When working with clients who experience a moderate level of anxiety, I often blend mindfulness based stress reduction with cognitive behavioral therapy. Anxiety affects the body physically as well as mentally. Think about it. Can you recall a time you felt anxious about something? A test, a performance, seeing a friend, a first date, speaking in front of a crowd…are we there yet? Chances are, simply thinking about an anxiety inducing incident has already caused a chain of physiological responses in your body right now. Your hands might be clenched. The muscles in your legs might have tensed. You may feel butterflies in your stomach. Maybe you’ve pulled your shoulders up to your ears. All of these are your body’s normal reactions to anxiety. Practicing mindfulness can help target these symptoms. You can read more about mindfulness in my previous post here.

Now, go back to that example from before. What kinds of thoughts arise? Cognitive Behavioral Therapy (CBT) targets this thinking process. In a nutshell, CBT rests on the premise that a triangular relationship exists between our thoughts, emotions, and behaviors. If one of those is altered, then the others will change in some way, as well. For example, imagine you are lying in bed. It’s the middle of the night. You are home alone. Suddenly a crash of smashing glass explodes from the kitchen. What do you do?

Let’s take a second to slow down the process. What is your emotion or dominant feeling when you hear the crash? A lot of people identify with feeling scared, fearful, terrified. Now what might your thought be? Many people’s first thought is, “Someone has broken into my house!” And then on and on from there about what could happen next. So what do you do? Most often, people respond to this scenario by saying something along the lines of:
“Call the police!”

“Hide under the bed!”

“Grab a gun or baseball bat and go down there!”

Sound familiar? Now pause. Back up. What if you are like me, and you have a pesky pet who loves nothing more than getting into goodies on the counter once you’ve left the room? What if your thought was not that someone was breaking in, but more along the lines of, “That dang cat/dog! He better not be eating all those cookies I just made!” What are you feeling now? Irritated, annoyed, amused? So what do you do? I’ve heard responses ranging from “go clean it up” to “roll over and go back to sleep.”

Do you see how in this scenario we started out with the same triggering event, but ended up acting in two very different ways, depending on the emotion and the thoughts about it? This is the basic gist of how CBT works. Through increased awareness, you can examine how thought patterns might be causing you to act and feel, and you can learn tricks to change the outcome. Partnering with the right therapist, someone with whom you feel comfortable and safe, can provide you with the benefit of a clinician trained to identify troublesome thought patterns and challenge erroneous beliefs.  Often times the Thing (way of communicating, behaving, belief, etc.) that causes us problems in our everyday lives and relationships is something that, at one time, served us well and got us through a tough spot. Problems arise when situations change, and we no longer need that thing, whatever it was, to get through. By that time, it’s become a habit, which, though potentially difficult, is able to be unlearned. 

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