Anxiety and Worry Workbook; Part 1

April 05, 2020

Anxiety and Worry Workbook; Part 1

Re-Re Book

(Book Review and Resume)

What book I've read?

What statement I highlighted?

What the lesson I learned from the book?

Here I write down that all.

Actually, I read this book as a reference to my intervention plan for my client. But then, I end up read the entirely book because I couldn’t stop. This book come with scientific proved cognitive therapy. They give the description about psychological term with the easy to understand ways. They provide example in each worksheet. Then, at the end of book they give a list of professional cognitive therapist to contact if the readers want to having a session. From the start, they stated that this book can be used independently or with therapist supervised. Reading this book I can look back at myself, question myself, am I have anxiety? Did I cope anxiety with realistic ways? Did I have exaggerate thinking when facing anxiety-trigger situation? Even I do not do the worksheet, but as I read, I have a moment of evaluation myself. It is good book to knowing your anxiety, with or without psychology background, I am sure everyone can easily enjoy this book.

In total, there are 11 chapters in this book. I’ll break into 4 or 5 part here. So, here the first part summary I made. Maybe I highlighted and underlying most of the statement. Hihi…

Chapter 1 – Making a New Start

Fear and anxiety are part of loving – and often a useful part, at that. Fear warns us of an impending danger, like when we feel car slide on a wet or icy road or when a suspicious stranger appears to be following us. Feeling anxious can motivate a person to be better prepared for an important business meeting or take extra precautions when traveling to an unfamiliar place. The fact is, we need some fear and anxiety in our loves.

Fear and anxiety are as normal as eating, sleeping, and breathing. Since we need them for survival, it would be dangerous to eliminate all fear and anxiety from life.

Thousands of people with anxiety are living testimony that a person can live a productive and satisfying life even with significant periods of distress. You too can reduce the intensity, persistence, and negative effects of anxiety in your life. It is possible to “put the genie back in the bottle,” to return fear and anxiety to their normal, rightful place in your life.

Because of their known effectiveness, cognitive behavioral therapy are now recommended as one of the first-choice treatments for anxiety by the American Psychiatric Association, the American Psychological Association, and the British National Health Service.

The term cognitive refers to the act of knowing or recognizing our experiences. So cognitive therapy is an organized, systematic psychological treatment that teaches people how to change the thought, beliefs, and attitude that play an important role in negative emotional states like anxiety or depression. The basic idea in cognitive therapy is that the way we think influences the way we feel, and therefore changing how we think can change how we feel.

Life Situation, Event (trigger) à Thought (perception, interpretation) à Feeling (tense, anxious)

Cognitive therapy is a brief, highly structure talk therapy that focuses on everyday experiences to teach individuals how to change their emotional thinking and beliefs through systematic evaluation and behavioral action plans with the aim of reducing distressing conditions like anxiety and depression.

There are three phases to treatment:

Assessment. The therapist will ask lots of questions about the history of your anxiety, its symptoms, your everyday experiences with it, and how you’ve tried to cope. The goal of the assessment is to the understand the nature of your anxiety and develop a treatment plan that will work for you.
Intervention. Identifying the problematic thinking that is making you anxious, correcting these thoughts, helping you discover a new perspective on anxiety, and structuring action plans that will alter how you deal with episodes of anxiety.
Termination. Focus on skills necessary for dealing with the occasional return od anxiety. Its goal is to ensure the person has the ability to cope with future experiences of anxiety without therapist assistance.

Cognitive behaviour therapist adopt a particular therapeutic style that they believe provides the best context for learning how to overcome anxiety. This therapeutic style, along with the characteristics of a good therapeutic relationship (trust, confidence in therapist’s understanding, demonstrated concern and empathy, ease of self-disclosure, assurance of confidentiality), produces the best therapeutic environment for treatment for fear and anxiety.

You’ll gain the greatest benefit from cognitive behavioural therapy if you:

Have a significant problem
Are highly motivated
Have positive expectations
Can approach your anxiety as a learner
Are willing to work on the role you may play in making anxiety worse
Can be aware of and write about your thoughts and feelings
Can take a critical, investigative approach to your thoughts and behavior
Are willing to invest time and effort in completing action-based exercises

Chapter 2 – Understanding Anxiety

Fear is a universal emotion that signals we are in imminent danger. As such, it’s very useful. But when fear is misplaced, excessive, and disconnected from reality, it no longer provides an accurate and reliable signal of danger.

Fear is a basic, automatic response to a specific object, situation, or circumstance that involves a recognition (perception) of actual or potential danger. Physically, individuals might feel tense, on edge, have butterflies in the stomach, chest tightness, or a racing heart whenever he feel fear. And the fear could cause a change in behavior. In terms of cognitive therapy, the main characteristic of fear is a thought of imminent threat or danger to one’s safety.

Fear is a basic, automatic state pf alarm consisting of a perception or conclusion of imminent threat or danger to your safety and security.

Anxiety, in contrast, is a much more prolonged, complex emotional state that is often triggered by an initial fear. So anxiety is a more enduring experience that fear. It’s a state of apprehension and physical arousal in which you believe you can’t control or predict potentially aversive future events. Notice that anxiety is always future oriented; it is driven by “what if?” thinking. We don’t become anxious over the past, what has already happened; rather, we become anxious over imagined future adverse events or catastrophes.

Fear is at the heart of all anxiety states. When we’re anxious, fear is the underlying psychological state that drives the anxiety.

Cognitive therapy focuses on the fear at the core of your anxiety, so it’s important to have a firm grasp of the fear that underlies your anxiety experiences.

Individuals may be having difficulty identifying the core fear that occurs when they feel anxious because most of us focus on the feeling of anxious more than on what is making us anxious.

To use cognitive therapy strategies effectively to reduce anxiety. It’s important to discover the core fear, your evaluation of threat, that lies behind your anxiety episodes.

When you feel highly anxious, you’re affected physically, emotionally, behaviorally, and, of course, cognitively. You might not always be aware of it at the time you’re anxious, but in an anxious state you think, feel, and behave differently than when you’re not anxious.

It’s natural to feel overwhelmed by anxiety. Breaking down your anxiety experiences and dealing with each component will make anxiety feel less intimidating. Once you understand the component of your anxiety, you’ll be ready to apply the cognitive therapy strategies to them.

Therapist use several characteristics to determine whether a person’s anxiety qualifies as a clinical disorder:

Exaggerated intensity
Persistence
Interference. Tends to interfere with functioning at work or school, social events, recreation, family relations, and other routine activities. The negative effects of anxiety may be limited to certain areas of life, but the impact is definitely noticeable.
Sudden anxiety or panic. An occasional surge of anxiety or even panic isn’t uncommon, but frequent occurrences my represent an anxiety disorder. Spontaneous, “out of blue” panic is particularly noteworthy, and developing a fear of having further panic attacks is a significant feature of anxiety disorder.
Generalization. In anxiety disorder, the fear and anxiety often spread from a particular object or situation to a broad range of situations, tasks, objects, or people.
Catastrophic thinking. Tend to think about worst-case scenario. Because anxiety always involves the anticipated (the “what if”), the thinking style in anxiety disorders is biased toward assuming that serious threats are much more likely than they actually are. All of this thinking involves the possibility (“what if”) of some catastrophe that is an exaggeration of the real danger.
Avoidance. Most people with anxiety disorders try to eliminate or at least minimize their anxiety by avoiding anything that triggers it. Triggers could be certain situation (e.g., crowded store, highway driving, public facilities, meetings, movie theaters, or church), people (unfamiliar people, “sketchy” individuals, people in authority, ill people, etc.), or object (such as bridges, tunnels, hospitals, certain animals). Extensive avoidance might reduce anxiety in the short term, but it comes at high cost. It contributes to persistence of the anxiety condition and reduce a person’s level of daily functioning.
Loss of safety or feeling calm. Individuals with an anxiety disorder often feel less safe or secure than others/ Although they may go to great lengths to feel safe, any sense of security is short lived, and the feeling of apprehension and threat returns. Relaxing or staying calm can be quite difficult. In anxiety disorders the person may feel on edge, keyed up, and agitated more often than not.

Chapter 3 – The Anxious Mind

Anxiety decline naturally if left alone.

Anxiety varies greatly between situations and from person to person.

The important point is that the way you think determines whether anxiety persists or decline. Thinking about threat or danger and vulnerability or helplessness will cause anxiety to persist. Thinking about acceptable risk and personal ability leads to a decline in anxiety.

People become overly focused on threat and danger when anxious. Also thoughts, images, or memories of personal threat or danger can cause people to feel fear or anxiety.

The problem in anxiety disorders is that people tend to overestimate both the likelihood and the intensity of threat and danger. This type of dangerous thinking called catastrophizing, or blowing things out of proportion. Therefore catching and correcting your catastrophic thinking is an important cognitive therapy strategy for reducing fear and anxiety. Most people find it difficult to catch their anxious thinking because they tend to be overly focused on how bad they feel.

The core fear that underlies anxiety involves a tendency to automatically think dangerously – to catastrophize – exaggerating the probability and severity of bad outcomes of common, everyday situations.

Overestimate Danger + Underestimate Personal Coping = High Anxiety

When these thinking errors focus your attention exclusively on threat and danger, they make it impossible for you to consider less threatening or benign interpretation of situation. This exclusion prolongs the experience of anxiety.

Cognitive therapy focuses on strengthening your self-confidence and ability to cope with anxious situations. Cognitive therapy can teach you to become more aware of the cognitive errors that characterize your anxious thinking so you can question your anxious thoughts and shit to a more constructive perspective in your anxious concerns.

Numerous studies have found that people with anxiety disorders also develop anxiety sensitivity, which is fear specifically of the physical sensations of anxiety. When you repeatedly experience anxiety, you may develop a fear of the tension, heart palpitations, and breathlessness experienced during anxiety episodes, believing these symptoms might have serious negative consequences.

Another important set of beliefs about anxiety is called intolerance of uncertainty. This refers to a tendency to react negatively to unpredictable or uncontrollable situations and events. Most people with intense anxiety prefer the routine and familiar and don’t like surprises.

A final set of beliefs related to anxiety is discomfort with novelty, the unfamiliar. People with frequent anxiety often hate new, unexpected, or unfamiliar situations. Novelty is viewed as threatening. They may believe their anxiety is worse in unfamiliar situations; that they can’t cope with novelty. They may seek to stay with the familiar because they believe it is more predictable and controllable. Being in unpredictable and uncontrollable situations is especially difficult for the anxious person.

Cognitive therapy focuses on reducing “anxiety about anxiety” by encouraging greater tolerance for and acceptance of anxiety, its physical symptoms, uncertainty, and the unfamiliar.

The urge to escape what you think is causing your anxiety and then to avoid any further contact with it is a natural reaction to feeling anxious. Escape and avoidance are two strategies most commonly used to control anxiety. They are an automatic defensive response to fear and anxiety, and on the surface they seem remarkably effective in stopping anxiety dead in its tracks. Psychologists call this the fight-or-flight responses.

Clinical researchers and mental health professionals have long known that escape and avoidance are significant contributors to the long-term persistence of anxiety. There are three major problems with escape and avoidance:

They prevent anxiety from declining naturally
They prevent you from learning that the dangerous thinking causing the anxiety is false
They come at great personal cost by limiting what you can do, where you can go, whom you can be with. When you rely on avoidance, you end up believing you are weak, dependent, or inadequate – that you “no longer have a life.”

Safety-seeking behaviours is any cognitive or behavioural response intended to prevent or minimize a feared outcome. It is also an attempt to reestablish a feeling of comfort or calm and a sense of being safe.

Cognitive therapy helps people reduce and eventually eliminate unhealthy avoidance patterns so that anxiety can be allowed to decline naturally.

Trying to feel calm and safe seems like a good ideas, but there are four drawbacks to safety seeking:

It’s more difficult to process safety cues than danger or threat cues.
The emphasis is on immediate fear reduction, which means you can end up relying on inappropriate safety-seeking strategies
It prevents you from learning your perceptions of threat or danger is false
It reinforces the unrealistic desire to eliminate all risk

Worry is a persistent chain of repetitive, uncontrollable thinking that focuses on uncertain future negative outcomes. It involves repeated mental rehearsal of possible solutions that fail to resolve the sense of uncertainty about an impending threat.

We’ve learned that worry is a problem in anxiety because:

It keeps your focus on thoughts of threat and danger
It reinforces a sense of personal helplessness because it’s difficult to control
It fuels a sense of uncertainty because it’s always future oriented, and the future in unknowable
It is an avoidance of the core fear that underlies anxiety problems

Eight aspects of anxious thinking that contribute to the persistence of anxiety:

Automatic catastrophic thinking
Helplessness beliefs about anxiety
Cognitive errors about threat/danger
Heightened sensitivity to feeling anxious
Low tolerance for the unfamiliar and for uncertainty
Reliance on escape and avoidance
Search for calm and safety
Excessive worry

Cognitive therapy program can teach you how to turn excessive worry into realistic problem solving so that worry does not keep you focused on imagined future threat or danger.