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Understanding Psychotherapy for Anxiety Disorders

There are millions of sufferers of Anxiety Disorder in our country and millions more who suffer but without a panic attack that makes it a psycho-emotional disorder.  Most patients who see their family doctor are given tranquilizers and antidepressants to alleviate the symptoms. 

Real treatments for Anxiety Disorder, however, that actually alleviate the causes and inappropriate reaction to the aberrant thinking are typically administered by qualified psychotherapists and psychiatrists.  To treat any phobia or anxiety disorder it is necessary to alter the thinking of the patient.  

Most patients ultimately recognize that their reaction to trivial or improbable events is inappropriate.   What is at the very root of all panic-related disorder is the patient’s inappropriate reaction that is easily dealt with in the mind of non-sufferers. 

In the case of GAD, or Generalized Anxiety Disorder, the patient’s real issue is not the panic or even what caused it to occur in the beginning of their disorder.  The real issue that must be addressed is their understanding that they have a basic flaw in their thinking – an inappropriate response to uncertainty. 

Non-sufferers of anxiety-based disorders have an appropriate level of response to uncertainty, typically disregarding the assignment of any, let alone disproportionate, significance to a trivial or low-probability issue, risk, or potential outcome.

Therapists will often begin with non-intrusive types of therapy like Anxiety Management Therapy, which is not part of or included in invasive therapies such as CBT.  AMT is composed simply of relaxing the patient and, when relaxed, introducing role-played scenarios of stress-related or anxiety-provoking stimuli.  The goal here, without psycho-intrusion, is an attempt to allow the patient to get comfortable with planned exposure to anxiety and to learn to talk about it and start to revise their thinking.

If the therapist recognized the need to go further in altering the patient’s thought patterns, then CBT is typically the next step.   CBT has as its primary goal the retraining or the patient’s basic orientation to anxiety and anxiety-provoking stimuli.  This is done by allowing the patient to begin to understand how their aberrant reaction occurs, acknowledging that it is invalid or aberrant, and that changing how they think about it is appropriate.  Note:  It is key, here, for the patient to independently acknowledge this invalidity rather than being told or coached.  Without a genuine acceptance of this concept and the attendant desire to change their thought patterns leading to aberrant reactions, the patient’s progress will stall or terminate.  Once this plateau of awareness has been attained, the patient is introduced to the deeper aspects of the therapy.  This typically includes having the patient document their feelings as the panic events occur and how they really feel about them when not in the grips of a panic attack.

The final step in CBT is to begin the process of replacing aberrant reaction with appropriate and normal reactions.  Once the patient achieves initial success in this thinking-replacement process it is possible to build upon it – developing much more intensive and aggressive objectives – with the ultimate goal of the elimination of the anxiety attack and its reoccurrence.

CBT is a long-term process often requiring more than a year to complete.  CBT is administered in both group and individual settings with equal success.