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How CBT is Utilized for Anxiety

You might have heard a lot of talk about cognitive-behavioral therapy (CBT) and its benefits but still not be entirely sure what it is. Often CBT is a popular treatment for people who struggle with anxiety. It is the most widely used treatment approach to managing anxiety.  If you have ever heard that if you can change your thoughts, you can change your life, or that if you act on your dreams, you’ll be more confident, you’ve heard of cognitive and behavioral ideas.  CBT aims to change our thoughts and behaviors to help us feel better and achieve our goals. CBT looks at how negative thoughts, or cognitions, contribute to anxiety.

Cognitive-behavioral therapy combines techniques from two schools of psychotherapy: cognitive therapy and behavioral therapy.  Cognitive therapy aims to change our thinking while behavioral therapy aims to change our actions. Combined, these evidence-based techniques are extremely effective for treating various mental health concerns, including anxiety, depression, substance abuse, trauma, and more.

The following are cognitive-behavioral techniques commonly used for anxiety. The way they are applied varies from person to person and depends on the individual experience and context.  A therapist uses these techniques tailored to their individual client.

Anxiety Psychoeducation

Psychoeducation is an important part of treating anxiety. The understanding and normalization of anxiety will allow you to better recognize your symptoms, and understand the rationale behind common treatments.

Reframing Thoughts

Reframing our thoughts is a cognitive technique.  This technique invites us to take inventory of our thoughts and the things we are telling ourselves.  We know that what we tell ourselves shapes our beliefs about ourselves and life, our emotions, and our behaviors.  When we are anxious, we often don’t see things accurately.  We might not accurately view situations, judging them to be more dangerous than they are.  We can worry about the future and start to think everything will turn out badly.  We revert to black-and-white thinking about situations, stressing ourselves out even more.  When we analyze our thoughts, we can more objectively evaluate if they are accurate.  We can also change our thoughts to ones that are more empowering. Reframing our thoughts can have a drastic positive effect on our mood and behavior.

Mindfulness Exercises

Mindfulness exercises are behavioral interventions. They can include deep breathing, progressive muscle relaxation, and other coping skills.  Deep breathing helps calm our nervous system response to anxiety and is a fast and easy way to calm down. Progressive muscle relaxation helps us relax our muscles and become more in tune to whether we are tense or relaxed. Other coping skills include ways to improve the present moment: listening to music, exercising, stretching, meditating, socializing, etc.

Recognizing Triggers

We can retrigger our anxiety in various ways.  We might be too vigilant, too avoidant, or too compulsive.  If we are too vigilant, we will notice every change in our bodies or environments and then ascribe some meaning to it.  This can trigger a cascade of anxiety.  We need to learn to calm our vigilant minds.  If we are too avoidant, we can go to great lengths to avoid the things we are afraid of.  Avoidance increases our anxiety so we have to learn to lean into situations. If we are compulsive, we might constantly expose ourselves to anxiety-provoking things, like reading about diseases when we are worried about getting sick or checking on an ex when we are trying to move on.  In this case, we need to learn to reduce those behaviors.

Anxiety can feel like a debilitating experience but it is something  that can be treated and controlled.  Cognitive-behavioral techniques, like the ones outlined above have been shown to be effective for anxiety and panic.  Many clients also find they can manage these symptoms without medication, since medication is often not an effective long-term solution.

If you need therapy for anxiety or a cognitive-behavioral treatment, please reach out to me and I am happy to work with you to overcome this common mental health problem.

Erin Doyle Theodorou, M.Ed., LPC, NCC

590 Franklin Ave.

Suite 2

Nutley, NJ


973-963-7485

etheodorou@theodoroutherapy.com

Learning to Make Peace with the Differences in Ourselves and Others

How comfortable are you with being different? How comfortable are you with other people’s differences?

Take a moment and pause to think of the people you are closest with.

Do you find these people are like you in terms of beliefs? Political, personal, and otherwise? Do your friends have a wide range of perspectives and approaches to life? Or do you find your relationships center around a shared outlook and belief in life and how the world works?

Often when people come to counseling, the sessions are relationship focused, namely on relationship problems. As you can probably guess, differences lead to conflict rather than sameness in relational dynamics. I see clients time and time again not being able to wrap their mind around how a partner, friend, or family member acts or thinks as they do.

Yet the OTHER person is not the problem. It is the orientation towards differences that is likely at the heart of the issue.

Differences are part of being human. It does not make you unhuman because you are different. We have sameness and we have difference. As do all the people we meet and interact with.  As does all our family, friends, colleagues, etc.

From a family system perspective, we have togetherness and separateness. We have individuation and connectedness. The goal of becoming self-differentiated is learning to balance these forces to manage our self and our relationships.  The aim of counseling is to find a way to be more at peace with ourselves and others.

At the cornerstone of many relationship issues tends to be an inability to tolerate differences and manage our responses. Too much togetherness can lead to problems. Too much distance can equally lead to problems. A healthy balance leads to a stable life with healthy relationships.

Some people are afraid to be themselves because of the fear of how others will respond. They have grown up in a family where differences are not valued. Often not tolerated.

Often in dysfunctional families, we see the mindset of we should all think and feel the same way i.e., “group think.” Differences are not very well accepted if you did not hold the party line. There is a great value in sameness.

The truth is if you are self-aware, self-defined, and self-regulated you are going to be different from other people. AND THAT IS A GOOD THING. That is a human thing.

And if someone else is going to be self-aware, self-defined, and self-regulated they are going to be different from me. That is a good thing too.

Acceptance means we respect that other have a right to be their own unique persons. Our world becomes a lot more interesting when we learn to accept other people’s differences.

We can have differences while also being connected. Although for many people it is hard for them to connect with someone who is different from them because again their existence is based on sameness. So, if you are not the same as me then I need to exclude you, or we are not going to connect because we are not the same.

In counseling, I often point out to clients I will not believe everything everyone else believes. I will not feel everything else feels. This is a certitude that holds true for us all.

Accepting differences is a part of maturity and growing up. Accepting that not everybody is me. Developmentally, that is what teenagers look for me when they reach adolescence. Teens want to fit in and be around like-minded people which during that specific developmental stage is appropriate. It is not a permanent state to live in as we mature into adults.

Weaknesses or limitations that we all possess make it hard to make peace with differences in ourselves and others. Accepting differences means accepting others’ strengths without feeling inferior, meaning you do not feel less than the other person because they have a strength. Just like you do not feel more than the other person because you have a strength.

It is understanding that other people’s strengths mean nothing about my strengths. Their differences mean nothing about my differences.

That is where I think the therapeutic value comes in and can be helpful. Counseling can help you accept that they can be different and think different, I can be me and think differently.  Many people in sessions struggle with worrying about what another person in their life thinks of them.

Accepting differences mean coming to accept other people are entitled to think as they will and for us to be unaffected by it. To accept we do not need to fight to change people’s perceptions of us. Thus, if they have a negative view of me, I am LETTING them have that negative view of me and I am not absorbing it. I do not think I am bad or stupid or worthless. YOU may think that. That is your right to do so. Those are your thoughts. In turn it gives me a greater amount of detachment and neutrality because I accept their differences. And their differences can be ludicrous especially in dysfunctional people. But that is okay. Those are their beliefs for whatever reason, but they are not my beliefs. We can observe rather than absorb them.

It is healthy to realize I am not you and you are not me. It is a helpful notion to have with other people. And it such a common struggle for people of all ages and from all walks of life.

If you are not comfortable with differences is leads to hiding, lying, keeping secrets in our relationships. Those are the difficulties that arise when we need sameness to feel comfortable.

I think part of maturing and getting older is accepting people think differently than I do, and they will. And that is okay.

A common way you know you struggle with accepting differences is when you try to change someone. We are not respecting differences if we are trying to fix others. It is not accepting the principle of we are all not the same.

The thing you must remember is accepting differences is not accepting the behavior.

If someone thinks harshly or badly about you, if I accept their differences, it does not mean I will stay in for the abuse. It means I now must make choices about how I am going to relate to this person. I cannot change them, and I have probably tried to many times. But I can’t—now what to do I do to position myself with them that has the least toxic effect? In turn you are accepting their differences by adjusting yourself to that reality. Then we care for ourselves more while respecting their differences.

We must remember there are not only differences in beliefs, but differences in how we react and respond. If you really want to get a reaction from someone, feel differently than they feel.

Feeling neutral can be seen as a bad thing as some. Because being neutral can be unsettling. People often feel more comfortable in emotional reactions because even if they are not healthy, they are familiar.

People may not like or accept this response. Reactivity may be what they are comfortable with. Remember, reactivity is lack of being okay with difference. Because if you are okay with difference, why would you be reactive to the other person? If you are okay with being neutral and with differences, you do not need to be reactive.

If I am okay with my position, I do not need to react to the positions of others.

They may not in turn have everything they want, but I do not have everything I want. Such is life.

Being okay with differences reduces the reactivity in our relationships. It leads to less conflict and more harmony.

Others can believe what they choose but I must then act accordingly. Oftentimes, we do not like the options of acting accordingly—it may mean boundaries, it may mean loss of the relationship, it may mean loss of finances, it may mean lots of things.

In counseling, people often ask how they can CHANGE the other person. Or struggle with accepting the other person WILL NOT CHANGE. Yet one of the best ways we can change a belief in others is not to be reactive to it. It is often counterintuitive and surprises the other. Thus, them having that belief is totally on them—they need to take responsibility for that belief and its repercussions.

It is also accepting that other people may not believe what you believe. People may challenge your beliefs and values. Yet I am not going to defend myself out of that belief—often when you are defending yourself, you already loss.

Defending yourself does not fix the true issue at play.

How much does defending oneself truly work? Often the belief comes from an irrational position, an emotional position, or a systems position. It is not coming from a LOGICAL position so giving all the facts is not going to change anything about what you believe, or the other person believes. We see this at play in the political arena daily.

This principle is not about forcing or changing differences, it is about RESPECTING differences. Even if those differences are illogical or irrational, we then just must decide how we will respond in turn. That is true emotional maturity.

As I frequently share with my clients, I cannot change others irrational beliefs. Thus, I respect that—those are their beliefs. I may not believe them to be true at all but that is okay. That is my belief. Now, what am I going to do?

Accepting differences can be both liberating and scary. Both emotions will come up the more you differentiate. You understand you are truly alone. When you experience the difference of where you end and the other person begins, it can get scary. But also, profound.

The person I have is me. Therefore, inner bonding work can be so important. Because really the only person you have is you. Yet this is true for us all.

There are other people we connect with. But we do have to learn to stand alone. That is a part of emotional maturity.

Counseling can be a way to develop the ability to cultivate respect for differences in our self and others. This can help all the relationships we have in our life including our relationship with self.

The Most Common Reasons People Seek Counseling

Many people visit a counselor over the course of their life and there is a wide range of reasons people seek counseling. It wasn’t long ago that counseling was viewed as something that should be kept secret, but thankfully, times have changed. You do not need a “big” reason to go to counseling–it can often make a good life even better!

Mental health is something one should manage before it becomes a crisis. Welnness is the cornerstone of professional counseling. From a wellness perspective, counselors focus on prevention and help clients develop goals to work towards their optimal physical and mental health prior to the onset of problems. Everyone is different, and we all have unique circumstances and problems. Yet, each area of an individual’s life inevitably affects other areas. Counselors are trained to develop treatment plans that recognize the interplay/interconnectedness of the different components that compose the well-being of our clients’ lives.

If you have never gone to speak with a counselor, you may wonder what a person gets out of talking once a week to a near stranger about their struggles in life.

Plenty, it turns out.

The reasons people seek counseling are as varied as people themselves. Thus the first question I ask a new client in our intake session is, “What is bringing you to counseling and why have you decided now is the right time?” I am curious as to the ratione behind why a person has decided to start counseling because it is often something clients will share they contemplated for a long time before following through on.

It is also an open question which helps me to get real, elaborate, and intimate answers. You can never predict where the answer to this question will take a session. Yet often the presenting problem is not the problem the client is really looking to work on.

There are some common threads that bring people to seek out counseling. Below are the top reasons people decide now is the time to get into treatment.

1)Increase self-esteem

We all want to be confident–nothing can make or break your ability to create the life you want as your self-esteem. There are clear links between the way we feel about ourselves and our overall mental and emotional well-being. It is also very intricately linked to how you see the world. Counselors help you recognize your full potential, work on communication skills, and find motivation. For many, speaking with a therapist can help them see their problems more clearly and take action.

2)Find and/or Improve a Relationship

Relationships can have a significant impact on how you feel. This includes your relationships with family members, colleagues, friends, and romantic partners. It is not uncommon to seek help with a relationship that has become a source of anxiety ad distress. A counselor is able to listen objectively and are a neutral third party. They can help you better understand and nurture the relationships that are important to you.

Finding and creating a great relationship is a life goal many amongst us have. Whether it is improving the relationship one is in or finding a healthy partner, relationship concerns often drive people to counseling. Counselors will work with clients to understand why things have gone wrong and how problems can be overcome. Many counselors work with families and couples.

3)Improve Career and Job-Situation

Having a career one loves or improving your current job situation is a pressing life problem for many. It can be especially challenging to find a new orientation for your career. Sometimes people are thinking about quitting their job and starting their own business, others want to find more satisfaction in their current occupation. We spend alot of our time at work and our relationship with our job can greatly impact of our mood and day to day functioning.

4)Be Happy

Many people seek out counseling with the vague goal of “being” happier. The goal of therapy is to help you live a more fulfilled, functional, and happier life by helping you deal with your thoughts, emotions, and the daily stresses of life. Often over the course of treatment, clients often discover that happiness in and of itself is not the goal but comes as a by-product of something else in life.

5)Eliminate Negative Thinking and Be Positive

A negative mindset cannot create a positive life. Yet many struggle to limit their negative self-talk. Getting aware of your negative thought patterns and reframing them is a key to getting the negativity out of your life. Awareness is the first important step. The second step in identifying, reframing, and implementing change. CBT is commonly utilized to achieve this goal.

6)Find Inner Peace

It is quite common for a client to report feeling restless or dissatisfied with their life. Often people can’t put their finger on why as on paper their life seems to be going well. Many clients are looking to develop peace of mind and live at harmony with themselves and the world around them. This can be achieved by working on one’s inner psychology.

7)Find and Live with Passion

Many people feel their life lacks passion–whether it is their relationship, professional life, or their day-to-day experience in general. Many come to counseling to tap into the passion that may have long escaped their life.

8)Improve Ability to Focus

One’s mental focus is important to being successful in life. Where your focus your attention, one’s time and energy goes. Being able to concentrate and effectively use one’s mental focus, is a key skill that can really improve your overall life. When people are struggling emotionally, they often report struggling to focus.

9)Mental Health Issues

Counseling is an effective way for people with mental health problems and to work through their symptoms in a supportive environment. Many come to therapy because they feel depressed often described as the “common cold” of mental health issues. Yet whether it is an anxiety disorder or mood disorder, many emotional issues can be alleviated through talk therapy.

10)Life Transitions or Important Decisions

People who are in periods of transitions or are facing down a pivotal decision, can benefit from counseling. Common transitions include adjusting to adulthood, starting a new career, marriage, becoming a parent, divorce, death of a loved one, retirement, etc. Some people benefit from the unbiased feedback that a counselor can provide. I often remind clients that in your personal life, people have opinions of what you should be doing, often a vested interest in what you decide/how it impacts them. Your counselor does not.

11)Self Discovery

As Socrates said, “The unexamined life is not worth living.” Counseling is a good opportunity to reflect on past experiences and explore feelings and values. Having the insight to understand what makes us who we are; why we respond the way we do; what excites us and drives our passion; and what challenges us and produces negative thoughts. Self-awareness is the basis for doing well life well.

12)Feeling “different” from family, friends, etc.

Many people feel those around them do not understand them. Sometimes they feel alone. It is normal to be different and it is worth exploring. We all experience the world through our own eyes, and from our own perspective-this is why two people can witness the same event and have vastly different recollections of it. Naturally, this makes it difficult for us to step outside of ourselves, and realize that everyone also experience their world through their own unique lens. Yet connection is important and the feeling that we “fit in” are basic human needs. A counselor can help you celebrate both our differences and embrace our commonalities.

It is important to remember that talking to a counselor is not the same as talking to a friend. Counselors are trained to be careful and unbiased listeners. Therapists guide people through some of the most personal and painful experiences of their lives. When appropriate, your therapist may challenge you to recognize thought and relationship patterns that aren’t helping you move forward.

It is important to realize that counseling and mental health treatment is a healthy action for everybody. Whatever the reason is for seeking it out, clients will find a safe and confidential environment with a supportive individual who will listen to them non-judgementally and strive to understand thoughts and feelings from a client’s point of view. Clients come from all walks of life; a little counseling can help everybody to improve their every day lives.

Please feel free to reach out to me:

Theodorou Therapy, LLC

Erin Doyle Theodorou, M.Ed., LPC, NCC
590 Franklin Ave.

Suite 2

Nutley, NJ 07110

973-963-7485

etheodorou@theodoroutherapy.com