WHAT TYPES OF PSYCHOTHERAPY ARE MOST COMMONLY USED TO TREAT ANXIETY?

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The research consistently favors cognitive-behavioral therapy (CBT) as the most effective treatment for the various anxiety disorders. Psychodynamic therapy has a long history, but less research backing. A newer therapy called Eye Movement Desensitization and Reprocessing (EMDR) remains controversial, but is recognized as a treatment option for trauma-based anxiety disorder. Group therapy has also been used extensively with trauma victims as well as socially phobic individuals. Other approaches include clinical hypnosis and marital and family therapy. Whereas numerous other therapies exist, the above are most often discussed in the literature.

Because of its relevance to anxiety disorders, we will discuss CBT in more detail here.

Cognitive-behavioral therapy focuses on changing the thoughts (cognitions) and behaviors that maintain anxiety. The “cognitive” part involves the identification and modification of irrational, unhelpful thoughts (“It's terrible!”) that contribute to anxiety. Once the client learns to evaluate perceived threats more realistically, and through practice adopts more accurate beliefs (“It's inconvenient, but I can deal with it”), she can reduce her level of anxiety. An important foundation of CBT is the idea that our feelings and behaviors are not determined by actual events, but rather by our beliefs or thoughts about the events. Much of the work of CBT also focuses on addressing behaviors and providing exercises and assignments to help the client make changes in his day-to-day life (e.g., less avoidance, more pleasurable activities).

One of the most potent techniques in CBT is exposure therapy This approach involves exposing the client—in gradual steps—to whatever it is that is triggering his anxiety (e.g., traumatic memory, phobic stimulus). At each step, the client's anxiety is allowed to peak and then diminish before advancing to the next step, until the client can be in the presence of the trigger with little or no anxiety. Research has consistently found exposure to be a key element in the effective treatment of anxiety.

Therapies that focus on interpersonal relationships , such as couples', family, and group therapy, may also be valuable. With these types of interventions, people come to better understand how to communicate clearly and resolve differences better. Individuals may also be taught some specific skills to ease anxiety in social situations.

Therapists who use a psychodynamic approach help you become aware of secret and forbidden wishes, as well as the hidden defenses you use to repress these wishes. This approach may take several months to years. The forbidden wishes (meaning we think punishment will happen if we think or feel or act on them) are thought to be part of all of us and to generate anxiety when we become aware of them. Psychodynamic therapists believe that we can reduce anxiety and assume more control over our decisions by reevaluating and accepting these forbidden wishes. The psychodynamic approach, which draws its support from case studies, parent-child observation, and conventional wisdom, is much less structured and thus difficult to research.  

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD