How To Treat Anxiety with Cognitive Behavioral Therapy

Writers from William Shakespeare to Abraham Lincoln have weighed in on the relationship between how we think and how we feel. We’ve all heard the age-old saying “mind over matter,” and the phrase “the power of positive thinking” taken from a popular self-help book also underscores the belief that thoughts influence emotions. Perhaps best summarized by a quote attributed to Lincoln (“most folks are about as happy as they make up their minds to be”), the idea that we can change how we feel by thinking about things differently has been around for a long time.

But is Cognitive Behavioral Therapy (CBT) just a new spin on positive thinking? Does it really work when you’re struggling with a bona fide anxiety disorder, not just a little nervousness before a test or a public speaking gig? CBT is more sophisticated than the admonition to think more positively, and when used as a treatment modality by a trained therapist, CBT can be an effective intervention for people struggling to cope with crippling anxiety.

Cognitive behavioral therapy was developed by psychologist Aaron Beck in the 1960s, and has been thoroughly studied as a psychotherapeutic treatment modality. Therapists can teach CBT to people in individual sessions on in groups, and people seeking relief from anxiety would then continue to practice the techniques at home.

How does it work? Some therapists work with pencil and paper worksheets to help people with anxiety disorders use CBT, while some use interview techniques to help uncover the troubling thoughts. Allowing for some variation among therapists and treatment facilities, here are the basic steps involved in CBT.

• Start with a situation that causes anxiety. Your therapist will ask you to set the scene. Maybe the event that causes anxiety is a stressful meeting with a colleague, or a social situation, like a date. Your therapist will have you describe this trigger for anxiety in some detail.
• Identify your thoughts. Not how you felt, or what you did, but with your therapist’s guidance you’ll identify each specific thought you had when facing your trigger situation. Identifying common thinking errors is a critical part of this step.
• Identify your emotions. Again, with guidance and support, your therapist will help you identify each specific feeling you experienced.
• Examine resulting behaviors. This is the “what happened” part of the story. What did you do? When used to help people struggling with addiction, for example, often the story ends with picking up a drink or a drug. CBT can be very helpful in relapse prevention.

Some of the benefits of CBT include:

• Teaching rather than “therapizing.” Usually, when using CBT, the therapist doesn’t interpret your anxiety or explore the psychodynamics of your entire life history. You learn how to feel better by thinking differently and making better decisions in the here and now. The therapist takes on a teacher role and helps you to feel less anxious quickly by teaching you about the relationships between thinking, feeling, and doing.
• Structured, rather than free flowing. Your sessions have a certain structure and are progressive – each one teaches you a skill or technique and they build upon each other. You don’t have to explore your childhood or talk about your week unless that helps you work on the current skill.
• Keeps therapy “fresh” in between session by using homework. What you learn in session is reinforced via homework assignments. Therapy and CBT techniques aren’t just what happens in session, but right from the start, they are practiced and reinforced in your everyday life. If you run into glitches and have tough days, you can work on fine tuning techniques in session and trust that you’ll leave with more homework assignments aimed at helping you with those challenging issues.
• Demonstrated effectiveness. Quoting studies and statistics does not make for riveting reading, but a quick google search tells the story of CBT effectiveness. In some specific cases, CBT is demonstrated to be as effective or even more effective than certain medications. This stuff works and it works well. This article provides an extensive summary of studies in which CBT was used to treat anxiety disorders.

Anxiety disorders can be brutal to live with, but they are also responsive to treatment. CBT is a well-known, well-respected, and well-studied psychotherapeutic technique that is relatively easy to learn and practice. The bottom line? You can kick your anxiety to the curb using CBT and get on with enjoying life.