Therapy for Anxiety

Anxiety is very important for our survival. The release of adrenaline in our brains helps us to mobilise our bodies in order to avoid danger through the so-called ‘fight’ or ‘flight’ responses. For the most part, this enables us to react more efficiently in a traumatic situation, increasing our chance of surviving. Unfortunately, for a significant number of individuals, their experience of anxiety goes far beyond the situation-appropriate fight or flight response. Anxiety Disorders are conditions involving excessive fear and anxiety and associated behavioural disturbances. Some commonly occurring Anxiety Disorders include (but are not limited to) the following:

  • Social Anxiety Disorder- “a marked fear or anxiety about one or more social situations in which the individual is exposed to the potential scrutiny of others” (p.202, American Psychiatric Association, 2013).
  • Panic Disorder- Involving recurrent panic attacks that include “an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes” (p.208, American Psychiatric Association, 2013). Panic attacks can involve symptoms such as sweating, heart palpitations, dizziness, nausea, trembling, and feelings of unreality just to name a few.
  • Generalized Anxiety Disorder- “excessive anxiety and worry…occurring more days than not for at least 6 months, about a number of events and activities” (p.222, American Psychiatric Association, 2013)

Unsurprisingly, one of the most commonly occurring tendencies in the above Anxiety Disorders is avoidance behaviours. Avoidance behaviours can be described as any (internal or external) behaviour aimed at getting distance from a feared situation. For example, people with a Social Anxiety Disorder may decline social functions or may consume alcohol or other substances to excess to avoid the feelings of discomfort associated with socialising. People who experience panic attacks may resort to avoiding places where they have experienced panic in the past, or places that are far away from home. Or people with a diagnosis of a Generalised Anxiety Disorder who may worry about job performance (amongst other things), may resort to adopting an overly perfectionistic attitude to their work to try and avoid the feared outcome of making an error.

Although the desire to try and avoid feared situations is completely understandable, avoidant behaviours tend to feed on themselves, in that the more one avoids the feared situation, the more one sends a message to their brain that the situation is something that should be feared. Feedback loops such as these create stronger neural pathways in the brain, making it more likely the brain will have this thought in the future, which makes it likely that a person’s fear will grow over time with continued avoidance. Such avoidance can also propagate painful self-fulfilling prophecies, whereby the person feels increasingly powerless to cope with their anxiety symptoms. In the above example of the person with social anxiety using alcohol or other substances to try and lessen the fear felt in social situations, it is often the case that people later feel embarrassed about their level of intoxication in comparison to that of their peers and may actually end up receiving the criticism from peers that they were trying so hard to avoid in the first place! Given such a significant number of people experience anxiety like this, it is important that there are evidence-based therapeutic approaches available to help people avoid the painful trap of ongoing avoidance behaviours.

Most therapies for anxiety generally involve teaching coping strategies that enable people to tolerate anxiety in the moment, and then making a gradual plan for moving toward the feared situation, so that people can have the experience of coping, rather than helplessness. These repeated positive experiences of coping help the person communicate a very important message to their brains about their ability to tolerate challenging situations, making it possible for more positive neural pathways to be formed and increasing that person’s opportunities in life. At Next Wave Psychology, we also adhere to the idea that for therapy for anxiety to be most successful in the long term, understanding the less conscious underpinnings for such anxiety is as important as learning coping strategies. Otherwise, it is not uncommon for one particular anxiety issue to be dealt with, only to have another pop up in another area to take its place.

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. American Psychiatric Publishing: Washington, DC; London, England.