"My life has been full of terrible misfortunes, most of which never happened" – Michel de Montaigne
"Essentially a tool kit for the anxious mind" – US writer Brad Stulberg, who lives with anxiety, on CBT (1)
Anxiety disorders are the most common mental health problem. As a cognitive behavioural therapist, I see the effects of anxiety every day: it is easily the most common problem reported by clients at Kinsale CBT.
Anxiety is a normal part of life and we all know what it's like to feel anxious – exam stress, awaiting medical results, starting a new job, becoming parents. However, when anxiety is persistent and severe, it becomes debilitating. Managing anxiety is crucial because anxiety can be very gripping, interfering with our day-to-day life and our relationships. In these instances, anxiety has become a clinical problem, what we call an anxiety disorder, requiring treatment and management.
There are many different categories of anxiety. These include social anxiety, panic disorder, agoraphobia, generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD), specific phobias, health anxiety (hypochondriasis), and post-traumatic stress disorder (PTSD).
There are certain thinking patterns common to anxiety.
Anxiety disorders share other common features.
These factors, present from early on in childhood, can increase the risk of the development of an anxiety disorder.
These are factors which can contribute to the first onset of an episode of anxiety.
You will most likely be referred for cognitive-behavioural therapy (CBT) by your GP, who is most people’s first port of call. Research confirms CBT is by far the most successful psychotherapy for the treatment of anxiety.
To manage anxiety, you must first understand that it is maintained by a number of factors. These include cognitive/thinking biases, positive beliefs about worry ("worry keeps me safe", "worry shows I care"), intolerance of uncertainty ("I need to be sure") and overly cautious behaviours. CBT is psycho-educational: it helps you explore the counterproductive nature of your worrying thoughts and cautious behaviours, showing how they influence how you feel and act.
In therapy, practical treatment interventions will be set out and tailored to your needs. These include learning to identify and challenge unhelpful and negative thoughts (cognitive restructuring) as well as detaching from safety behaviours (behaviours developed to minimise anxiety) which do not serve you. We will also set out gradual exposure-based approaches which can offer you dramatic results, helping you to manage and overcome your fears and anxiety. We will also incorporate acceptance and mindfulness techniques to ensure you can learn to make lasting change. These life skills can prevent against future relapse.
We know from neuroscience that we can literally rewire our brains with CBT, a process known as neuroplasticity. As CBT expert Dr Harry Barry pointed out in an Irish Examiner interview, “you are not doomed to be anxious for the rest of your life” (2).
(1) – https://www.outsideonline.com/2279856/anxiety-cant-be-trained-away
(2) – http://www.irishexaminer.com/lifestyle/features/dr-harry-barrys-techniques-for-an-anxiety-free-life-420329.html