Everybody worries, but some people have more than their share. Their peace of mind is often disrupted by “what if?” thoughts of bad possibilities. They recognize that worries are repetitive and unrealistic, but when they try to stop worrying, it gets worse rather than better!
When severe violations of safety, trust, or vulnerability occur, including outright threats to survival, humans are wired to shut down higher-order neural functions and fight, flee, or freeze in order to survive the threat. Clients suffering from post-traumatic stress are faced with the dilemma of figuring out how to carry negative personal history in the present moment without letting it dictate or control their behavior.
A recent study published in Medical Care (Serpa, Taylor, Tillisch, 2014) showed that veterans who participated in a nine-week mindfulness-based stress reduction (MBSR) program experienced significant reductions in anxiety, depression, and suicidal ideation from baseline to completion of the nine weeks.
Clients who feel worthless are chronically unhappy. They might find some solace by throwing themselves into work or by being an incredibly kind and caring friend. But underneath it all, they have a nagging sense that they don’t matter. In therapy, they might express their emotions and dutifully complete their homework assignments, but it is all just to be cooperative and avoid rejection. So, the therapy remains stuck.
Although cognitive behavioral therapy (CBT) works for most clients with anxiety disorders, the exposure tasks are not easy. Because exposure to anxiety-provoking situations is difficult, tending to your client’s willingness throughout treatment is essential to a good outcome. Here are two standard cognitive-behavioral strategies to enhance willingness:
Clients with anxiety and fear will normally have co-existing problems, such as self-worth issues and depression. Cognitive behavioral therapy (CBT) is an evidence-based way to address these conditions. With over forty years of supportive research and over 269 meta-analyses, CBT is the gold standard for treating anxiety.