Job interviews, money woes, important exams, or public speeches.
Everyone experiences anxiety at times.
But when the worry starts to impede our functioning or enjoyment of life – seeking help can be a huge relief.
Anxiety disorders are the most commonly occurring mental health problem in the United States. According to the National Institute of Mental Health, about 25-35% of the U.S. population will suffer from an anxiety disorder at some point in their lifetime. That’s a staggering number.
The good news is that anxiety is one of the most treatable psychological problems – especially using cognitive-behavioral therapy or CBT. “Cognitive” simply means “thinking.” How we think directly impacts how we feel and behave. In the case of anxiety, our thoughts tend to be negatively focused about the future and what could happen. The most common type of anxious thoughts start with, “What if…?” For example, “What if I fail my test?” “What if I blow the interview?”
Whenever we tell ourselves that something negative or threatening might occur, our bodies automatically respond with anxiety. Anxiety is the emotion that prepares us for a perceived threat. The key word here is perceived, as anxiety comes from our thinking, beliefs, and ideas – and these can sometimes be inaccurate.
This is where CBT is helpful. CBT assists in identifying anxiety-provoking thoughts, helping us learn skills to evaluate their accuracy, and then challenging and changing those thoughts to more accurate beliefs. For example, if you think, “What if I fail my test?” a therapist would help you look at the evidence for and against the thought to see how true or false it is compared with the facts. The therapist might ask: “Have you failed tests in the past? What evidence do you have that you will fail this test? And, if you did fail, would that be so bad?”
These are just a few of the questions you and a therapist might explore in gaining a more accurate picture of your situation. Then, together you would work on changing those thoughts to better align with reality and identifying alternative outcomes. For example, if you realize you do study thoroughly and tend to do well on tests, you can work on adjusting your outlook to be more positive (“I will do O.K. on this test”) and not so worst-case-scenario focused. Or, if you realize you don’t prepare well or tend not to be the best test-taker, you can take active steps to improve (e.g., study more, learn strategies, relaxation skills). Creating a more balanced and broader view of the possible outcomes helps lower anxiety to a more manageable level.
CBT is active, usually short-term, and focused on helping you learn and master skills that you will have for the rest of your life. This allows you to learn how to eventually manage the anxiety on your own without a therapist, which also builds confidence and self-esteem while allowing you to regain full enjoyment of your life.
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Dr. Steve Orma is a San Francisco-based licensed CBT clinical psychologist, recognized mental health expert, and specialist in the treatment of anxiety, stress, and insomnia.
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