Therapy for Anxiety

Fear, the emotional reaction to threat, protects us by motivating escape or avoidance. But an incorrect appraisal of threat - anxiety without objective danger - is pathogenic and can produce serious medical, occupational, and social consequences - not to mention the gratuitous suffering. At this point in our history, cognitive behavioral therapy for anxiety produces better outcome than other forms of talk psychotherapy, and better long-term outcome than medication.

Neurotic anxiety differs from the adaptive emotion of fear, because the avoidance response is based on a false appraisal of threat. At a rational level, the individual may appreciate that the situation is not objectively dangerous, but is nevertheless highly motivated to avoid it. Why this is so is described at: Two Minds.

In most situations, when you make a mistake you get corrective feedback from the environment. But when you avoid a stimulus that is not objectively dangerous [e.g., flying, sex, social situations] you do not discover the truth. In fact, since the avoidance response was rewarded - you experienced the relief of avoiding what you thought would be painful - the mistaken motivation was strengthened. The recursive relationship between avoidance behavior and the mistaken belief that underlie it is the crux of the anxiety disorders listed below.

Generalized Anxiety Disorder

Any focus on threats that is not related to problem solving is an example of worry. Generalized Anxiety Disorder is the technical term for chronic worry and is the basis of the disorders listed below.

Social Phobia

People with social phobia fear they will embarrass themselves. Unfortunately, thinking about potential embarrassment produces physiological reactions that may themselves be embarrassing.

Once Barry begins to blush for any reason, the belief that blushing is embarrassing, along with the fact that embarrassment produces blushing, provides a recursive structure that turns a biological reaction into a psychological problem. Ironically, the more one wants not to have a blushing problem, the more one has a blushing problem.

Panic Disorder

Panic attacks are common; everyone experiences them once in a while. Panic disorder results from the appraisal that the symptoms of panic - e.g., elevated heart rate, blood pressure, respiration rate - are themselves threatening. The positive feedback between the experience of threat and the reaction of the body to that experience is analogous to the audio feedback that occurs when a microphone is too close to a speaker. In fact, panic attacks are not dangerous and respond well to treatment.

• Click here to download our Anxiety Therapy Treatment Manual. We hope you find it helpful. If this approach is well matched with you, you may find some of our other materials to be helpful as well.

"Worry does not empty tomorrow of its sorrows, only today of its strength."