2012-01-12 / Relationships

Do you dwell on the negative? Cognitive therapy can help

The meeting was about to start. There were several contenders vying for the account. By all rights, B en’s group should get the bid, hands down. The team was counting on him to lead the presentation. Ben had prepared for weeks until he knew the statistics cold. But now his mind was blank. He started to panic and felt dizzy, sweaty and shaky. Ben just knew he was going to make a fool of himself and embarrass the whole team. Forget about getting the promotion and bonus he’d been counting on. He’d be lucky if he kept his job! He went to the men’s room to splash cold water on his face, in an effort to calm down, but that didn’t seem to help.

A recent Time magazine article written by Alice Park reported that “Anxiety disorders —which include generalized anxiety disorder, obsessive compulsive disorder (OCD), phobias, panic disorder, social anxiety and post-traumatic stress disorder (PTSD) — are the most common mental illnesses in the U.S., affecting about 18 percent, or 40 million, of adult Americans. And adults aren’t the only sufferers. Phobias and other clinical conditions can strike in childhood, and students applying to college, preparing for finals or entering a brutally tough job market have as many reasons to be anxious as their parents and grandparents.”

For those who are suffering, anxiety can be frightening, debilitating and often embarrassing. These people may go through their days carrying exaggerated worry and tension, even when there may be little or nothing to provoke their concerns. They may predict catastrophic outcomes and convince themselves of the likelihood, no matter how illogical. Many find themselves increasingly limiting their activities because they doubt their capabilities. Sometimes, just the thought of getting through the day causes dread.

There are often strong benefits to becoming anxious. When we are hyperalert, we are able to safeguard ourselves from danger, and heighten our senses to our advantage. There has been extensive research documenting the physiological changes in the brain when a person becomes anxious or frightened. Hormones can be released that stimulate top performance and attention, giving us an extra edge. Athletes, actors and high-risk surgeons, among others, often count on this boost when they are performing under pressure.

When anxiety levels cross a certain threshold, however, we enter a range where we lose our ability to concentrate, reason effectively or perform at an optimal level. There may be times that our level of stress is so severe, we may become frightened, believing we are physically ill or losing our minds. Over time, excess worry and fear may wear out our physical and emotional resources, and compromise our immune system’s ability to fight disease. Genetics, family upbringing and life experiences all have bearing on our levels of anxiety and ability to cope.

The good news is that there are viable strategies that can help us find the right balance to gain mastery of our anxiety. Research has demonstrated that a widely promoted form of psychotherapy, called cognitive behavioral therapy (CBT) helps anxiety sufferers learn powerful skills to master out-ofcontrol feelings.

Patients are taught to confront their fears, rather than running away from them.

Motivated sufferers can learn to apply skills to every day situations that will help them ease their worries and fears. With out-of-control fears, it is often helpful to slowly expose a person to the frightening situation and to support them through the upset, until they become gradually desensitized. As the person is able to tolerate the exposure, they are introduced to increasingly more stressful demands until they have mastered the fear. Over time, the person should hopefully perceive that they have the coping strategies to tolerate the situation, so they will react more calmly. This intervention has been largely successful for many fears, such as driving, insects, or social anxieties.

A major component of cognitive therapy is helping people identify negative or distorted self-talk that impacts on their emotional well-being. In his bestselling book, psychiatrist David Burns describes 10 “cognitive distortions” that greatly impact a person’s mood. These inaccurate thoughts often reinforce negative thinking or emotions. We may tell ourselves things we believe sound rational and accurate, but really only serve to keep us feeling badly about ourselves.

Most of us engage in some distorted thinking, some of the time. However, people who are highly stressed are more likely to “beat themselves up emotionally” and regularly engage in more serious negative self-talk.

Cognitive therapists help clients challenge the negative distortions in the way they think so they take active steps to view themselves in a more healthy way.

In the more severe cases, when CBT alone proves unsuccessful, there are medications available that help take the edge off, so the sufferer is better able to learn effective coping strategies. ¦

Linda Lipshutz, M. S., LCSW, is a psychotherapist serving individuals, couples and families. A Palm Beach Gardens resident, she holds degrees from Cornell and Columbia and trained at the Ackerman Institute for Family Therapy in Manhattan. She can be reached in her Gardens office at 630- 2827, or at palmbeachfamilytherapy.com.

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