Anxiety Therapy

Anxiety Therapy Techniques & Guide

In order to overcome anxiety disorder, it needs to be approached with all possible positive angles and perspectives available. Research has shown that therapy is usually the most effective option in treating anxiety. The reason behind the therapy being more successful is because it treats more than just the symptoms of the problem.

Anxiety Therapy interventions are designed to:
Making you realize your fears and worries.

It teaches you how to relax.

How to look at a particular situation in a different way.

Develop a better way of coping and confronting the fear.

Problem solving skills.


WHO CAN GIVE ANXIETY THERAPY
Licensed psychologists are highly qualified to diagnose and treat anxiety disorders. Experienced mental health professionals including, clinical social workers, psychiatric nurses are also aware of the increasing anxiety disorders and they too can make the diagnoses based on their experience of having helped the other patients recover from anxiety disorders and subsequently refer the patient to an expert.

With the dawn of psychoanalysis and Freud many people have turned to therapists to find solutions to their problems related to anxiety disorder.

CHOOSING A THERAPIST: Well begun is half done. So before choosing a therapist following issues should be in mind.

TRAINING AND CREDENTIALS: This includes the expertise of the professional with treating the disorders. The therapist should be a licensed professional with the state should have the required training and experience.

KNOWING ABOUT ANXIETY THERAPY:
Before the therapy is started it is better to know about the basic approach and treatment.

The course of treatment, length, frequency duration of sessions too should be understood.

The cost and mode of payment including the fee schedule must be cleared before starting the therapy.

Confidence and being comfortable with the professional treating you is very important.

Use of the web site of National Association of Cognitive-Behavioral Therapists (NACBT) can be made to search for certified CBT therapists in your area.

WHAT TO EXPECT FROM ANXIETY THERAPY:
Whenever a person begins therapy a question on what to expect from it is always present at the back of the mind.

The outcome of the therapy depends on the type of problem being dealt with and varies with individual experiences. Some of the objectives one can expect are:

INITIAL ASSESSMENT: This involves answering a questionnaire which assesses your current problem along with history of other problems. Answering these forms will help in assessment of your depression, anxiety, relationship issues and will help the therapist determine the area where therapy is required. It also helps in finding out your symptom level prior to treatment. This is helpful to the person who is undergoing treatment as it helps to analyze your own progress.

READING MATERIAL: Along with the therapist it can be worked as to what additional reading materials will provide you with information. Ample time should be given and extensive reading should be done.

PERIODIC ASSESSMENT: In this repeated filling up of forms is required to monitor and analyze the progress made. This is very helpful for both the therapist and the individual undergoing therapy. It helps in knowing what the problem is currently and what more measures can be taken to achieve better results. It helps you to gauge if any change has been brought upon in your emotional response, anxiety or depression.

PLAN OF TREATMENT: Depending upon the issues which need more intervention of therapist along with the concerned individual can plan out a treatment modality. If problem of insecurity or relationship conflicts are to be given more importance in the case a plan can be devised to address that problem.

SELF HELP: Nothing can bring upon better results unless self help is not a part of it. Similarly in this along with therapist techniques and methods can be planned which can be practiced outside your therapy session. This is a very effective way of handling your emotions, negative thoughts and behavioral problems. It helps in building a sense of self effectiveness.

AGENDA SETTING: In this step by step issues are taken into consideration and also the output of the previous sessions is analyzed.

IMPORTANCE OF EMOTIONS: Stress is laid on importance of emotion and validation towards oneself during a low phase. The therapist can modify the therapy to help you to understand and recognize your emotional experiences without feeling overwhelmed about it.

TYPES OF THERAPY FOR ANXIETY:
COGNITIVE BEHAVIORAL THERAPY: Aaron Beck developed a treatment for anxiety and depression based on Cognitive therapy.

This is the most widely used therapy and research has shown that it is very effective in the treatment of panic disorder ,phobia, social anxiety disorder, generalized anxiety disorder ,among many other conditions.

It focuses on identifying, understanding and changing the thinking of behavior pattern. It is considered as a very well established, highly effective and a lasting treatment. It is practical, rational and action oriented.

As the name suggests it involves 2 main components:
COGNITIVE THERAPY: It is short term focused psychotherapy for a wide range of psychological problems. It examines the negative thoughts or conditions which contribute to anxiety.
Cognitive part of the therapy refers to thinking or learning which can be taught to the person. The person then needs to take what has been taught and practice at home through means of repetition and get the new learning set into the brain over and over again so that it then becomes automatic and habitual.

PSYCHOLOGICAL PROBLEMS WHERE COGNITIVE THERAPY IS APPLIED:
Anxiety ,Anger Marital Conflict, Panic Fears Eating Disorders , Substance Abuse Alcohol abuse and dependence , Personality Disorders.

AIM OF COGNITIVE THERAPY: You cant fix what you cant see, so it aims at identifying the negative thoughts and beliefs and correcting them changing the way one thinks about it. It aims at how you are thinking and behaving and communicating today rather than on early childhood experiences.

HOW DOES COGNITIVE THERAPY WORK IN TREATING ANXIETY:
Thought challenging in cognitive therapy is also known as cognitive restructuring in which the negative thoughts are challenged and replaced with positive thoughts.

Aaron Beck and his colleagues use the acronym AWARE in their approach in Cognitive therapy. In this the person is first taught to learn to accept anxiety which in turn helps them to overcome it.

ACCEPT your anxious thoughts as natural and adopt a patient attitude towards change. Identify the negative thoughts. At the time of having these thoughts in your mind analyze for yourself as to what exactly were you thinking when these thoughts came into your mind.

Maintain a journal to help you to be aware of your self talk.

Keep a note of the positive and realistic phrases to counteract the negative ones.

Psychologists call these as automatic thoughts as they come to the mind immediately when a situation which can cause fear arises.

WATCH and observe your thoughts non judgementally. Challenge your negative fears and feelings. You are the best judge to know as to will the thing that you are getting anxious about actually happen. Be realistic. Focus on the things on which you have a control and let go of the other things which are beyond your control.

ACT as if you achieved your goal and have overcome your fears and are getting better. Replace the negative thoughts with the positive ones. Once the negative thoughts have been identified work using a positive attitude to replace them. The more positive you think the better would be the outcome.

REPEAT as much as possible. Keep accepting, watching and acting on your fears and feelings .Do it till it becomes like your second nature.

EXPECT a realistic improvement. Along with being hopeful and confident do recognize the fact that there may be a chance of the anxiety relapsing. But at the same time do not give up but learn to cope with the setback thereby working on your coping skills.

BEHAVIOR THERAPY: It examines how you behave and react in situations that trigger anxiety. The basic concept of cognitive therapy is that it is mainly our own thoughts and not the external events which affect the way we feel.

The situation is not responsible for the way you feel but it is how you perceive about the situation which is responsible for your behavior .How one responds to a particular action or an event depends upon individual expectations, attitudes and beliefs.

In other words negativity will only add to your negative emotions of fear and anxiety.It addresses negative patterns and distortions in a way that we look at the world and ourselves.

In this type of therapy patient is actively:
Involved in his own recovery.

Has a sense of control and learns skills that are useful through out life.

Reading about the problem.

Keeping records between appointments.

Completing homework assignments.

Repeated practice for improvement. In a nutshell in cognitive behavioral therapy a patient is taught.

EXPOSURE THERAPY FOR ANXIETY
If one tries to avoid anxiety it only makes it difficult to overcome it. Avoiding your fears to keep away from them makes them grow stronger.
In Exposure Therapy you are exposed repeatedly to the situations or objects you fear in order to increase your self control during those situations. It also helps in diminishing your fears.

This can be practiced in two different ways:
1. The therapist may ask you to visualize or imagine a scary situation.

2. Or you experience it in real life.

Exposure Therapy can be used alone as a therapy or it can also be combined with Cognitive Behavioral Therapy.

SYSTEMIC DESENSITIZATION
A step to step approach is adapted wherein you are gradually exposed to the fearful situations instead of directly confronting you with your biggest fears. So first a mildly threatening situation is worked up gradually to a more severe one.

Direct exposure could be traumatizing. With the help of systemic desensitization one can challenge ones fears, build confidence, and master the skills of fighting panic.

This has 3 phases:
1. LEARNING RELAXATION SKILLS: In this a method of deep breathing and muscle relaxation techniques are taught to be practiced and followed at home. These help in reducing the physical responses to anxiety like trembling and hyperventilating thereby promoting relaxation. By systematically tensing and then relaxing the different muscles in your body helps in easing out the muscle tension. As your body relaxes your mind will follow.

2. CREATING A STEP BY STEP LIST: In this you are required to make a list of the situations you are scared off in a step by step manner taking you towards your goal. Each step should be specific, clear and with a measurable objective.

3. WORKING THROUGH THE STEPS: Once the list is made then the time to work on it with the help of your therapist begins. The aim in this is to stay in that particular situation till the fear subsides.
This is a way to realize that the scary feelings are transient and they do subside. In case at any step the anxiety gets too much you can switch to the relaxation technique. Once relaxed switch back to the other steps. By doing it like this you will be able to get over the fear without getting distressed.

MINDFULNESS BASED COGNITIVE THERAPY:
While cognitive therapy has been found to be effective in treating generalized anxiety disorder, significant number of patients suffer from residual symptoms. Cultivation of mindfulness has been suggested to be helpful for such people.

This is a form of group therapy derived from mindfulness based stress reduction MBSR developed by Jon Kabat Zinn.

It is an effective and acceptable treatment for reducing anxiety and mood symptoms and increases awareness of everyday experiences.The main aspect of this is mindfulness meditation.

MAKING ANXIETY THERAPY WORK FOR YOU:
As there are no shortcuts to success similarly there are no quick fixes for anxiety. Apart from therapy one needs to help ones own self to overcome anxiety. It needs both commitment and patience. Being positive to your surroundings your daily activities and your social life will promote positivity in your mind.

SELF HELP ANXIETY TIPS:
EDUCATE YOURSELF ABOUT ANXIETY: Though education will not cure you of your anxiety it will surely help you to be more informed about it in order to reap maximum benefits from it.

CULTIVATE YOUR CONNE'CTIONS WITH OTHER PEOPLE: Try to avoid loneliness as it is the root cause for letting anxiety set in. Make it a point to meet friends, interact with others socially, join a self help or support group.

Share your feelings with a close friend or a relative. The aim is to not make your self feel vulnerable by being isolated. So the more you interact the better it would be.

ADOPT A HEALTHY LIFESTYLE: Any kind of physical activity should be incorporated in your daily routine. It could be some kind of a sport or activity of your choice. Being physically occupied helps in relieving stress, tension, and anxiety.
Research has shown that as much as 30 min of exercise three to five times a week can provide anxiety release. Aerobics done for an hour everyday gives maximum benefits. It relieves tension , stress and boosts physical and mental energy and enhances sense of well being by release of endomorphins.t

ABSTAIN FROM ALCOHOL AND SMOKING: Use of alcohol, smoking and other stimulants like caffeine should be well avoided. Alcohol initially reduces anxiety but aggravates it as the effect wears off.And smoking leads to a higher and not to a lower level of anxiety. Drinking to relieve anxiety can also cause alcohol dependence which can make things worse.

INCREASE YOUR EMOTIONAL INTELLIGENCE: Emotional intelligence gives ability to fight stress and bounce back from adversity, trauma and loss. I t is not exactly going to safeguard you from tragedies of life and its hardships but will definitely make you more resilient.

BREATHING EXERCISES: Anxiousness causes the breathing to be fast which leads to dizziness, breathlessness and tingly sensations in the hands and feet. These sensations in turn result in anxiety. But by practicing deep breathing exercises you can reverse these symptoms and reduce anxiety.

ADOPT HEALTHY EATING HABITS: Eating a balanced breakfast followed by frequent small meals is the key to keep the blood sugar level at optimal levels. As going hungry for long hours leads to irritability and can make a person feel anxious. Including complex carbohydrates helps in stabilizing the blood sugar and also helps in boosting serotonin which is a neurotransmitter which has calming affects.

ENOUGH SLEEP HELPS: Lack of good sleep results in compromising the ability to handle anxiety. Adequate sleep helps in maintaining the emotional balance which is a key factor in coping with anxiety.

REDUCE STRESS FROM YOUR LIFE: If you are in a company of people who make you anxious it is best to avoid them. Try to relax and do fun things. Examine the stress factors in your life and try to reduce them.

MEDITATION AND ANXIETY THERAPY: Conflicts of negative and positive thoughts in our minds result in causing anxiety. Meditation helps in relaxing your body and stops the continuous thinking process going on in the brain thereby relaxing it.
It can be practiced on own. A correct body posture with a quite non disturbing environment is required to meditate. It has been said that 20 min of meditation every day helps in relieving stress.

BIO FEED BACK: Regular feedback using sensors which monitor the heart rate, blood pressure, breathing and muscle tension helps you to recognize the anxiety response of the body and helps to cope and control it via relaxation techniques.

MEDICATIONS IN ANXIETY THERAPY: Although antidepressants are used in treatment of anxiety results have shown than they are more effective when used in combination with cognitive behavioral therapy.
Most popular medications used are selective serotonin reuptake inhibitors like Prozac, Zoloft, and sedatives such as Valium and Zanax. Benzodiazepines are the most commonly used anti depressants.

People on medications and therapy together have shown better results in terms of reduction of symptoms and relapse as compared to those on medications alone. For certain kind of disorders like social anxiety disorder and phobias medications are not required on a long term basis. In comparison to it people suffering from Obsessive Compulsive disorder need it at a regular interval of time. The point to be kept in mind is that these medications bring about only a temporary cure and do not treat the underlying cause.

A word of caution in case medications have to be taken:
They should be strictly avoided in cases of pregnant women as it crosses the placenta barrier. In people above the age of 65 too should avoid these medications as even a small dose can cause amnesia.

In cases of people with a history of drug or substance abuse it should be avoided as it may lead to dependency.

Be patient and have realistic expectations as it takes time for the drug to reach its therapeutic effect. Close evaluation on the dosage and effectiveness has to be monitored along with the treating doctor.

Avoid total intake of alcohol as even small doses can lead to poor coordination and impaired thinking leading to increased chances of meeting with accidents. Anti anxiety drugs if taken with alcohol, pain killers or sleeping pills can prove to be fatal.

Monitoring your response and close contact with the doctor is very essential l. As everyone reacts differently to medication is it important to judge your physical and emotional response. Any kind of side effect or concern should be openly discussed with your doctor as reduction or tapering of the dosage may be required.

HERBAL TREATMENT: Chinese people have been using the passion flower for treatment of anxiety for many years.

SIGMUND FREUD AND ANXIETY DISORDER:
Sigmund Freud too was believed to be suffering from panic disorder while writing the papers on anxiety neurosis. Sigmund Freud had symptoms of anxiety disorder and though he was told that there was nothing wrong with him he was not satisfied and to know about it he went into detail and searched for a psychological cause and in quest for that he built a elaborate model built on psychology of the mind and the internal conflict leading in causing and maintaining anxiety.

FAMOUS PERSONALITIES WHO HAVE SUFFERED FROM ANXIETY DISORDER:
You are not alone in fighting with anxiety there are many famous influential , creative and inventive popular people too who have gone through the same .Some of them are names like Naomi Campbell , Jhonny Depp , Barbara Striesand , Robert Burns , Oprah Winfrey, Sir Issac Newton , Sally field , and Courtney Love.

If you are suffering from anxiety disorder or know someone who is therapy is your solution to lead a normal life.

Submitted by Dr.Neelu Khanna.

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