Anxiety is generally experienced as an unpleasant feeling that something bad is going to happen, although this interpretation of the situation may be unconscious. Anxiety may be felt in the body as muscular tension, chest or abdominal sensations, sweating, heightened startle reactions, or other symptoms. It may be experienced mentally as worry or obsessions. It may occur in a particularly acute form as a panic attack, which is often interpreted as a medical emergency even though it isn’t.
Almost everyone experiences anxiety in some situations or at some point in their lives. When the intensity or frequency of anxiety is high, and it interferes with someone’s functioning, then the person may have an anxiety disorder. Although many people may be prescribed medications to treat anxiety, these can have side effects and generally are only helpful as long as they are being used.
There are effective psychotherapeutic ways of helping people deal with anxiety, whether in combination with medication or without medication. Good psychotherapy can have lasting benefits even after the therapy has ended.
I often employ cognitive-behavioral therapy (CBT) in helping people with anxiety problems. Cognitive-behavioral therapy assumes that a person’s beliefs, attitudes and interpretations of reality affect the person’s emotions and behavior. By becoming more aware of these cognitions and consciously reconsidering them, a person can then decrease undesired emotional reactions and maladaptive behavior. CBT is thus more oriented to the present and future than some traditional psychotherapy styles that emphasized exploration of childhood events for self-understanding.
CBT may also involve behavioral methods such as relaxation training or carefully planned exposure therapy in which a client deliberately exposes himself or herself to thoughts, objects or situations that generate anxiety. When properly implemented, exposure therapy can increase tolerance of anxiety and eventually decrease anxious responses to stimuli that had provoked anxiety.
We may also employ “behavioral experiments” in which the client predicts the outcome of a specific behavior, engages in that behavior, and compares the actual outcome to the predicted outcome. Such experiences can help clients challenge faulty expectations and change patterns of avoidance which often result from anxiety and interfere with the quality of life.
With some clients I may employ other methods such as Eye Movement Desensitization and Reprocessing (EMDR) or hypnotherapy to help them with anxiety.