Anxiety and Worry Workbook; Part 2

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.

I've finished this book about a week ago. But, when I write down this while reading about what I highlighted, I ended up reread again. Wkwk...

It's surprisingly that I really enjoying read a 'college' book as I enjoy read a fiction one. Glad that my reading interest still as high as I when young (It's like I already old though).

I highlighted some statement that I like but no directly relate with the cognitive therapy I discuss in this post.

Chapter 4 – Getting Started

As with physical fitness, it takes committed action to maintain mental and emotional fitness. Cognitive therapy is a mental fitness training program that will build your psychological strength so you can face the stresses.

Research studies have shown that individuals who engage in homework assignments between cognitive therapy sessions experience greater improvements in anxiety or depression than individuals who don’t.

Homework or self-help exercises are defined as any specific, clearly defined, structured activity that is carried out in a person’s home, work, or community to observe, evaluate, or modify the faulty cognitions and maladaptive behaviors that characterize anxiety.

It is true that cognitive therapy focuses a lot on how we think and behave. But the thoughts and beliefs important in cognitive therapy are emotional – they deal with our emotions and not our intellect. Cognitive therapy is all about changing emotions, and in this program we continually ask people to observe, record, and understand “how they feel.”

The ability to observe your thinking, evaluate it, and consider alternative ways of thinking is more important to success of cognitive therapy than how far you went in school or your IQ.

Cognitive therapy is always applied to the unique features of a person’s anxiety experience.

Cognitive therapy considers automatic thoughts and beliefs about threat and helplessness basic elements of anxiety. By addressing these cognitive benefits for reducing anxiety than medications.

People on medication for anxiety can benefit significantly from cognitive therapy.

There is no research evidence that a well-organized and disciplined personality type benefits more from cognitive therapy than anyone else.

Cognitive therapy does focus on the present, but past difficult experiences and childhood adversities may be considered when they have an important influence on individuals’ present emotional functioning.

Research outcome studies that formally evaluated cognitive therapy have shown that individuals with severe anxiety symptoms and disorders can achieve significant symptom improvement.

Behavior change is a very important part of cognitive therapy. Although changing one’s thinking about anxiety is critical, it is just as important that people also change their behavior and act differently in response to their anxiety.

Cognitive therapy emphasizes the importance of “realistic thinking” and not “positive thinking”. It reduce anxiety by teaching people to replace unrealistic, exaggerated thinking with more accurate, realistic evaluation of threat in ordinary daily activities.

Many of the significant effect of cognitive therapy are seen in the first few sessions. You can expect to see some improvement within the first 4 to 6 weeks of cognitive therapy.

People in formal cognitive therapy can experience a sudden reduction in anxiety from one week to the next. It is unknown whether these sudden changes occur when using cognitive therapy self-help.

A number of ingredients that are critical to an effective self-help exercise:

1. Clear rationale
2. Cost-benefits review
3. Precise description
4. Graduated steps
5. Record keeping
6. Practice, practice, practice!
7. Evaluate and problem-solve

Rules for success

1. Make time for yourself
2. Start low and work up
3. Pace yourself
4. Keep written records
5. Catch the thoughts
6. Be patient and don’t give up
7. Celebrate success and problem-solve barriers
8. Don’t fight anxiety; let it flow

As with any fitness program, daily practice in applying cognitive and behavioral strategies to your anxiety experiences will determine the effectiveness of the treatment. Taking a realistic, consistent, and determined approach to the exercises will enhance the anxiety reducing effects of cognitive therapy.

Chapter 5 – Developing Your Anxiety Profile

Your anxiety profile will sum up what triggers anxiety for you and how you respond to anxiety-producing situations, with a particular focus on your anxious thoughts, as well as details about how you tend to try to cope.

The physical symptoms of anxiety are often the most prominent and most disturbing feature of anxiety. There are important differences between people in how they feel physically when anxious and which symptoms bother them most. Consequently it’s important to understand the physiological symptom profile associated with your anxiety experiences.

The core fear is the driving force behind anxiety and that this “core fear” consists of generating anxious thoughts about the likelihood and severity of future threat to yourself or loved ones. Without question, the most important part pf the anxiety assessment is determining the nature of your anxious mind. Learning to identify your anxious or fearful thoughts is essential before you can take advantage of other cognitive and behavioral strategies to lower your anxiety level.

What threat or danger do you tend to think about when anxious? It’s important to be aware of how you exaggerate the likelihood and severity of future threat when you’re anxious. This tendency to overestimate the possibility and severity of bad outcomes is at the heart of your core fear. No doubt it occurs most strongly when you feel anxious, so learning to catch your exaggerated evaluations of threat (i.e., catastrophizing) during anxiety episodes is an important part of cognitive therapy.

The goal is to increase your sensitivity to your automatic tendency to focus on the worst so you become better at countering such thinking.

When we focus entirely on our thoughts of threat and danger, we often commit errors in logic that lead us to unrealistic, even irrational, conclusions. These cognitive errors contribute to our false assumption that some severe threat is highly likely to occur. We’ve found that teaching people to become more aware of their thinking errors when feeling anxious can help them correct their faulty anxious thoughts and beliefs.

People with anxiety problems believe that the best defense against the worst thing happening is to take control.

There are three major problem with control in anxiety:

1. Creation of false control. The control you seek is unattainable because the fear is internally based, it is a thought, feeling, or sensation that remain no matter what you do or where you go. Therefore, any sense of control is merely temporary and creates only an illusion of safety.
2. Dependence on maladaptive control responses. Because you want immediate relief from anxiety, you will reach for control responses that produce a quick fix. Thus strategies like escape, avoidance, and seeking reassurance are used thought these strategies are responsible for persistence of the anxiety problem. So the mantra in anxiety becomes “long-term pain for short-term gain.”
3. Excessive preoccupation. The perceived need for control can quickly take over your life and become your primary daily goal. Decisions that involve meeting the basic demands of family, work, and community living are made based on what will minimize your anxiety and ensure a sense of comfort and security. In the end the need to control anxiety, to avert the worst possible outcome, can take over your life and greatly limit your ability to function. In the end attempts at control leave you feeling more out of control.

Worry is the fuel thrown onto the “fires of anxiety” that intensifies the heat and endurance of the flame. Discovering how you worry during anxiety episodes is a final piece of an anxiety puzzle that is targeted for change in cognitive therapy.

You develop a personal “anxiety profile” before starting an intervention program to ensure that cognitive and behavioral strategies target the specific contributors to your persistent anxiety.

Your anxiety profile will be an important guide, informing you where changes need to be made to overcome your problems with anxiety.

Chapter 6 – Transforming the Anxious Mind

In cognitive therapy we often work on anxiety-inducing thoughts first because this is good preparation for doing behavioral exercises, which people with anxiety often find more difficult and challenging,

Clinical anxiety is a lot like a computer virus. Once activated, fear takes over so you think, feel, and behave in ways that end up perpetuating the anxiety. The goal of cognitive therapy is to deactivate, or turn off, the fear program and return you to a normal state of functioning. This is achieved by transforming or changing your anxious thoughts and beliefs.

Cognitive interventions focus on transforming the anxious mind by recalibrating automatic threat and danger cognitions so they are more realistic, strengthening your confidence in your ability to cope with anxious concerns, and improving your recognition of the safe and benign aspects of situations that make you feel anxious.

Anxiety plan for reducing your anxious thinking:

Step 1: Normalizing from the start

Step 2: Catching automatic anxious thoughts

Step 3: Gathering evidence

Step 4: Doing a cost-benefit analysis

Step 5: Decatastrophizing the fear

Step 6: Correcting cognitive errors

Step 7: Generating alternative perspectives

Step 8: Practicing the normalization approach

Step 1: Normalizing from the start

To change your anxious thinking, first it’s important to know what you should be thinking: “If my thinking is faulty or exaggerated when I’m anxious, then what should I be thinking in this situation?”

Your goal should be to reduce anxiety, not eliminate it.

You can think more realistically about anxious concerns by generating a good description of “normal anxious thinking” and referring to it whenever something triggers your anxiety. Practicing this will help you reach the goal of thinking this way whenever you experience an episode of intense anxiety.

Step 2: Catching automatic anxious thoughts

Part of the reason we get trapped in our catastrophizing thoughts is they occur so automatically that our anxious mind has taken over before we realize it. So in cognitive therapy we teach people how to “catch automatic anxious thinking” so they can slow down enough to evaluate and correct those thoughts. This second step in transforming the anxious mind, then, involves learning a new cognitive skill” consciously and intentionally identifying your exaggerated thoughts of threat and danger earlier and earlier in the anxiety cycle.

Step 3: Gathering evidence

Taking the perspective of a detective questioning your own anxious thoughts and beliefs is extremely difficult. Most people get caught up in the emotion and abandon their reasoning skills. But this an important cognitive therapy skill that can be used to reduce anxious thoughts and beliefs. Evidence gathering is a major cognitive therapy strategy for correcting the exaggerated thoughts about threat and danger that are responsible for your anxiety.

Questioning anxious thoughts and beliefs through evidence gathering is a key clinical skill in cognitive therapy for correcting the exaggerated thoughts of threat and personal helplessness which are important contributors to your anxiety. It takes repeated daily practice to perfect the use of evidence gathering as an effective anxiety-reduction tool.

You need to be realistic about the benefits of evidence gathering. Don’t expect your anxious thinking to disappear now that you are disputing it with contrary evidence. Evidence gathering is a strategy to repeatedly correcting anxious thinking when it occurs! That’s why so important to repeatedly practice responding to your anxious episodes by questioning, questioning, questioning the anxious thoughts.

Step 4: Doing a cost-benefit analysis

If you’ve been living with anxiety for a long time, your anxious way of seeing yourself and your world may have become an entrenched part of your life, and your may have forgotten the cost that it’s exacting. Doing a cost-benefit analysis is a powerful way to increase your resolve to correct this faulty thinking. Reminding yourself of the heavy price you’re paying for continuing to listen to your exaggerated thoughts and beliefs about threat and danger will help weaken your investment in “always assuming the worst.”

Use evidence gathering and a comprehensive cost-benefit analysis of your automatic anxious thoughts and beliefs as complementary interventions whenever you experience anxiety.

Step 5: Decatastrophizing the fear

For many people suffering from anxiety, some imagined dreaded outcome has become a “nightmare” they seek to avoid at all costs. In such cases, confronting the imagined catastrophe is a powerful therapeutic tool for defusing its anxiety-inducing power.

To decatastrophize an imagined worst-case scenario that is the ultimate fear underlying excessive anxiety, you’ll need to produce a detailed written elaboration of the catastrophe and practice repeated imaginal exposure to it and acceptance of a plan for coping with the disaster.

Self-help exercise to decatasrophising the fear:

1. Identity the worst-case scenario, the ultimate fear that is the source of your anxiety. Decatastrophizing won’t be effective unless you work with your deepest fear.
2. Write down a detailed description of the worst-case scenario. Describe in as much detail as you can what you imagine might happen to you.
3. Now spend some time reviewing the catastrophe you wrote down. Try to imagine what it would be like to live out this worst-case scenario.
4. Work on developing a problem-oriented coping plan that you could use if the catastrophe ever struck.
5. After writing down your coping plan, each day for 2 weeks, repeatedly imagine yourself coping effectively with the worst-case scenario.

If the decatastriphizing exercise doesn’t held reduce your anxiety, make sure you’re imagining a real catastrophe, the worst scenario you can imagine, no matter how unlikely, not just fairly negative outcome.

Step 6: Correcting cognitive errors

Training yourself to become highly conscious of cognitive errors plays an important role in the process of learning to correct the thoughts and beliefs responsible for your anxiety.

Step 7: Generating alternative perspectives

It will take time and repeated practice before a healthier, more realistic interpretation or explanation of your anxious concern progresses from an intellectual view to an emotion-based conviction that you truly accept.

Step 8: Practicing the normalization approach

Practice make it perfect.

Book details:

Author: David A. Clark and Aaron T. Beck
Year: 2012
Publisher: The Guilford Press