Treating Anxiety Disorders With Psychotherapy
For many, psychotherapy is the most effective way to treat anxiety disorders. Read about the approaches that have proved most successful.
When anxieties become overwhelming and recurrent, they can cripple a person’s ability to function, and can trigger physical symptoms that include a racing heartbeat, shortness of breath, and dizziness. For those whose life is marred by anxiety disorders such as panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and phobias, a treatment plan that includes psychotherapy can offer relief.
Cognitive-Behavioral Therapy for Anxiety Disorders
Psychotherapy focuses on re-educating and reshaping a patient’s behavior and thought processes by teaching strategies that can help cope with anxiety-producing thoughts and behaviors. Medications may or may not be involved, although in many patients, psychotherapy is combined with drug therapy to achieve the maximum benefit. Psychotherapy that focuses on behavior is termed behavioral therapy. Psychotherapy that focuses on thought processes is termed cognitive therapy (it is also more popularly known as "talk therapy"). The goals are the same: to help a person identify what triggers anxiety and, by acting or thinking differently, how to minimize the anxiety. The two can be combined as cognitive-behavioral therapy (CBT).
Behavioral psychotherapy involves techniques that reduce or end the self-defeating behaviors that are undesirable fallouts of anxiety, replacing them with gratifying and supportive behaviors instead.
Techniques used include:
- Breathing exercises to replace shallow and rapid “panic” breathing with slower, deeper, and more relaxed breathing
- Mentally pausing to put a situation in context (“It’s not as bad as I think.”)
Cognitive therapy teaches the patient how to connect thoughts to the sweaty-palm realities of anxiety disorders and how to alter his thought patterns to head off or minimize the anxiety symptoms.
“For many anxiety disorders, psychotherapy alone, and cognitive therapy specifically, seems to be as effective as medication alone. Other types of psychotherapy have not been shown to be as effective,” says Mark Watling, MD, a psychiatrist at the Anxiety Treatment and Research Centre at St. Joseph’s Healthcare in Hamilton, Ontario, Canada.
Cognitive-behavioral therapy, the combination of the mental and behavioral approaches, can take several forms, including:
Rational emotive therapy, a fine-tuning of cognitive therapy that focuses on how to most efficiently change thought patterns
Rational behavior therapy, a form of cognitive therapy that teaches the patient to self-counsel in addition to the counseling received from a psychologist
Starting Psychotherapy for Anxiety Disorders
Recognition that help is needed is essential to dealing with anxiety disorders. A visit to your family doctor should be the first step. From there, psychologists are a valuable resource, particularly those with a background in cognitive-behavioral therapy.
“When I see a patient and diagnose them with an anxiety disorder, I then review with them the possible treatments that have proven to be effective, review the stats on how effective, and discuss the pros and cons of each treatment. I then usually leave it up to the patient to decide how to proceed based on the information,” says Watling.
The mistake some make is to do nothing. “The hope that ‘all things will change, given enough time’ is generally incorrect when an individual suffers from anxiety,” says Charles Goodstein, MD, clinical professor of psychiatry at New York University Langone Medical Center. “Psychic pain and the disabilities and unnecessary compromises that it brings about, even if the pain seems to have been there ‘forever,’ can be overcome. Sometimes the measures are simple, sometimes complex, but the results are worth the effort.”