CBT Therapy for Anxiety
What is Anxiety?
Anxiety can be described as a feeling of nervousness, fear or unease. It is completely normal to feel anxious from time to time. Most people feel anxious before sitting an exam, giving a presentation, or doing a job interview. This is is because our body is releasing the right hormones such as adrenaline and cortisol that will help us to rise to a challenge or do something that is important to us.
When we feel anxiety in the body it is a response to the fight or flight response. The symptoms of anxiety are the same as the effects of adrenaline in the body such as feeling dizzy/lightheaded, shallow breathing, racing heartbeat, feeling sweaty, cold hands, shaky knees, feeling nauseous or butterflies in the stomach. These experiences of adrenaline or anxiety can be extremely distressing if they are ongoing and persistent in our lives.
However, when anxiety feels ongoing, overwhelming and distressing to the extent that it is preventing us from doing the things in life that matter the most to us, then it might be time to seek support from a therapist.
What is Worry?
Worry is a future-focused thinking style that often accompanies anxiety. It is characterised by “what if…something bad happens” or “what if…I won’t be able to cope”. Worrying is a normal thinking style that our mind uses from time to time to help us solve problems and respond to our fight or flight responses in order to stay safe. However, when worry becomes persistent, excessive and feels uncontrollable then it can become overwhelming and debilitating in a person’s life. When we believe our worry is uncontrollable, it can lead us to start ‘worrying about our worry’, such that that it is harmful to our wellbeing, both physically and mentally.
Anxiety and Uncertainty
Dugas and Robichaud compare the sensations of anxiety we experience in our body as having a feeling of ‘uncertainty’. It is that feeling in the belly or chest that something is wrong or that something bad is going to happen to you. Having a ‘fear’ or ‘intolerance’ of ‘uncertainty’ is what keeps worry and anxiety going for us. We when we notice that feeling of uncertainty in the body our response is to try to figure out what the problem is in order to avoid or control the feeling. We then start to worry by asking ‘what if…?. Often we will go through as many future scenarios as possible both real and imagined in order to prevent something bad from happening, and to control that feeling of uncertainty or anxiety in the body.
People who worry excessively spend a lot of time trying to gain certainty. Dugas and Robichaud describe it as like having an allergy to pollen. Even a small exposure to pollen for someone who is allergic can have a strong reaction. Similarly, someone who is ‘allergic’ or ‘intolerant to uncertainty’ will have a strong urge to find ways to seek certainty. The problem is that it is impossible to have 100% certainty in this life. In CBT, we aim to teach excessive worriers the skills to become more tolerant to uncertainty in order to reduce worry and anxiety in their lives.
Types of Anxiety
There are many different types of anxiety and CBT as an evidence-based psychotherapy is recommended by the Nice Guidelines for all anxiety disorders (https://www.nice.org.uk/guidance/qs53).
Generalized Anxiety disorder involves ‘persistent and excessive worry’ about a number of events or activities (e.g. finances, work, school, family) to the extent that it affects our daily activities.
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