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Anxiety Disorder and Panic Attacks: How Cognitive Behavior Therapy Can Help You
Copyright (c) 2010-2023 Dr Jeannette Kavanagh
In your journey to conquer anxiety and to eliminate panic attacks from your day-to-day life, no one approach will be totally right, but Cognitive Behavior Therapy can be a very powerful part of your recovery. In this short article, I want to explore what's involved in Cognitive Behavior Therapy, so that you can make a decision whether or not you'd like to explore it with your therapist.
De-Constructing Cognitive Behavior Therapy (CBT)
When we de-construct the term, we look at each of the three words separately to increase our understanding of the whole.
Cognitive
The first part of CBT is from the Latin cogito I think. Some of you might recall those Philosophy lectures about Rene Descartes and his famous 'cogito, ergo sum' - I think, therefore I am. In general conversation, we link 'cognitive' with an intellectual engagement. We hear about cognitive deficits caused by brain damage, so let's say that the cognitive component of this therapy involves our brains, our thoughts. It explores how you think and react to things, and how those thoughts elicit an anxiety response or start your panic attacks. If you want to eliminate panic attacks, you have to recognize your role in creating and maintaining them via what I call unhelpful thinking, unhelpful habits of mind.
Behavioral Or Even Behavioural
In this treatment model, the behavior component isn't just about how you behave in the sense of what you do. It's also about how you react before you do things, and it's also about how many of those behaviours become a habit and almost automatic. The behavioural component is also about the range of responses your therapists make available to you. Your therapist will work with you to find alternative ways to react, to break down your automatic responses. Through CBT, when you see that lift (elevator) door opening, you'll be able to react in a calm way instead of automatically panicking about using the elevator. Cognitive Behaviour Therapy is an extremely interactive approach.
Therapy
The third part of CBT, therapy, is from the Greek therapeía healing. The healing or therapeutic component is about what you and your therapist do. It might involve you learning relaxation exercises, but it's also part of an ongoing conversation and series of observations about your thoughts, reactions and actions. My counselling Practice and my e-kit Calming Words involves helping people to learn to meditate and I encourage daily meditation as part of building up our reservoir of calm which is depleted daily by our hectic lives.
Eliminating Panic Attacks using Cognitive Behavior Therapy
Each anxiety or panic attack follows a well-documented cycle. R Reid Wilson in his book Facing Panic calls it the Panic Cycle.
First step is where you have contact with stimuli which makes you feel anything from slightly nervous to downright terrified. For instance, if you have had panic attacks in the shopping Mall, you'll feel terrified just entering those automatic doors.
In a Cognitive Behavior Therapy approach your therapist would have you look closely at that initial trigger. You may be asked to do something that seems paradoxical: you may be asked to increase the number of times you experience that initial fear. That's called an exposure-based intervention, and it can happen in your therapist's office or in the Mall. It's a way of allowing you to see what you already know at a rational level. Namely, that there is nothing to fear. Cognitive Behavior Therapy allows you to think (cognitive) about your fear response (behavior) so that you can construct a more appropriate response (heal).
At the end of most panic attacks the anxiety reducing behaviour of choice is avoidance. You stay home, or you only go to the Mall with a friend who knows about your problem, or you only go to the movies if you can sit on the aisle seat - ready for a quick escape.
You're in charge. However, at both ends of the panic attacks cycle your reactions (cognitive responses) and behaviour (panic or escaping) are the cause of your continuing discomfort. Both sets of behaviour are inappropriate. Both can be discussed as a way of re-writing the script. What script? The one that says 'enter Mall, feel terrified'. It's your thoughts that evoke your adrenaline (fear) response. Through Cognitive Behaviour Therapy, we can help you work with those thoughts and responses to re-align them so that you change your response to entering the automatic doors at the Mall - or whatever triggers your fear.
Dr Jeannette Kavanagh has a counseling and coaching Practice in Melbourne Australia, to help people find their unique solutions to anxiety and panic attacks. For over two decades, Jeannette has helped thousands of people overcome anxiety and panic attacks. Visit her website http://www.calmingwords.com/ to sign up here for a FREE MP3 Relax on Cue.
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