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I recently posted about anxiety because it is so prevalent at this point in time. That may be for a variety of reasons, not the least of which is all the turmoil that the pandemic has presented to us. Over the years I have talked to many patients about what they can do to try and take control of their anxiety by using a well established tool called Cognitive Behavioral Therapy. And yes, I use some of these tools myself.
Not sure if you have anxiety? Use this link to test yourself.
What is Cognitive Behavioral Therapy (CBT)?
CBT is a technique used by psychologists to help patients recognize what their thoughts center around and to help them reverse what are often times negative patterns. These techniques were pioneered by several individuals including David Burns and Albert Ellis. Here is the link to my article about anxiety where you can find out more information about them and their books as well as an overview of anxiety in general.
I will try to simplify some of the concepts of CBT to make it more relatable. One of the most important things that you have to become aware of while using CBT is exactly what your thought patterns are and sometimes this needs to be coached by a licensed psychologist or mental health counselor. Some or our negative thought patterns are on auto pilot and we don't even realize what we are doing.
Once you recognize what your tendencies are, you will see patterns that just don’t make sense in many circumstances when held up to further scrutiny.
Perhaps it's best if I give you a few examples.
“I missed up that presentation. I’m so stupid.”
“My boss wants to meet with me. What have I done wrong now?”
“ Why does this always happen to me?”
“What’s wrong with that idiot! He just cut me off!”
Notice that all of these have a negative slant to them.
Obviously, there are many more examples of this sort of thing. One of the most common is what is called "catastrophic thinking”. In my medical practice this is commonly seen when a patient has a fear of dying or a fear of cancer. So whenever they get sick, no matter what the problem is, they automatically jump from the most likely explanation to the fear that they are going to die. “I have a runny nose, I must have cancer of the sinuses.” In some instances it takes a lot of work, and a lot of testing, to convince them that they don't have cancer or a terminal condition.
Another common negative thought pattern loop is what I call
the “What-iffer”-
What if I fail my test?
What if I lose my job?
What if my wife leaves me?
Many, if not all of these “what if” situations will probably never come true, yet they cause us considerable grief.
So how does CBT help to reverse these patterns?
Let me preface this by saying what CBT is not- it is not about trying to get to the root cause of what makes you think this way. So you are not going to do ten years of Freudian psychotherapy to only find out that you had issues with your parents as a child…. yet you still haven’t resolved the problem…. and after ten years are still anxious!
CBT will give you a plan to reframe your thought processes. So here is where the work comes in on your part. You need to take the time and have a conversation with yourself and ask questions like these.
Did I really miss up that presentation? The whole thing? Or maybe just a small part of it? Maybe I need to get some objective feedback from one of my colleagues.
Am I really stupid? Of course not. I'm educated, I have skills, and I can learn.
Maybe my boss wants to meet with me to tell me about something good I have done. Or to inform me about a new project. It doesn't have to mean that I made a mistake and he is coming here to reprimand me.
Does it really always happen to me? Always? Let me think of some times where I did the same activity and things turned out better.
Is that person that just cut me off really an idiot? Maybe they have a family member at home that is sick and dying and they're trying to get there in time. Maybe they're on their way to a job interview and their family is depending on them because they have been out of work for a long time.
It's through this type of give-and-take that you learn to reverse those patterns and avoid negative thinking. I'm not going to fool you. This is going to take time and effort on your part. It would also be a good idea to journal these types of thought patterns and the questions that you ask yourself so you can go back and look at them overtime.
The literature says that CBT works about 75 to 80% of the time as long as the patient sticks with it and does the work. And as I said before one of the best things is that it has no side effects!
Here are some other tips you can use to reduce your anxiety.
Avoid caffeine and other stimulants- this is a must!
Try to get eight hours of sleep if possible (insomnia will be an upcoming topic we discuss)
Exercise, even 15 minutes a day, may be beneficial
Don't be judgmental of yourself, or others
Avoid using words like always and never
State 5 reasons why the thought you just had may be wrong
Deep breathing exercises and meditation have been around for thousands of years. There's a reason for that! Take advantage of them.
If you were confronted with a situation that is causing you anxiety write it down on paper. And then write down what you will do if the situation comes to fruition. For example: I may be losing my job. So I need to get my résumé together and start making a list of my contacts and begin exploring other opportunities- just in case.
If you would like more information on this topic you can read “ The New Guide to Rational Living” by Albert Ellis or “ The Feeling Good Handbook” by David Burns. I tell patients that when they read these books, some areas may outline thought patterns that are not their own. For example, maybe you don’t have catastrophic thinking issues. If not, skip that area.
I also tell them that these books are not intended to be read cover to cover in one sitting. Think of them as workbooks. You will learn one technique at a time once you learn how you think, and then just keep adding tools to your armamentarium.
And lastly, remember that you can only control your reactions to what happens around you, so learn to stop trying to control that which you indeed cannot control.
“Man is not worried by real problems so much as by his imagined anxieties about real problems. “— Epictetus
I hope you found this information helpful. If you did please share it with a friend and subscribe to receive my free weekly newsletter.