitive Behavioral Therapy:
The word Cognitive has to do with the mind & thoughts… while behavioral has to do with behavior. In cognitive behavioral therapy, the two are linked. Therapists analyze how your thoughts effect your emotions and behavior and help you take a more rational and practical approach towards your problems and your life.
CBT can help people affected by a wide range of mental health problems such as panic attacks, phobias, depression, anxiety, social anxiety disorder, eating disorders, Obsessive Compulsive Disorder (OCD), and Schizophrenia.
Cognitive Behavioral Therapy takes a more Solution-Focused approach and focuses on the client’s present and future rather than the past. Within Cognitive Behavior Therapy there are three different approaches; the RET approach, Cognitive approach developed by Dr. Aaron Beck around 1976, and the Satir Model developed by Banmen Satir in 1991.
RET approach: The main principle behind the RET approach is to immediately identify the clients poor thought patterns and redirect them into more productive ones. This approach is very direct and at times considered blunt and has the greatest prognosis with clients who take responsibility for their own recovery. This type of therapy is not recommended for those who are weak hearted.
The Cognitive and Satir Approaches are developed around identifying personality characteristics and helping the client overcome the weaknesses in their thinking patterns. The Cognitive methodology is rooted in treatment of Personality Disorders.
Aaron T. Beck , a psychiatrist is the founder of Cognitive therapy and is best known for his work in the areas of Depression and Personality Disorders.
Cognitive therapy helps patients to limit cognitive distortions by teaching patients to record their worries, listing evidence that justifies or contradicts the extent of their concerns. Through CBT patients learn that “worrying about worry” worsens anxiety and they are taught to take a proactive approach to solve their problems instead of practicing avoidance or procrastination.
The process of cognitive therapy:
CBT can be done individually or in groups. CBT (Cognitive behavioral therapy) involves a therapist working with the patient to understand how thoughts and feelings influence behavior.The goal is to change negative thought patterns that lead to the patient’s anxiety and replace them with positive and more realistic thoughts.
The therapist works by breaking down what seem like big problems, into smaller chunks. By doing this the problems appear less intimidating and can be faced and solved more easily, and more effectively.
The therapist will initially check that CBT is suitable, and ask questions about the past to understand what is happening now.
The patient is asked to keep a journal and is taught to identify and write down his/her negative thoughts and note down what is happening, their thoughts and emotional process at that point in time. The therapist offers a better way of looking at things and thinking about events. Combating the thoughts or behaviors which are the main cause of pain and stress helps the patients to recognize alternative perceptions and, therefore, find alternative solutions to their problems.
Some people have a tendency to only focus towards the negative and brush aside any positive experiences they lived in the past and believe it will never happen again. They may also relive the negative events again and again and thus increase their feelings of guilt, unfortunately excessive feelings of guilt is a major factor in causing depression.
If you are suffering from Panic/Anxiety attacks, Agorophobia or OCD, Watch this video
Cognitive behavior therapy trains the individual to think rationally and promotes thinking before acting, it helps the individual gain a more objective insight over their issues and helps them overcome anger and emotional outbursts.
People tend to personalize everything by trying to understand and rationalize every single event in their life, CBT helps the individual achieve a positive balance over their thoughts in life. There are also other therapies and techniques which will help you to get rid of anxiety attacks forever.
What Cognitive behavioral therapy will teach you:
Dr. Burns, in his book “Feeling Good,” lists out the common cognitive distortions which lead to emotional distress. These are :
- All-or-nothing thinking: You see things in black and white categories. If your performance falls short of perfect, you see yourself as a total failure.
- Over-generalization: You see a single negative event as a never-ending pattern of defeat.
- Mental filter: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water.
- Disqualifying the positive: You reject positive experiences by insisting they “don’t count” for some reason or other. You maintain a negative belief that is contradicted by your everyday experiences.
- Jumping to conclusions: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion.
- Mind reading: You arbitrarily conclude that someone is reacting negatively to you and don’t bother to check it out.
- The Fortune Teller Error: You anticipate that things will turn out badly and feel convinced that your prediction is an already-established fact.
- Magnification (catastrophizing) or minimization: You exaggerate the importance of things (such as your goof-up or someone else’s achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow’s imperfections). This is also called the “binocular trick.”
- Emotional reasoning: You assume that your negative emotions necessarily reflect the way things really are: “I feel it, therefore it must be true.”
- Should statements: You try to motivate yourself with shoulds and shouldn’ts, as if you had to be whipped and punished before you could be expected to do anything. “Musts” and “oughts” are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.
- Labeling and mislabeling: This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: “I’m a loser.” When someone else’s behavior rubs you the wrong way, you attach a negative label to him, “He’s a damn louse.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded.
- Personalization: You see yourself as the cause of some negative external event for which, in fact, you were not primarily responsible.
From: Burns, David D., MD. 1989. The Feeling Good Handbook. New York: William Morrow and Company, Inc.
A Cognitive behavior therapist will work with you to identify the above faulty thinking patterns and help you achieve more rational and positive solutions to your problems.
Some of the techniques used in CBT:
- Challenging irrational beliefs;
- Relaxation,
- Education and training;
- Self-monitoring;
- Cognitive rehearsal;
- Thought stopping;
- Communication skills training;
- Assertiveness skills training;
- Social skills training;
- Bibliotherapy;
- Homework assignments;
One of the main objectives of cognitive-behavioral therapy is to challenge maladaptive interpretations of events and destructive patterns of thinking which lead to negative outcomes in the individual’s life.
Often, one of the most positive steps of cognitive-behavioral therapy is when the patient learns that his/her thoughts are not rational, and even the most dreaded outcome has possible solutions. When the patient is able to find a realistic and possible outcome to his/her problem, the fear and anxiety usually fades away.
Individual cognitive behavior therapy usually involves weekly or fortnightly consultations/ sessions with an experienced therapist, the sessions usually last for 50 minutes. The total duration for therapy can last from 6 weeks to 6 months. Goals will be agreed upon between the therapist and client, and it will be a collaborative approach. Basically, it won’t work unless the client is willing to work!
Family members can participate in the treatment plan of patients with GAD. They can provide additional details about the patient’s symptoms and they can contribute to the formulation of the treatment plan.
Cognitive therapy has received a lot of positive review from research experiments, it has been found that cognitive therapy is more effective than behavior therapy, psychodynamic psychotherapy and pharmacotherapy. However these findings need to be further established by large scale studies.
If you’re suffering from anxiety attacks and would like to take control of your anxiety without medications, then take a minute and check this resource on the best treatments that are available for anxiety attacks.
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References:
- “A Guide to Understanding Cognitive Behavioral Therapy”, British Association for Cognitive Behavioral Therapy. Accessed 29 May 2007.)
- Barlow, D. H.: (2007) Clinical Handbook of Psychological Disorders, 4th ed. & “SSRIs”, Mayo Clinic. Accessed 29 May 2007.)
