Cognitive Behavioral Therapy for Anxiety and Phobias

Cognitive Behavioural Therapy is considered the treatment of choice for:

  • Anxiety
  • Depression
  • Panic
  • Agoraphobia and other phobias
  • Social phobia
  • Obsessive compulsive disorder

It is also used to a greater or lesser extent in treating the following:

  • Schizophrenia
  • Bulimia
  • Post traumatic stress disorder

The aim of CBT is to help you understand how you think about yourself and your life, and how those thoughts effect how you feel. The goal is to change dysfunctional thinking and challenge old behaviour patterns with more positivity and a calmer body and mind.

Does it work?

Absolutely! It has proved to be extremely effective although one or two caveats should be mentioned. It doesn’t deal with the past at all, and some research and some therapists believe that dealing with past traumas can be extremely important although this is a matter of some conjecture. If exposure feels unduly difficult then perhaps further exploration of underlying causes is called for, and CBT doesn’t cover this. Read more about the background to CBT.

So what actually happens? The therapist will explain the vicious circle: Situation – Thoughts – Feelings – Actions – Situations etc.
He or she will then show how to break the cycle by changing the thoughts and actions. If the thoughts and actions change the feelings and situations you fiond yourself experiencing will also change.

For example:

A woman going to work one day feels anxious on the metro, she starts to question herself: what will happen to me? What if I go mad or freak out? I won’t be able to cope! Her heart beats faster and faster and eventually she gets off two stops earlier and walks the rest of the way to work.
After CBT treatment the same woman might catch feelings of anxiety rising inside her. She might tell herself that she has attributed these feelings to being on a metro in the past but that she was wrong, she is perfectly safe. If she panicked it would pass and nothing bad would happen to her. She could cope with it and has probably already felt as anxious as she ever will. Instead of getting off at the next stop she modifies her behaviour by staying put. Within minutes the feelings have subsided and she’s feeling ready for her day at work.

What to expect:

Hour long sessions normally weekly for on average twelve weeks, graded exposure so mountains are broken down into molehills, writing and homework and hard work. Success!
Useful links:

Cognitive Behavioral Therapy (CBT) aims to change your thoughts and behavior and is statistically proven to have a high success rate when treating anxiety, panic, and phobias. CBT is made of two elements, cognitive therapy and behavior therapy.

Behavior Therapy targets the way you react to things which trigger anxiety, or feelings you associate with the onset of anxiety. The goal is to break the link between the situation or feeling and the symptom. Another important aspect of Behavioural Therapy is learning how to achieve physical and mental relaxation.

Cognitive Therapy teaches the sufferer to notice their thought patterns, and understand how they are misinterpreting events and causing automatic negative thoughts to spiral out of control resulting in anxiety and panic building up.

CBT can be very helpful to the sufferer of anxiety, panic, or phobias. I would even go so far as to say there is little chance of a complete cure if you do not understand some crucial aspects of CBT. In my experience though CBT was best used for tackling situations which occurred daily.

For example, with agoraphobia I drastically increased my comfort zone, but my phobia of using the Metro or Underground wasn’t helped as I was not a regular user. If you have never tried CBT it is worth speaking to your doctor about it. It can be relatively quick (a month or two) at bringing good results, and because the sufferer does all the work, the outcomes are in your control, this means your progress is much likelier to be permanent.

If you are lucky you can visit a Cognitive Behavioural Therapist and have a series of sessions. If this is impractical or unaffordable there are two books which are extremely good. And, as all always, books are cheaper than therapy and, when you read, you know you are hearing from an expert.

Mind Over Mood, by Christine Padesky and Dennis Greenberger, is a modern classic which explains the process thoroughly.

The Anxiety and Phobia Workbook, by Edmund J. Bourne, was recommended to me by my therapist.It will form a sound basis for your recovery.

They are both excellent books.

When to use CBT

If you believe that your anxiety issues are purely learnt, that is to say that you subconsciously attached fear to a situation erroneously, than you will find Exposure, probably with the help of Cognitive Therapy, fairly easy and quickly successful. Your doctor will be able to recommend or refer you to a qualified
therapist, (Here’s the website for the BACP – British Association for Behavioural and Cognitive Therapies.

Can I do it myself?

The basic principles of Cognitive Behavioral Therapy are quite straight forward. There are numerous books on the subject that make the process even more accessible.

If the books are so good why go to a Cognitive Behavioural Therapist?

A therapist will have dealt with tens or hundreds of clients like you. They will know the pitfalls, be able to encourage you to tackle situations to which you are phobic at the right pace, and will be extremely useful as you try to change your negative cognitions (thoughts). Also, if you are suffering from extremely deep seated phobias, have other complications (such as severe depression or any suicidal tendencies) working with a therapist is going to be best.

How long does it take to get better?

That depends on you! It’s time to understand that the calm and confident person you want to be is already inside you, trying to get out. The Cognitive Behavioural Therapist can only teach you some techniques to help you find them. That said, 8-12 weekly sessions is the normal guide, but it may be more or less depending on your attitude!

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