"People are not disturbed by events but by the view they hold about them." Epictitus

Anxiety is one of the most challenging and unhealthy negative emotions that we humans can experience.  It is experienced by all of us at some time or other and it takes many forms.

Some of the more familiar labels used to describe common anxiety problems are work related stress, panic attacks and panic disorder, post traumatic stress disorder, performance anxiety, and general and specific phobias.  Each of these emotional problems has its own focus, but each shares a common origin.

Experientially, anxiety results when we perceive there to be a threat or danger to ourselves or our domain (those we care for and/or what we consider to be our own property).  It doesn't matter if the danger or threat is real or imagined, because all that is required for us to experience anxiety is the perception of a threat or danger.  Often we cause ourselves to become anxious over a possibility of a threat or danger, even if one doesn't exist and has little chance of existing.

Another way of thinking about anxiety is to see it as fear.  We are all prone to fears and each of us has different things that we are afraid of.

Generally speaking we become anxious when we focus our attention on the future and its uncertainties.  Conversely, depression tends to be experienced when we focus our attention on the past and pay attention to significant loss or failure.  However, with anxiety we look into the future and perceive a threat or danger and then we engage in circular, non-productive thinking patterns such as worry.  We ask ourselves, 'What if...?' and then we usually answer our own rhetorical question with a negative outcome.  Not content with that, we then assume the possible negative outcome to be factual and certain, and we then think about the implications of that thing happening.  This forms a negative chain we call 'awfulising' or 'catastrophising'.  When we involve ourselves in this process of negative outcome prediction our minds make a magical leap from 'possibility' to 'probability'.  If it can happen then it almost definitely will happen.  We have negatively focused probability radar, and this provides us with further 'evidence' which we use to disturb ourselves further.

Anxiety is often experienced with other negative emotions, such as depression, anger, guilt, shame, hurt, jealousy or envy.  Very often, when we experience anxiety, we also experience physical symptoms of anxiety which we use as further 'evidence' that our anxiety is well justified;  Increased heart-rate, increased blood pressure, pounding in our ears, palpitations, sweating etc.  When we focus on these symptoms we disturb ourselves further about the veracity of our fears.

Cleary, when we are anxious, we experience physical sensations, anxious thoughts (or worries) and these effects the way we behave.  We have behaviours which feel instinctive and automatic as our bodies are flooded with adrenaline to aid us when we meet the perceived threat.  The 'fight or flight' response is triggered as we prepare to deal with the threat by fighting it or fleeing from it.  Most commonly we make a very clear decision to avoid situations which we find anxiety provoking.  Avoidance is solely responsible for initiating and maintaining our phobias.

So, while we are experiencing anxiety as an emotion, we also become aware of physical symptoms, thinking consequences, and behavioural consequences.  However, once we have an insight into the way this works then we can buy ourselves the opportunity to interrupt what we previously thought of as an automatic reaction.

Anxiety and its consequences are triggered by our beliefs and attitudes.  All of us have two types of thinking patterns or beliefs, beliefs that are healthy (rational) and beliefs that are unhealthy (irrational).  Healthy beliefs lead to emotional well-being and enable you to achieve your goals and to move on and heal yourself when something bad happens.   Beliefs that are unhealthy lead you to feel stuck and disturbed and cause you to do things that sabotage healing.

Healthy beliefs are flexible and are based on the things that you want, the things that you like, the things that you desire and prefer but they are realistic and consistent with reality.  This means they are accepting that sometimes you may not get what you want.  Reality shows us that.  An example of a healthy belief about the risk or threat of negative judgement may be 'I want to be liked in social situations but I accept that there's a possibility that some people may not like me.  This does not mean I am an unworthy or a Failure.  I'm worthy but fallible.  My worth does not depend on whether I'm liked or not'.  Essentially, you do not put a condition on yourself despite the risk of negative judgement.  This type of belief would cause healthy nervousness or concern but not anxiety when out socially.

Unhealthy beliefs are the opposite of the healthy ones.  They are inflexible, non accepting, rigid, absolutists or dogmatic.  They are based on MUSTS, HAVE TO, GOT TO, NEED TO, ABSOLUTELY SHOULD. They are unrealistic and unhelpful to you because do not allow you to accept the possibility of risk or threat.  An example of an unhealthy belief about loss may be 'I absolutely must be liked when I'm out socially.  If I am not liked then proves I'm a failure or worthless'. This type of belief would cause anxiety in social situations.

CBT enables a person to change their unhealthy beliefs into their healthy versions though cognitive and behavioural work.  These usually starts with education and understand and moves on to learning how to challenge unhealthy beliefs to finally learning to strengthen the healthy beliefs through cognitive and behavioural work.

Ian Martin
CBT therapist and lecturer