Common Features of Anxiety Disorders

CBT Treatment of Anxiety Disorders

Research has shown CBT to be very effective in the treatment of a broad spectrum of anxiety disorder symptoms. In this section I will address the following questions:

What are the different types of anxiety disorder diagnoses?

What are some common features of anxiety disorders?

How is CBT used to treat anxiety disorders?

How long does CBT treatment usually last?

Are there any additional resources that you recommend?

What are some common features of anxiety disorders?

While there are many different types of anxiety, at varying degrees of severity, there are several features that virtually all forms of anxiety have in common and that serve to maintain anxiety.

They include:

Avoidance: It makes sense for us to avoid what we are worried about. But there are two significant problems with avoidance:
- Avoidance can significantly limit where we can go and what we can do

For example: a woman who is worried that a terrorist attack will occur in New York City limits her trips into New York as much as possible. She confines herself to a local area and misses out on activities that she enjoys (e.g. attending Broadway shows)

Avoidance can prevent us from successfully facing the source of our anxiety

For example: a man who is afraid of flying refuses to take plane trips, and therefore never learns whether he can successfully survive a plane flight. His fear of flying is maintained because he never puts his fear to the test.

Avoidance may appear to be an effective short-term anxiety management strategy, but in the long-term, it maintains anxiety.

"Anxious Thinking:" Anxiety is often maintained by the way people think about certain things, situations, or people. In his book The Worry Cure, Dr. Robert Leahy outlines 17 typical “cognitive distortions” to which anxious people often fall prey. Among them are:
- Catastrophizing: Believing that the worst possible outcome will definitely occur
- Fortunetelling: Believing that you can predict what is going to happen in the future
- All-or-Nothing Thinking: Believing that all situations can be viewed in black and white; for example, I am either 100% successful, or a complete failure
Intolerance of Uncertainty: Thanks to the work of Freeston, Ladouceur, and their colleagues, clinicians have recently focused on the role of intolerance of uncertainty in maintaining anxiety. Anxious individuals tend to have a very difficult time tolerating uncertainty, and strive to create certainty, often in situations where no certainty is possible (i.e. will it rain during my vacation?). It is common for anxious individuals to frequently seek reassurance from others in order to reduce uncertainty. If uncertainty cannot be reduced, frustration and increased anxiety result.
Need for Control: Anxious individuals tend to want to control as many aspects of their lives as possible. The trouble is that there are many things in life we cannot control, no matter how hard we try. When anxious people fail in their attempts to control a situation, they are often left feeling frustrated and even more anxious.

Safety Behaviors and Rituals:
- Safety behaviors are any behaviors people adopt to help them cope with anxiety

For example, always carrying around a bottle of anti-anxiety medication or always taking someone along when traveling

Rituals, typically found in OCD, are physical or mental actions that people feel compelled to perform in order to reduce their obsessive thoughts

For example, counting, checking, repeating, arranging

Rituals and safety behaviors provide us with a false sense of security; that is, they tell us that the only reason we were able face the thing we fear is because we engaged in our safety behavior or ritual. This keeps us thinking that whatever we are fearing is indeed scary and should be feared. And it keeps us performing the rituals and safety behaviors, no matter how burdensome they become.