Cognitive Behavioral Therapy For Anxiety

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There are several faulty thinking patterns common to people struggling with anxiety that can be isolated and addressed. At the top of the list lies catastrophizing, which is the cognitive distortion where the worst case scenario is imagined and then treated as if it were a foregone conclusion.

Anxiety is a mix of thoughts, emotions, and bodily sensations. We’ve got to first recognize that within normal bounds anxiety is adaptive. It’s the evolutionarily programmed response to a threat in the environment and our ancestors would not have survived long without it.

Therefore we can only call anxiety maladpative when the conglomeration of thoughts, feelings, and bodily sensations is incommensurate with the threat that occasions it or when the threat is only perceived, not real.

It’s essential to make the distinction between adaptive and maladaptive anxiety because both are subjectively experienced as unpleasant but only one is a sign of dysfunction. Many people want a pill for everything, they operate under the false assumption that they should never have to feel any pain, any unpleasant emotions, any uncomfortable thoughts. But all of these undesirable states are part and parcel of the human condition. They exist for a reason. In the case of anxiety, when it’s commensurate with the threat that occasions it there’s nothing to cure, nothing to fix, everything is working perfectly and the correct response is gratitude for having a built in, expertly designed alarm system.

But for some the alarm system has begun to malfunction and needs some tweaking. In many of these cases we can isolate catastrophizing as the culprit. Any and all threats in the environment, perceived and real, are turned into the worst case scenario and then treated as if they were a foregone conclusion, leading to a cascade of other uncomfortable thoughts, emotions, and bodily sensations. This is why we say in CBT that your beliefs about the activating event have more to do with consequences than the activating event itself.

The key is to actively challenge thoughts in the moment as they arise, bringing the mindful attitude, reason, and accumulated life experience to the forefront instead of getting swept away by the terror. First isolate the perceived or real threat that has cued off the anxiety response, then ask, “Are my thoughts commensurate with the threat or are they exaggerated? Did I just jump to the worst case scenario for what might happen? What do my past experiences in similar circumstances tell me is the most likely outcome?”

The foundational point to remember in all of this is that you don’t want your anxiety to go away, it’s your friend not your enemy. What you want is for that built in alarm system to work properly. You have the power to make the necessary tweaks by actively recognizing and then challenging the faulty thinking patterns responsible for the malfunction.