Cognitive Behavioral Therapy (CBT) is an effective treatment approach for depression. CBT is one of the most widely used psychotherapeutic methods for emotional problems, like anxiety and depression, and even physical problems, like chronic pain.
Many of you will remember the reality TV show, “Fear Factor” that aired on NBC several years ago. On this show, contestants would compete by completing dangerous stunts or experiences that would make most people cringe in fear! The show gained popularity at that time for presenting the most outlandish situations that people would participate in (e.g., being swarmed by thousands of insects, eating rat guts, and even electrocution!).
Some of us watched these contestants in shock and disbelief. And guess what? We liked it! Why? Well, are at least three reasons. First, they were doing things we would never even think of doing. Second, we liked to see their reactions. And third, we like to see people push themselves to do something they are afraid of doing and be successful in doing it.
Depending how “real” this reality show was, the contestants on this show were fearful of the stunts they were asked to perform. Again, if these stunts were real, of course they were scared, …wouldn’t you be? But many of them pushed through and did it. That’s what made it so great to watch.
How about you? What situation in your life do you need to push yourself to do, and you know fear is holding you back? In the last blog, I discussed how the avoidance of feared situations will only serve to strengthen the fear, and exposure to the feared situation, in appropriate pace and stages, will help to alleviate the fear. This is considered to be a more behavioral strategy within Cognitive Behavioral Therapy (CBT). This current blog will address more of a cognitive strategy.
The stunts mentioned earlier on the show, “Fear Factor” represent fears over situations that are not typically presented in real life. You typically will not need to swim in a pool of alligators or drink poison!
More realistically, you may face the following:
Do any of these seem to fit your situation? If so, you’re not alone. According to the Anxiety and Depression Association of America, nearly 40 million people in the United States (18%) experience an anxiety disorder in any given year. Additionally,
Fear, another word for anxiety or worry, is very prevalent in our society. A good working definition of anxiety is as follows:
Anxiety (fear or worry) is a feeling of uneasiness or distress about some real or perceived threat or situation that is occurring now or that is believed will occur in the future, and to which is believed will, or is likely to, result in a negative outcome.
There are several points to this definition to consider. First, anxiety (fear or worry) is a feeling, not a thought. Sad, angry, and happy are also feelings. Thoughts are those beliefs you hold about a situation that lead to feelings of sadness, anger, or happiness, for example. It is important to remember that it is your thoughts that determine feelings in most situations. So, in the above examples of feared situations, it is important to understand what thoughts you have about the situation that lead to the fear.
Hopefully you can see how the thoughts in these examples can lead to the feeling of fear or anxiety.
One way that cognitive behavioral therapists treat anxiety, fear, or worry is by helping the person learn to dispute their faulty thinking. Once a thought is determined faulty in some way (e.g., biased, assuming, without evidence, or otherwise irrational), it is disputed. This can be done in several ways. One great way of disputing thoughts is by asking yourself questions. Asking questions, from the outset, establishes that you may not yet know the answer, or that the answer you have come up with may be wrong or have alternatives. Asking questions gets you to think more specifically about the situation and thoughts that are contributing to your anxiety.
Albert Ellis, in his theory, “Rational-Emotive Behavior Therapy” (REBT) suggests asking yourself the following questions:
Asking questions like these can help to discover the irrationality of some previously held, self-defeating beliefs. It can help you let go of preconceived notions you may have about yourself or the situation. And preferably it can lead to developing new, more effective, and rational beliefs, that will lead to less anxiety, fear, or worry, and more peace of mind.
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Face your fears, because if you don’t you may always have them.