The Treatment of Anxiety

“Short term consultation, long term emotional independence…”

Anxiety Therapy Philadelphia PA – Rational Emotive Behavior Therapy is effective in helping people who suffer from anxiety disorders because it is a skills based therapy. Essentially there are five forms of anxiety: anxiety about losing control, anxiety about uncertainty, health anxiety, social anxiety, and panic attacks. Analyzing your past or simply having a warm relationship with a psychotherapist will not help you in overcoming feelings of anxiety and the social withdrawal that typically results from anxiety.

Here is a brief outline of the REBT understanding of anxiety. It begins with the ABC model of Anxiety:

(A) Adversity

You perceive a threat to what you hold dear (i.e. personal domain). This may be a threat to your self-esteem or a threat to your sense of comfort.

(B) Basic Attitudes: Here you unknowingly hold unhelpful attitudes which lead to your anxiety

  • “My self-esteem will be lowered by my poor performance. I must not perform poorly. It would be unbearable to do so.”
  • “My sense of comfort will be reduced if I go into that uncomfortable situation and I could not stand to be uncomfortable in that way. I must avoid it at all costs.”
  • “My dreaded fear absolutely must not occur and if it did I could not bear coping with it.”
  • “I must have certainty that the worst case scenario will not happen because if it did I could not survive or withstand it.”

(C) Consequences of your basic attitudes

  • Emotional consequence (Anxiety)
  • Behavioral consequence (you withdraw or avoid threatening situations)
  • Thinking consequence (creating a greater threat in your mind than may actually exist and minimizing the resources you have to draw upon to deal with the threat)

Effective therapy for anxiety begins by teaching you the ABC model of Rational Emotive Behavior Therapy and how to use it to understand the real source of your anxiety, your unhelpful attitudes about the perceived threat. Once you see that (A) Adversity does not directly cause your feelings at (C) Consequence but that your Basic Attitudes or (B) play an important role you begin to have hope. I will teach you how to question your unhelpful attitudes like “I must not perform poorly and it would be unbearable to do so.” Through our discussions I will show you how to adopt a different and more useful attitude like “I really want to perform well and avoid a poor performance but there is no absolute necessity to do so. I could survive a poor performance even though that would be challenging and I would learn something from doing so.” Furthermore, I will teach you how to use some simple breathing exercises so you can better tolerate any anxiety you might feel as you do my between session homework assignments aimed at helping you change your behavior. 

In summary, the treatment of anxiety begins with education about the relationship between your basic attitudes and your anxiety with its associated avoidance behavior. I would quickly zero in on your specific basic attitudes and begin to help you change those attitudes so you become liberated from anxiety. Finally, we would rehearse new behaviors and coping skills like deep breathing so that you would leave the session ready to take real steps in changing your behavior. Lastly, between sessions I would encourage you to read my Intermittent Reinforcement emails aimed at reminding you how to think and behave differently in your home, work and social environments so that you make progress in an efficient manner and master the new coping skills thereby no longer having a need for psychotherapy.

Reference:

Dryden, W. (2003). The REBT Pocket Companion for Clients. New York: Albert Ellis Institute.