Pollard / Iljon Foreman Cognitive Behavioural Therapy (CBT) Cognitive Behavioural Therapy (CBT)

Your Toolkit to Modify Mood, Overcome Obstructions and Improve Your Life
1. Auflage 2016
ISBN: 978-1-84831-951-6
Verlag: Icon Books
Format: EPUB
Kopierschutz: 6 - ePub Watermark

E-Book, Englisch, 288 Seiten

Reihe: Practical Guide Series

Change can often seem like an impossible task, but this practical book will help you put it into perspective. With guidance from two experts, you'll recognise the behaviours and thoughts that hold you back, and will develop skills to think more positively, act more calmly and feel better about yourself. Using the same tools employed by CBT practitioners, this book is full of activities and experiments to explore and challenge, stories and exercises to provide perspective, and a clear framework to encourage and guide you. The authors' friendly and supportive approach will help you learn to manage recurrences of negative thinking and behaviours, and to develop strong coping strategies. CBT incorporates the latest therapies and research, including ACT and mindfulness, and explicitly addresses problem areas like insomnia and depression.

Elaine Iljon Foreman and Clair Pollard are Chartered Clinical Psychologists with expertise in cognitive behavioural therapies. Elaine's focus is in clinical research into anxiety, while Clair works with the NHS and The Back-Up Trust.

Autoren/Hrsg.

Pollard, Clair

Iljon Foreman, Elaine

Leseproben

CHAPTER 3

Managing anxiety

From ghoulies and ghosties

And long-leggedy beasties

And things that go bump in the night,

Good Lord, deliver us!

Traditional Cornish prayer

UNDERSTANDING ANXIETY

The internet offers around 46.5 million answers to what anxiety is all about! So that you don’t have to go through them all (at 5 minutes per website that’s around 450 years of your time) in this section we condense it down to the basic essentials:

• What it is
• Where it comes from
• What forms it takes and, most important of all …
• What you can DO about it.

WHAT IS IT?

Anxiety is often described as a feeling of worry, fear or trepidation. But it’s much more than just a feeling. It encompasses feelings or emotions, thoughts and bodily sensations.

try it now

You might be more sensitive to one or two of these. Remember when you last felt really scared? Write down what you remember noticing, and then look at the examples we have given. Don’t worry if one column’s blank – it’s common not to notice everything when you first start looking at your emotions, thoughts and physical feelings.

Situation when you last remember feeling terrified

Physical sensations What happened in your body?

Emotions What did you feel?

Thoughts What went through your mind? Words? Pictures?

Examples of typical reactions

Heart racing, sweating

Feeling absolutely petrified

What will happen next? Will I have a heart attack? Will I look like an idiot?

Occasional anxiety is absolutely normal within our everyday experience. If you didn’t feel anxious, ever, that would be something to worry about! Life presents us with challenges, which we aren’t always confident we can handle, so a degree of anxiety is natural. The challenges can be stressful events including actual danger, happening in the real world, and/or the things our minds conjure up, such as what if a catastrophe did occur – like meeting those ghoulies and ghosties which we mentioned at the start of this chapter.

FEELINGS OR EMOTIONS

When we experience severe anxiety we usually feel terrified. While sometimes it is quite straightforward to identify what it is that we are scared of, at other times we just get an overwhelming feeling of panic. But whether you love or hate this feeling depends to a great extent on your personality and the context.

Believe it or not some people seek strong sensations, and for these people sometimes the more powerful, the better! Experiencing high anxiety can be pleasurable, even though that might sound peculiar. Think of horror films, amusement parks or ‘extreme sports’ holidays. Certain people love the adrenaline rush these activities provide. The key is that usually the enjoyment is linked to it being a time, place and activity that they have chosen. They would probably be less enthusiastic about something that was happening to them uninvited, unwanted, out of their control and downright dangerous!

THOUGHTS

We all usually try to make sense of our environment, and to understand what is happening to us. It can be really frightening not to know what is happening, and to anticipate that whatever is going to happen next will be even worse. Anyone experiencing feelings of panic and terror is likely to try to figure out why it’s happening, and what it means. How we make sense of our world is what tells us whether it is safe or dangerous. Shakespeare neatly summed this up, writing in Hamlet, ‘there is nothing either good or bad, but thinking makes it so’.

So the link between thoughts and emotions is already becoming apparent – if you think something is really dangerous, you are likely to be seriously scared of it. People watching a horror movie are less likely to enjoy it if they then start looking out for aliens and monsters when they leave the cinema, while those who recognize it as being ‘only make believe’ can safely enjoy the scariness in the confines of the cinema, knowing that in reality there are no such dangers.

BODILY SENSATIONS

It can be quite astonishing to discover how many different sensations can be triggered by anxiety and how many different parts of the body can be affected. You may get just a few of these or most of them. The most common sensations are:

• Your heart may beat faster and harder
• Your chest may feel tight or painful
• You may sweat profusely
• You may tremble or have shaking arms and legs
• You may have icy cold feet and hands
• You may have a dry mouth
• You may have blurred vision
• You may need to go to the toilet or have a churning or fluttering stomach
• You may have a horrible headache
• You may feel that you’re ‘not really here’ or that you are somehow out of your body, looking down on everything, detached from your surroundings
• You may feel as if everything is very unreal
• You may feel dizzy, light-headed or faint
• You may feel you have a lump in your throat or that you can’t swallow
• You may feel nauseous – you may even vomit
• You may feel tense, restless or unable to relax
• You may have general aches and pains.

As we mentioned, it is normal to experience anxiety when we feel we are in danger. Your body responds with the ‘triple F’ reaction, Fight, Flight or Freeze. It’s a really important automatic response – your body does it all by itself. The 3 Fs are linked to the survival of our species over the years. Take the example of disturbing a hungry wild animal out in the bush. Depending on both you and the type of animal, you might try to fight it, to run away as fast as you could, or to keep stock still in the hope that it had poor eyesight and wouldn’t charge at you. Which of the 3 Fs do you reckon you’d choose?

In situations you perceive as dangerous, your body produces a whole range of chemicals (including adrenaline) which trigger all of the physical symptoms above. These bodily changes are what have helped the human race to survive. The chemicals released cause physical changes which enable us to run far faster than otherwise, have greater strength, and generally have a better chance of defending ourselves and our loved ones. That’s great for an objective danger like a wild animal, but not particularly helpful when the perceived danger is more of a social one, like being afraid you will make a fool of yourself or a (most likely unfounded) fear of a physical catastrophe such as having a heart attack or brain haemorrhage.

In a moment we will go on to look at different specific types of anxiety problem. Each links to a range of thoughts about what is happening. So for instance, if you suffer from panic attacks you’ll probably fear that when you experience one something terrible will happen such as a heart attack, or a brain haemorrhage, or that you’ll go hysterical and make a total fool of yourself. If your problem is obsessive-compulsive disorder, then your fear may be that if you don’t do things in the right order, or clean or check sufficiently, then something dreadful will befall you or those close to you. A key feature of post-traumatic stress disorder is that the person tries to avoid reminders of the trauma. They frequently think that if they’re reminded too sharply of what happened, they’ll start re-experiencing it, and that the feelings might be more than they can bear. In this chapter we will look at different anxiety disorders in turn. However, the techniques we discuss to manage anxiety are general ones. If your anxiety problem is more severe or specific then the further resources in Chapter 9 will help you discover where else you might get help.

If you are someone who feels anxious a lot of the time, or your anxiety is so intense it’s starting to affect your everyday life, you may be suffering from one of the anxiety disorders. While we mentioned that anxiety is normal in certain situations, it becomes a problem when:

• It is out of proportion to the stressful situation
• It persists when a stressful situation has gone
• It appears for no apparent reason when there is no stressful situation.

USEFUL TIP: WHERE TO START WITH ANXIETY

1. Try to understand your symptoms
2. Talk things over with a friend, family member or health professional
3. Look at your lifestyle – consider cutting down or steering clear of alcohol, illicit drugs and even stimulants like caffeine
4. Apply some of the CBT techniques in this chapter.

It’s quite common for people who are suffering from anxiety to also have symptoms of depression. If this is true for you then Chapter 6 on managing depression may be helpful for you.

CBT looks at how our thoughts, emotions, physical sensations and behaviours all interact to maintain our anxiety. When we perceive a ‘threat’ of any kind – whether that is a fear of something that is happening right now or a worry about something that...