What can help?
Fortunately, there is an evidence-based treatment, cognitive-behavioral therapy, that has now been shown in countless research studies to be extremely effective for anxiety management.
CBT is a short-term, problem-focused form of therapy. The aim of therapy is not to gain insight into one’s problems or delve into one’s childhood, but rather to learn to actively approach problems in the here-and-now and find appropriate coping skills that can be utilized whenever anxiety arises.
In CBT, people learn to take charge of their anxiety, instead of letting their anxiety take charge of them.
Here is a description of some of the methods utilized in CBT.
- Exposure and Response Prevention: Targets the avoidance behaviors that maintain anxiety. The exposure process involves confronting, in a gradual fashion, the things that one fears. During exposure exercises, one is asked to refrain from engaging in any safety behaviors, rituals, or other responses designed to decrease anxiety in the short-term. There are several types of exposure exercises:
- In vivo exposure consists of having a person physically encounter specific real-world situations that are typically avoided because of anxiety
For example, someone who fears large crowds may conduct an in vivo exposure by entering a crowded subway car
- Imaginal exposure is used when anxiety triggers cannot be easily (or safely) encountered in the real world
For example, someone who is afraid of contracting a deadly disease might be asked to imagine coming into contact with that disease
- Interoceptive exposure involves deliberately inducing the physical aspects of anxiety
For example, someone who experiences hyperventilation due to anxiety may be asked to breathe through a straw to induce shortness of breath. Such an exposure helps a person see that the symptoms of anxiety, while unpleasant, are ultimately harmless.
- Cognitive Work: Cognitive work in CBT involves teaching people to challenge the distorted thinking that is maintaining their anxiety.
For example, A man who experiences panic attacks learns to challenge the catastrophic thoughts (i.e. “I’m going to die”) that arise whenever he starts experiencing panic symptoms. He begins to recognize that panic attacks are not lethal, and thus, he becomes less fearful of future attacks.
- Acceptance and Mindfulness Work: Part of CBT treatment for anxiety involves helping people learn to accept uncertainty, and accept that they cannot control everything. Acceptance work is often accompanied by mindfulness training. Mindfulness training consists of exercises that help people learn to fully accept their thoughts, feelings, and experiences in the present moment, without judging them. Once people are comfortable with their thoughts and feelings in the present, they can make sound decisions about what actions to take in the future.
