In my work as an expat psychologist, I often help and support people with anxiety disorders: panic attacks, stress, insomnia, and I might say that my work as an anxiety psychologist occupies approximately 60 per cent of my time.
Unfortunately, all these cases requiring anxiety treatment or, at least anxiety consulting become more and more frequent and, indeed, very present in expats' daily life. And they seem to be recognized as usual and "normal" things, not as any kind of disorders.
I'm stressed out!", "I can't handle it anymore!", "What a hectic life, always in a rush!", "I am completely burnt out!". Does any of this sound familiar? Have you ever asked yourself, why you're living in this constant state of anxiety?
CBT Principles of Anxiety Consulting
As a cognitive behavioral therapist, I provide anxiety consulting using proven techniques which become an effective and one of leading treatment for anxiety. Research shows that in some cases CBT gives positive results after as few as 8 sessions (with or without medication).
I teach my clients the core principles of self-management. You will learn about the connection between your thoughts, emotions, and the way you behave in different situations. You will understand how your thoughts and behaviors interact to create anxiety and how to identify your anxiety's red flags.
Anxiety Therapy with CBT includes 3 main steps
I always start with some psychoeducation to give my clients some food for thought about their case and anxiety in general and possible coping skills. Usually people seeking assistance with anxiety, have a quite limited knowledge about it. For instance, you might know you're afraid of large groups of people or don't feel comfortable using public transportation or even have a constant feeling of anxiety without any special reasons. I find a good idea to start with discussing triggers, sources of anxiety, etc. What are the situations when you feel most anxious? What do you think and feel? How do you respond the situation and how is affecting your life? The reason behind asking all these questions is that the anxiety is defined by avoidance. It's important for clients to understand that every time they avoid an anxiety-producing situation, their anxiety will become even worse the next time around.
So, the second step is to challenge your negative thoughts. I should be honest – challenging long-held beliefs can be very difficult. One CBT technique is training yourself to imagine the best, worst, and most likely outcomes of a situation. After successfully challenging an old belief, you can try to replace it with a new (at first, neutral) one. You will learn how to start thinking neutrally rather than negatively, putting your fears into perspective.
Then we can move to the exposure therapy. The main idea is learning how to face your fears, because when you expose yourself to the source of anxieties and nothing bad happens, the anxiety lessens. This sounds easy, but there's a hard work behind creating effective coping skills.
I had a client suffering from an anxiety attacks every time he was using metro, particularly during morning and evening rush hours. In his case the exposure therapy started with creating a fear hierarchy, which gave him a realistic picture of sources of his anxiety. Then he learned relaxation techniques like deep breathing, progressive muscle relaxation, etc. to initiate a calming response within his body. This usually needs several sessions and a regular practice to be sure that you can have an automatic body response.
And finally, my client was moving though his fear hierarchy. The goal was to make him feel comfortable in moderately anxiety-producing situations while using relaxation techniques as self-managing skills. Then he could move on more challenging levels of the hierarchy.
The most important point is that the client should be allowed to feel comfortable at each stage before moving on.
As a CBT anxiety psychologist, I should stress the importance of facing fears on a regular basis for an effective anxiety treatment. Managing anxiety is not easy, so, the more you practice – the better and more confident you feel.