We control every aspect of our life except the way we think, yet it is our thinking which is also a major contributor to the perpetuation of the disorders. Many of us are aware of the predominant role our thoughts do play. This was confirmed in one Australian study of panic disorder that showed patients had ‘a clear bias toward attributing cause to cognitive factors’(Kenardy et al. 1988). That is: patients were very clear in their opinions that their thoughts caused much of their distress. As in my experience with clients, the study also showed people preferred ‘cognitive coping strategies’ in preference to medication. Yet without professional assistance many of us are unable to break the cycle of anxiety producing thoughts.
We continually add to our fear by the way we think. In other words we are continually scaring ourselves with our thoughts.
CBT is a series of strategies specifically targeted to our particular disorder. For panic disorder these strategies can include relaxation, breathing techniques and ‘interoceptive exposure’ and cognitive therapy. This is usually conducted by a trained cognitive behavioural therapist and is usually done in the therapist’s office. This is called in vivo.
Interoceptive exposure is designed to produce a number of the most common symptoms, including accelerated heart rate, dizziness and the effects of hyperventilation. Combined with cognitive techniques we can begin to change our fearful interpretation of the symptoms and break the anxiety producing thoughts. Armed with cognitive behavioural strategies we go into situations and/or places and ‘test’ our ability to manage our anxiety and panic attacks.
People who have overlapping symptoms of other anxiety disorders need to be taught the various cognitive behavioural strategies related to each symptom group. Studies indicate that short-term CBT can have lasting beneficial effects (Otto et al. 1994). Unfortunately CBT has not been readily available, although this situation is beginning to change.
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