Psychotherapy for Anxiety
Most individuals experience periods of mild anxiety, especially in relation to obligations, deadlines, and other everyday life situations, such as driving in traffic. Mild anxiety is a normal part of life and includes things like worrying, tension, and agitation. Research has indicated that mild anxiety is beneficial, because it heightens awareness and alertness. For some individuals, feelings of anxiety are more intense, prolonged, and debilitating – causing serious disruptions in normal functioning. Psychotherapy is effective in treating all forms of anxiety – from mild to severe.
What is Psychotherapy?
Sigmund Freud’s work on psychoanalysis led to our contemporary research, practices, and understanding of “talk therapies.” Freud’s method of psychoanalysis emphasized the patient’s “free associations.” Freud encouraged his patients to talk about whatever was on their minds. As people became more used to discussing their lives with him, surprising and troubling issues would emerge, which Freud would then interpret for the patient. Freud also encountered what he called catharsis during psychoanalysis. During the re-telling of painful memories, individuals would re-experience the emotions associated with the memory they were discussing, and this would result in a catharsis, or release of previously held negative emotion.
Psychotherapy may be primarily effective because of the intimate relationship formed between patient and therapist. In psychotherapy, the patient is disclosing difficult feelings and is depending on the therapist to help them resolve complex issues. Often, patients present with troubles in their major relationships, and in the general way they relate to others. Examining these issues in the context of a trusting and intimate relationship with a therapist helps in two ways: (1) patients begin to see their own unique relational problems, and (2) these problems are partially addressed by the reparative nature of the relationship they form with their therapist.
What types of Psychotherapy address Anxiety?
Many forms of psychotherapy have been used effectively to treat Generalized Anxiety Disorder (GAD), but 3 methods are currently viewed as most effective:
- Behavioral therapies focus on the imbalance between the activating and calming nervous systems. They identify the stimuli, or triggers that cause over-activation, and introduce behaviors, such as deep breathing and the use of imagery, to increase the effects of the calming nervous system.
- Cognitive therapies focus on the thought patterns involved in anxiety. They identify patterns that increase anxiety, and work to create new patterns of thought that lead to decreased anxiety.
- Cognitive-Behavioral therapies combine different aspects of both approaches.
What is Anxiety?
The American Psychological Association recognizes several different anxiety disorders:
- Generalized Anxiety Disorder is characterized by a pattern of chronic and intense fears and worries. Individuals have great difficulty disengaging from these worries and concerns. They have difficulty relaxing, and may have a consistent feeling that something really terrible is about to happen. They are anxious most days, most of the time, and may have intense anticipatory anxiety – or persistent worries about the future.
- Panic Disorder involves discrete episodes of high anxiety. Individuals experiencing panic attacks experience sudden onset of intense terror and dread, along with physical sensations such as rapid heart rate and hyperventilation, sometimes to the point of passing out. Sufferers begin to develop fears of their next panic attack, and may respond by severely curtailing their activities and involvements.
- Phobias are intense fear responses to particular situations or things, such as fear of flying, fear of enclosed spaces, and fear of dogs. When individuals with phobias are exposed to the situation or object they fear, they experience a panic response. Individuals can develop phobias to an enormous range of situations and objects. When they remove themselves from the anxiety-producing situation, the panic response subsides. Phobias become particularly severe when individuals curtail activities and involvements.
- Obsessive-Compulsive Disorder involves obsessions, which are unwanted and uncontrollable thoughts and feelings, along with compulsions, which involve ritualistic behaviors used to attempt to prevent or stop these obsessive thoughts and feelings. One common example is persistent fears of germs or contamination (obsession), leading to ritualistic cleaning of the body and home. In severe cases, this disorder is debilitating because the person affected cannot participate in normal daily activities, like work, due to their need to engage in compulsive behavior.
What Causes Anxiety and Anxiety Disorders?
Regular anxiety is adaptive. Normal anxiety responses have evolved over time to help us focus with alertness on situations requiring our attention. All anxiety responses involve the autonomic nervous system. This part of our nervous system contains two divisions: the sympathetic, or “activating” system, and the parasympathetic, or “calming” system. In anxiety, the activating system is overactive, and the calming system is underactive. Anxiety disorders involve chronic and maladaptive changes in the balance between these two systems. Research suggests that the causes of such changes may be due in part to genetics, personality, and environment.
Additional Resources
American Psychological Association
American Psychiatric Association
National Alliance on Mental Illness