If you are looking into treatment for anxiety and depression, you will most likely come across Cognitive Behavioural Therapy (CBT). It is the most widely used therapy for mental health disorders, including the treatment of anxiety and depression. Research has shown it to be effective in the treatment of panic disorder, phobias, social anxiety disorder, and generalized anxiety disorder, among many other conditions. You may be wondering what Cognitive Behavioural Therapy is and how it helps alleviate anxiety?
CBT is a tool that psychologists use to address unhelpful thought and behavioural patterns around how we perceive the world and ourselves. As the name suggests, this involves two main components:
  1. Cognitive therapy examines how thoughts or cognitions contribute to anxiety.
  2. Behaviour therapy examines how you behave and react in situations that trigger anxiety.
The basic focus of CBT is that our thoughts, rather than external events, affect the way we feel. In other words, it’s not the situation that determines how you feel, but your perception and interpretation of the situation.
For example, in those with anxiety disorders, worried ways of thinking fuel the emotions of fear and sensations of anxiety in the body. The goal of cognitive-behavioural therapy for anxiety is to learn how to recognize patterns of distorted thinking and then re-evaluate those thoughts. You might also practice approaching anxiety-provoking situations with the newly learned tools and skills of relaxation and self-soothing techniques. The idea is that if you change the way you think, you can change the way you feel.
Skills that you can learn through CBT:
  1. Self-awareness of thoughts, feelings, and behaviours. Becoming more present and aware at tracking our own feelings, thoughts, and behaviours is a meaningful step, as this increased awareness will allow one to figure out what and how we would like to change.
  2. Challenging unhelpful thoughts and thinking patterns. Thoughts are not facts. Instead of treating every thought like it’s worth listening to, we become more skilful at putting on the ‘thinking cap’ and investigating whether a thought is accurate and helpful in the given situation. If not, we try to come up with other perspectives of looking at the situation. Learning how to reframe our thoughts means that we can approach a situation with more confidence and hope.
  3. Managing the physiological sensations that are uncomfortable. Anxiety is part and parcel of being human. The fight, flight, or freeze alarm system within the body is functionally meant to help one make sense of danger and to react in a way that hopefully keeps one safe from impending threat. Sensations such as a fast heart racing, quickened breathing, clammy palms, tightness, and tension in the chest areas of the body are some of the unpleasant feelings that come with the emotion of fear. Learning how to manage these symptoms means being able to get through nervous situations more confidently. Deep breathing techniques are taught in simple-to-understand scripts and practiced together in sessions to allow for application outside of therapy sessions. Other strategies like grounding and muscle relaxation can also be practiced.
  4. Exposure therapy: Facing our fears and getting through them, as opposed to avoiding them, becomes a lifelong skill. There may be situations where the emotion of fear becomes crippling. In CBT, allowing oneself to overcome the fear through small, considered incremental steps will help the body gradually become desensitized to the feared event. This means entering situations that make us anxious (as long as they’re safe) and coping with them directly rather than avoiding them. Over time, this technique helps us experience less anxiety in these situations.

Myth busters for anxiety

Stigma around mental health remains prevalent, in part due to misunderstandings of what treatment looks like. Let’s work to reduce stigma by debunking three typical misconceptions about CBT for anxiety.
MYTH: CBT is only for people with clinically diagnosable anxiety disorders.
FACT
: Everyone can benefit from CBT for anxiety. We all fall into patterns of unhelpful thinking and unhelpful habits. CBT is a powerful mechanism to help break them and form new, healthier habits.
MYTH: Therapists will make me do things that are going to be extremely uncomfortable and weird, even when I don’t want to do them.
FACT
: The therapeutic relationship with your therapist is an essential factor in your progress in treatment. A therapy plan that is well-considered involves obtaining informed consent to mutually engage in skills and a firm understanding of how that will contribute to progress. Typically, therapy sessions happen once a week for 50 minutes. That means a client will spend less than 1% of their waking hours in therapy. The remaining 99% can be used to practice CBT skills in the context that matters — real life. Like any other habit, people tend to get more out of therapy the more they practice, just like learning any other new skill, sports, or starting out with a new musical instrument or language. Practice, practice, practice means you become more attuned to your internal states of mind and body and becoming a master of it.
MYTH: People must stay in therapy as long as anxiety lasts.
FACT
: CBT isn’t meant to continue indefinitely and doesn’t “cure” all symptoms. Instead, therapy can conclude when the client feels independent in applying skills to cope with anxiety.
With a toolbox of CBT skills, you can come to feel better equipped to meet life’s challenges. Being happier and less anxious is a bonus!
Clare Kwan
Principal Psychologist
Private Space Medical