Cognitive Behavioral Exercises for Anxiety
Anxiety Disorders, according to the latest research, is one of the most common mental health illnesses in the United States of America. Every year 40 million adults report suffering from symptoms of anxiety that not only affect how one thinks but how one FEELS (sleep disorders, constant digestion/stomach issues, heart palpitations, dizziness, fatigue, breathing issues, headaches and many more are common physical symptoms of anxiety). More and more research is showing that our children, as early as age 8, are also showing symptoms of anxiety.
What is an anxiety disorder?
Anxiety disorders develop from a culmination of factors such as an individual’s genetics, brain chemistry, life events, and even personality (or disposition/outlook on life).
It is safe to say, that many individuals are facing extreme amounts of anxiety at this volatile and disruptive time in history. So not only do we have our ‘normal’ amount of anxious activity that you may be ‘prone’ to or experiencing, but add on to it that we are all in a constant state of emotional trauma right now- that it has raised anxiety levels to all time high levels with incredibly disruptive symptoms and detrimental impacts.
There are may approaches to treating anxiety (and I do not believe that one way is the right way for everyone- as that is just not the case). In today’s post I am going to review a popular modality therapists like to use to treat anxiety disorders; a clinical process using cognitive behavioral therapy (or exercises) and it is considered an effective therapeutic approach that can help one manage his/her symptoms.
CBT
Cognitive Behavioral Therapy (CBT) “As a form of psychotherapy that treats problems and boosts happiness by modifying dysfunctional emotions, behaviors, and thoughts.”
Unlike traditional Freudian psychoanalysis, which probes childhood wounds to get at the root causes of conflict, CBT focuses on solutions, and encourages patients to challenge distorted cognitions and change destructive or dysfunctional patterns of behavior. This is one of the reasons I am so drawn to CBT as a modality for treatment- it doesn’t keep us stuck in the past, rather it focuses on the here and now and into the future.
This therapy technique is based on the principle that one’s thoughts, attitudes, and beliefs affect one’s behavior and that mental disorders like anxiety and depression can effectively be dealt with, by influencing one’s negative thought processes (again…this isn’t a one size fits all mode of treatment- there are many other approaches to treating anxiety other than CBT as well).
Cognitive Behavioral Therapy compares our thinking pattern to a pair of glasses that each of us wears and impacts the view the world we see in a specific way. If our thinking is positive, we will have a positive outlook on life, and if our thinking is negative, we will have a negative view of the world.
When an individual replaces negative and harmful thoughts with positive thinking, their anxiety and distress levels considerably reduces, allowing them to function normally.
Cognitive Distortions
According to a psychologist- Grohol (2016), these inaccurate thoughts and belief systems that reinforce negative behaviors, thought patterns and emotions are called Cognitive Distortions.
These distortions alter our vision from the truth and is experienced by all human beings at some point in their lives. When these distortions take over an individual’s thought processes, it leads to mental disorders like anxiety attacks, extreme feelings of despair, hopelessness, and doom.
Here are some common distortions affecting your thoughts and can be significant causes of anxiety:
1. Filtering:
Filtering refers to the distorted thinking of an individual who chooses to dwell only on the negative happenings of their life, ignoring all the positive occurrences.
Even though a lot of good may happen in the person’s day, the individual may choose to focus only on negative happenings, thus increasing levels of anxiety.
2. Polarized or Black and White thinking:
As the name suggests, this distortion is all about thinking in black or white, with no grey shades in between.
For example, if a student is weak at a particular subject, he/she may believe “that they are a failure and will not be able to succeed in their life” even though in reality they may be useful in other subjects.
This kind of thinking leads to a sense of despair, eventually increasing one’s sense of anxiety.
3. Overgeneralization:
When overgeneralizing, an individual may tend to make decisions based on the occurrence of one or two events. For example, if a man fails in an interview, he may conclude that he would “always” fail “every” interview and “never” succeed.
The words “every,” “never,” and “always” are often mentioned in overgeneralized statements. This kind of negative self-talk leads to poor self-esteem and high anxiety levels in an individual.
4. Jumping to Conclusions:
Jumping to conclusions refers to making a decision about someone or a situation without considering all the facts and evidence. E.g., statements like “All men are unfaithful,” “She hates me because I am a good student” are examples of this distortion.
This kind of distortion negatively impacts the individual’s relationships, causing him/her to be isolated from others.
Also, the mental strain of judging situations and people tends to take a toll on one’s mind causing an individual to become more anxious and susceptible.
5. Catastrophizing / Magnifying or Minimizing:
Also known as the binocular trick, this distortion refers to an individual’s tendency to blow things out of proportion by expecting the worst to happen.
E.g., the individual may make a small mistake in their exams and conclude that they should quit school. The other extreme form of this distortion is minimizing one’s positive characteristics or overlooking another’s imperfections.
The best example quoted for this situation is when an individual is in an abusive relationship.
The abused tends to minimize their self-worth and overlook their abuser’s imperfections ultimately. This distortion leads to wrong decision making, eventually leading to high anxiety levels.
6. Personalization:
Personalization occurs when an individual holds themselves unreasonably responsible for the occurrence of an unpleasant event. They may believe that it is either something they have done or have not done that has led to the happening of the event.
E.g., A woman may think that she had a horrible day because she walked out of the front door instead of using the back door.
This distortion causes an individual to get worked up about a lot of unrealistic things, thereby increasing their levels of anxiety.
7. Control Fallacies:
Human beings like to have a sense of control over what is happening in their lives.
In this distortion an individual may have the mistaken belief that either he/she is solely in control of other’s happiness and sense of well-being. Or, that others are responsible and in control of their happiness.
The individual either burns themselves out with unrealistic efforts trying to make others happy or are filled with extreme resentment about others not doing enough to keep them happy.
These unrealistic demands both from oneself and from others greatly enhance one’s anxiety levels.
8. The Fallacy of Change:
The unrealistic belief that others should act in accordance to one’s wish and fancy is called the fallacy of change.
This distortion is a source of unpleasantness, both in the individual’s life as well as in the lives of the significant people around him/her.
9. The Fallacy of Fairness:
Life is not fair at all times, and what seems reasonable to one person may seem very unfair to the other.
An individual suffering from this distortion may find it very hard to accept this fact. In turn, it may cause feelings of resentment and despair, causing the individual to suffer from anxiety.
10. Heaven’s reward fallacy:
This fallacy refers to the distortion where an individual believes that all their sacrifice, self-denial, and righteous actions are watched by a higher power and will be rewarded.
A sense of despair and unhappiness seeps in when the rewards don’t come, thus making the person very anxious.
11. Should or Should Not’s:
This distortion characterized by statements of “Should and Should not’s” which are internalized rules that govern the individual’s behavior.
If the individual goes against them, they are plagued with guilt, and if others go against them, the individual experiences annoyance and resentment. This irrational thinking is a great source of anxiety for the individual.
12. Emotional Reasoning:
This distortion causes the individual to believe that what he/she is feeling is the absolute truth.
This irrational belief system causes them to experience increased feelings of anxiety and unworthiness. E.g., If a woman feels ugly and disinteresting, she may believe that she is genuinely unattractive and not worthy of being admired.
13. Global Labeling/Mislabeling:
This distortion is a form of false thinking wherein an individual tends to exaggerate, generalize, and label themselves, situations, or other people without knowing the entire truth.
This kind of thinking leads to a lot of prejudice, misunderstanding and can be a cause of unhappiness in the person’s life, thus leading to a lot of anxiety.
14. Always being Right:
In this distortion, the individual considers themselves to be always right. They can go to any extent to prove their point.
This kind of thinking can be tiring and can be regarded as selfish and narcissistic. It causes a lot of mental strain on the individual as they are continually trying to prove themselves.
15. Blaming:
Anxiety builds up in an individual due to this distortion because they tend to believe that others are to blame for their unhappiness.
They don’t feel the need to take responsibility for their own happiness and suffer from discontentment.
Treating Distortions
Individuals suffering from the distortions mentioned above consider their false beliefs to be real and the absolute truth of their lives. This causes them to suffer from anxiety and various other mental disorders. The goal of CBT (as well as other approaches) is to help the patient to change these distortions to ones that allow a more open and detached viewpoint in order to feel more joy and happiness and contentment. A book that I love and many have found very useful is this one; which has awesome exercises, templates and tools in it.
The best way to approach cognitive behavioral therapy is with a trained clinician or coach. However below are some exercises that you can do on your own as well. As always- it is best to work with a trained professional if you feel your mental health is affecting your ability to function in any area of your life. Here is the national helpline that is a free, confidential 24/7 365-day a year treatment referral and information service: 1-800-662-HELP (4357)
Cognitive Behavioral Exercises
Dysfunctional Thought Record
This worksheet is used to help someone who suffers obsessively from negative thoughts. It is divided into seven columns where you can write down the following any time you experience an anxious thought or emotion:
- Can I identify what happened?
- Describe what was felt.
- What went through my mind and disturbed me? What did those thoughts/images/memories mean to me, or say about me or the situation?
- Can I identify the facts? What facts do I have that the unhelpful thought/s are totally true?
- What facts do I have that the unhelpful thought/s are NOT totally true? Is it possible that this is opinion, rather than fact?
- Can I describe what someone else would say about this situation? What’s the bigger picture? Is there another way of seeing it?
- What am I feeling now? (0-100%) What could I do differently? What would be more effective?
Fact or Opinion exercise
Write down on a piece of paper all of the negative thoughts you are having or thought or felt in the last 24 hours.
Next to each one look at it and mark fact or opinion next to the thought.
For example:
I am ugly. <opinion>
Nothing ever goes right for me. <opinion>
I failed this test. <fact>
Visualization therapy
Find a quiet place and visualize or imagine the situation that causes you severe anxiety. Then play it out in your head from start to end (do not stop, continue playing it out till the end that you could foresee). Ideally this helps us understand that no matter what happens, it will turn out to be okay, even if difficult. Constant visualization can desensitize us slowly to negative emotions and helps overcome anxiety.
Imagery Based Exposure
I constantly tell my coaching and clinical clients to LEAN into something that is disturbing to us so much that it takes the power away from the thought, feeling, etc. This exercise is similar to that. In imagery based exposure, you call to mind a recent memory that produced strong negative emotions and analyze the situation. Then you think about “what happened,” “what you felt,” “how you felt like reacting to the negativity” and label the various emotions you experienced. This is done repeatedly until the situation no longer has the power to trigger negative emotions.
Meditation
This is more of a behavior treatment but a very powerful one. Meditation is a popular tool used these days by individuals and clinicians alike. Ideally you are guided to consciously acknowledge your distracting thoughts and feelings but to release them and turn into the present moment. A couple of great apps to use for this are insight timer and headspace.
Deep breathing
This is also more of a behavior treatment but can be very impactful if practiced regularly. A good one to implement is the 4, 6, 8 model. Take a deep breath to a slow count of 4, hold your breath for a count of 6 and exhale fully to a count of 8.
As stated earlier, if you are experiencing anxiety, please do not hesitate to seek help.
