Cognitive Behavioural Therapy

Sarah Webb - BABCP accredited

Crawley, Horsham and surrounding areas

07929 587036    

What is anxiety ?

Anxiety  is a mixture of emotions, from feeling nervous or frightened, to experiencing panic or terror. A certain level of anxiety is normal – everyone experiences it and it can be helpful as it makes us pay attention to situations that might be dangerous. In prehistoric times, anxiety helped to keep our ancestors safe from dinosaurs and sabre-tooth tigers. In modern times it can still keep us safe, for example it might stop us walking home late at night through dark, unlit areas of our town.

What are the symptoms of anxiety ?

Some of the symptoms that we may experience when we’re anxious are:

  • Feeling nervous or frightened
  • Heart beating faster or heart flutters
  • Rapid breathing
  • Sweating
  • Trembling
  • Muscles tension
  • Dry mouth
  • Feeling nauseas
  • Butterflies in the stomach
  • Feeling dizzy or light-headed
  • Tingling sensations in the hands and feet
  • Surroundings seem distant or unreal.

Understanding anxiety

Anxiety affects us physically

Most people have heard of the fight-or-flight response. This is a physical response that occurs in life threatening circumstances – our reaction is either to fight for our life or run for our life. We need to respond very quickly in such circumstances and to do this we produce a chemical called adrenalin which triggers physical changes in our bodies to increase our chances of survival.

Some of the physical changes that adrenalin can trigger are:

  • Faster heart rate to increase the blood flow into the large muscles of our arms (preparation to fight) and legs (preparation for flight)
  • Breathing faster to increase the flow of oxygen into the muscles
  • More tension in the muscles as they get ready for action
  • Trembling or shaking of the body for a rapid response
  • Sweating to cool the body down; this also make us more slippery and harder to catch
  • Mind focusing on the source of the threat.

This production of adrenalin and the physical changes that it triggers has evolved over thousands of years to increase the chances that our fight-or-flight response will be successful. However, in today’s modern day life, we rarely experience situations that require a physical response because they are life threatening or extremely dangerous. Instead the situations that make us anxious often require a mental response that is thoughtful and problem-solving. The body still produces adrenalin in these modern-day situations however and it is the physical changes that this causes in our bodies that can be so distressing when we are anxious. It can be very helpful in such situations to say to yourself, “these physical sensations are perfectly normal and to be expected”. Remember that we have them because our ancestors needed a physical response to dangerous situations; it might even be comforting to think of them as a way of ‘staying in touch’.

Our thinking can make us anxious

If we go back to a time when people lived in close proximity to their natural predators (on the African savanna or in a densely populated forest, say), then it makes good sense to be continuously on the lookout for threats and dangerous situations; our lives would have depended on it. However, if we move forward to the current day, then we know that dangerous, life threatening situations are comparatively rare. Even though this is the case, some people still see threats or danger in everyday situations that are relatively safe and secure. For these people, their bodies are almost permanently in a heightened state of fight-or-flight response; they feel that their anxiety is out of control and dominating their lives.

Anxiety affects our behaviour

Many people avoid situations that make them anxious – they may stop going out to places that make them feel anxious or they may leave early. Other people use ‘safety behaviours’ – for example they might only go out to the shops when they know there will be less people about. Avoiding situations that make us anxious and using safety behaviours are common and they work, but only in the short-term. In the long term, the list of avoidance situations and safety behaviours grows longer and longer. They keep our fear very real and are a “solution” that causes problems sad icon.

How can CBT help with anxiety ?

Managing the physical symptoms of anxiety

As we know, the physical symptoms associated with anxiety can be unpleasant and difficult to manage. To begin with I get my clients to recognise and accept that the physical changes their body experiences when they are anxious are perfectly natural and to be expected. Following on from this I help my clients to learn specially designed breathing exercises and relaxation techniques that reduce the physical symptoms of anxiety. We also discuss how lifestyle choices such exercise, amount of sleep and caffeine can also affect our anxiety levels.

Overcoming worry

When we talk about experiencing anxiety we are usually referring to the physical, thinking and behavioural changes associated with a situation. The thinking part of anxiety is commonly referred to as worry,  and if we worry too much then we make ourselves anxious. People who struggle with worrying often make predictions to themselves about how a situation or event will go badly wrong and how they will be unable to cope when it does.

I work with my clients to help them explore their worrying thoughts; learn to evaluate them and to replace these thoughts with more realistic alternatives. We learn that excessive, undue worrying keeps anxiety going which in turn makes the worrying worse - a vicious circle develops which makes it more difficult to lead a ‘normal’ life.

Ending avoidance and safety behaviours

Once my clients become more knowledgeable about their anxiety - that the physical symptoms are perfectly normal and that the way they think can keep the anxiety going, then we move on to spend time identifying the situations they are avoiding and the safety behaviours they are using to help them cope with their anxiety.

Overcoming avoidance habits and getting rid of safety behaviours can be challenging and generally makes the client feel more anxious in the short term. Together the client and I will set realistic goals to help them gradually reduce their avoidance and safety behaviours. We’ll discuss a situation or event beforehand, what they are worried may  happen, and afterwards, what actually happened at the situation or event - could they cope and were their fears unfounded.