How to Reduce Anxiety With Cognitive Therapy


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by Jayaram V

Always know that your fears are your creations and you alone can resolve them by thinking rationally and realistically staying in the present. - Jayaram V

Anxiety may arise from both physical and psychological reasons. In this presentation, we will discuss mainly the psychological factors or the mental conditions that lead to anxiety. Anxiety is produced by the way people think about themselves and their future and how they interpret their experiences. Simply put, anxious thoughts arising from extrinsic and intrinsic factors produce anxiety.

Understanding the causes underlying the anxious thoughts is important because anxious thoughts may arise from both real or imaginary events and it is the latter which makes the resolution of anxiety rather difficult and complicated. In normal situations, anxious thoughts should usually arise from real causes.

For example, if you know that a certain unpleasant event is about to happen no matter what you do and you do not have any option to deal with it or prevent it, you are bound to experience anxiety. However, problems arise if the unpleasant event is imaginary or exaggerated by one's own fears rather than real.

In people who are by nature anxious, anxiety is produced not only by real causes but also by imaginary events and by their negative interpretation of what they experience. Normal people absorb shocks and setbacks without losing their balance and sanity. They take unpleasant situations, failures and disappointments in their stride as part of the price they have to pay to make a living. When adversity strikes, they go through the trauma and the negative emotions associated with it, but eventually move on.

Anxious people not only overreact in similar situations, they also tend to take them personally as terrible missteps on their part and fail to get rid of their negative feelings even long after the event happened. It is this tendency that is troublesome and needs our attention. When normal situations, which could have been easily ignored, begin to bother, it is an indication that the problem is acute and internal and requires personal attention. Anxiety becomes a problem, when one becomes irrational or hyperactive in response to the events that produce them. It is not what happens, but how one views what happens, how one interprets that experience and personalizes it in very negative terms, which creates mild to severe anxiety and incapacitates one from experiencing life normally.

Thinking styles that produce anxiety

People who suffer from anxiety frequently have to cope with their own personal demons that intensify it by knowing how they aggravate it by their negative perceptions, beliefs and interpretations. Studies in cognitive therapy show that anxiety is aggravated and perpetuated by certain habitual thought patterns, beliefs and assumptions, which overtime render people incapable of managing their lives and problems with courage and confidence. Therefore any solution to the problem of anxiety should be centered around identifying such thinking patterns and address them. Those who are prone to anxiety should identify their thinking styles and know how their anxiety is caused by their unverified beliefs, irrational thoughts, predictions and assumptions so that they can learn to think realistically and respond to situations rationally. Following are some of the thinking patterns by which people aggravate their fears and concerns that lead to social and performance anxiety.

Exaggerating the probable outcome. It is also called overestimating the probable outcome. Anxious people over react to situations. They tend to believe that what they fear or predict is certain to happen, whether in reality it is going to happen or not. Most of things we fear do not happen in life, yet often we cannot help fearing a negative outcome. In case of anxious people, the problem is even worse. They assume that things are going to work out badly or they may suffer overwhelmingly from an adverse or threatening situation, even if it is most likely not going to happen.

Examples: "I may be ridiculed or insulted if I speak out." "I may lose my job if I do not resolve this problem in time."

Mind reading. Anxious people suffer from persecution complex. They are constantly assailed by the near certain belief that other people are thinking about them negatively and critically, even if they may not be doing it or paying them any attention. This nagging feeling makes them very uncomfortable in the presence of others. It is true that in social situations, people make judgments about one another. However, unless we have clear indications, we cannot be certain of what is going on in other people's minds.

Examples: "She must be thinking I am stupid." "I believe everyone here is thinking I am the odd person because I have a different background."

Taking things personally. Anxious people take personal responsibility for the negative situations that arise in their lives, even if a host of factors that have nothing to do with them might have contributed to it. They also take responsibility for other people's behavior, even if they might not have caused it. For example, they might attribute other people fear, anger, sorrow, frustration or disappointment to themselves, thinking that they might have some how caused it, whereas in reality the real reasons may be entirely different.

Example: "I made my boss angry with a stupid statement." "I have made everyone unhappy by not showing up in time."

Unreasonable expectations. Anxious people tend to have unreasonable and perfectionist expectations about how things ought to be or how they or others should be, which makes them experience undue stress, since it is difficult, if not impossible to meet such high and exaggerated expectations. This behavior is manifested in their frequent use of words like, "should," "never," "always," and "must."

Example: "I have to be punctual everyday." "I should not make even a single mistake while making this presentation."

Catastrophic thinking. This is a tendency to believe that the outcome of a negative event or situation, even if in reality it might be a minor one, is going to be catastrophic, terrible and unmanageable. It makes anxious people feel fearful and experience feelings of helplessness and embarrassment. An example is to believe that it is going to be terrible if the car breaks down in the middle of a road or if one cannot speak effectively during a meeting or presentation.

Example: "I am late. This is going to be terrible disaster." "She did not respond to my greeting. She is going to promote someone else."

All or nothing thinking. Anxious people have trouble dealing with ambiguity and uncertainty. They view things in terms of their opposites as good or bad, perfect or imperfect, failure or success, solvable or unsolvable. This all or nothing thinking, which arises from their unrealistic expectations of perfection and unusually high standards of performance, which leads to anxiety, fear of failure and guilt. It also makes them overreact to their failures and setbacks, instead of learning from them and moving on.

Examples: "She said I must improve my communication. I am a failure." "She said she had some doubts about this proposal. It is obvious that she is going to reject it completely."

Selective thinking or cognitive bias. Anxious people tend to pay undue attention to specific aspects of their experiences or specific types of information, consistent with their beliefs and anxieties, which tend to aggravate their anxiety further. Thus they may focus on certain parts of their experiences or remember only certain aspects of their interactions with others or certain negative memories which continues to reinforce their anxiety producing thoughts and beliefs. Even if overall they had positive interactions and experiences with others, they remember only the negative ones that are consistent with their beliefs and ignore the rest. This makes them more critical in their thinking and attitude towards others and resolving their anxiety even more difficult.

Examples: Remembering a few negative conversations one might have had with one's spouse in the past and ignoring the pleasant moments they both might have spent together. Focusing on those who are overly critical and ignoring those who are largely appreciative.

Core beliefs. These are the assumptions and beliefs that become deeply integrated into one's consciousness and become part of one's worldview. They play a vital role in creating and sustaining one's feelings of anxiety. They also include long stand negative assumptions one develops about one's self-image and self-esteem and about others and the world in general. They determine how individuals cope with their problems and difficulties and how they regard themselves in personal relationships and difficult situations.

Examples: "You cannot trust people." "People find me rather aloof." "If you get too closely to people, you might get hurt."

Coping with anxious thoughts

We have seen that anxiety is created by our own beliefs, assumptions, exaggerated and imaginary fears, irrational thoughts and habitual thought patterns. The solution to anxiety therefore lies in paying attention to our own thinking and knowing what thoughts, beliefs and assumptions create our anxiety so that we can devise effective strategies to change them effectively. The following approaches are useful.

1. Be realistic. Validate your beliefs, that produce anxiety with facts and reason and subject them to reality check by looking for evidence, using your own experience and observation as the basis.

2. Challenge your thinking styles, especially the all or nothing thinking, catastrophic thinking, mind reading and selective thinking.

3. Focus on your strengths and compensate for your weaknesses. At the same time be willing to acknowledge your limitations in perfecting yourself, achieving excellence, performing actions, resolving problems and reaching your goals.

4. Learn to accept who you are no matter what your personal deficiencies are. Acknowledge your imperfections, weaknesses as part of your growing and learning. Know that you have limitations in your skills and abilities.

5. See as others do. Learn to observe yourself objectively as others do to balance your thinking and overcome self-deprecating thoughts that you may experience in social situations.

6. Refuse to accept your habitual negative thoughts and reactions and dispute them constantly as and when they arise with logic, facts, evidence, counter arguments and empowering thoughts.

7. Know that you cannot be perfect in every situation, you cannot impress everyone and once in a while you have to deal with unpleasant situations, face failures and experience frustrations and disappointments. This will help you to cope with failure and rejection without feeling devastated.

8. Develop confidence by doing things you fear by taking manageable risks and visualizing new responses to situations that produce anxiety.

9. Learn how to distract yourself with pleasant thoughts and emotions by doing something different, seeking newer experiences and learning to make the most out of your life within the limitations and constraints to which you are subject.

10. Practice visualization. Imagine situations that produce anxiety and deal with them mentally through visualization. By facing your fears in your min throough visualization, you can learn to respond differently to anxiety producting events and situations.

Suggestions for Further Reading

Reference: "The Shyness & Social Anxiety Workbook: Proven Step-by-Step Techniques For Overcoming Your Fear, 2nd Edition, by Martin M. Antony, Ph.D. and Richard P. Swinson, MD. This book is very informative, practical and effectively useful to those who suffer from shyness and social anxiety and want to deal with it in a step-by-step process. It is based on trusted and tested research done in the field of cognitive behavioral therapy and provides a complete and comprehensive program to create a personalized plan to deal with social anxiety and shyness through gradual exposure to social situations and anxiety producing thought patterns.

Disclaimer: All material in this article is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information. Readers should consult appropriate health professionals on any matter relating to their health and well-being, regardless of what he/she may read. Do not disregard medical opinion or make any changes to your healthcare based on what you may read. You are solely responsible for all decisions you make regarding your healthcare.

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