An Overview of Anxiety Therapy

Woman in anxiety therapy.

 Getty / FilippoBacci

Anxiety therapy is an umbrella term that refers to a range of different psychotherapeutic treatments for anxiety disorders.

Overall, according to the National Institute of Mental Health (NIMH), 18% of adults and 25% of adolescents aged 13 to 18 live with anxiety. In addition, 4% of adults and 6% of teens have a diagnosable anxiety disorder.

Different therapeutic techniques have been developed to treat anxiety and have evolved over time from early psychoanalytic approaches to the newest cognitive-behavioral therapies.

If you are living with anxiety, therapy can be an effective treatment that may help relieve your symptoms in a short period of time. However, that does not mean that therapy does not involve work on your part; most therapy involves homework and requires you to learn how to apply what you learn on your own once you complete the course of treatment.

Types of Anxiety Disorders Treated by Therapy

A variety of different types of anxiety disorder are treated with therapeutic approaches. Some of these include the following:

Regardless of the specific disorder, the underlying causes often follow similar patterns. People with anxiety tend to react to unpleasant thoughts, feelings, and situations in a more extreme way and may try to manage those reactions by avoiding triggers. Unfortunately, this type of avoidance only serves to reinforce fears and worries. Most modern types of therapy address negative thinking and avoidance to help you manage anxiety.

Types of Anxiety Therapy

The goal of all types of therapy for anxiety is to help you learn how to overcome your fear and calm your emotional reactions. This is true whether you are taking part in individual or group therapy; in fact, most of the types of therapy listed below may take part one-on-one or in a group setting.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) has been shown to be effective for a variety of types of anxiety disorders including panic disorder, phobias, social anxiety disorder, and generalized anxiety disorder.

The premise of CBT is that examining your negative thoughts and perceptions to identify distortions can be helpful to manage anxiety. Based on this premise, what you think about situations is more important in determining how you feel than what actually happens in those situations.

In other words, it is your thoughts that determine how you feel.

Negative thoughts make fear and anxiety worse. So, the goal of CBT is to correct irrational negative thoughts and replace them with more positive, realistic perceptions. This process is best done with a therapist because it can be hard to identify your own irrational thoughts. A therapist can ask, "What were you thinking before you started feeling anxious?" This will often help you to start seeing your thoughts in terms of the patterns that they follow.

For example, you might do a lot of "black-and-white" thinking, where you assume that things are all bad or all good. Instead, you would replace those thoughts with the more realistic perception that there are many shades of grey in between. It takes practice to use CBT techniques, but once you start to recognize your anxiety and your triggers, you can learn to apply the coping skills that you learn in CBT to manage fear, panic, and worry.

Exposure Therapy

Exposure therapy is often a component of CBT or used alongside it. The premise behind exposure therapy is that avoiding situations that cause you anxiety makes your fear grow stronger.

In exposure therapy, you are asked to either imagine doing something you fear or to actually approach and do it in real life. This is often done according to a technique known as "systematic desensitization," in which you start with the least anxiety-provoking action and work your way up from there.

Following this step-by-step approach of learning how to induce relaxation, creating a list of feared situations, and working through the list gradually is the heart of exposure therapy. This gradual process of alternating approaching what you fear with relaxation helps to pair the two in your mind and makes it easier the next time you have to go do what you fear.

Dialectical Behavioral Therapy

Dialectical behavior therapy (DBT) is a technique that was developed by Marsha Linehan in the 1980s to help people manage borderline personality disorder (BPD). People with BPD have problems managing their emotional reactions, particularly in relationships with other people. Their emotional reactions happen very quickly and it takes them a long time to return to their normal level of arousal.

While not specifically for anxiety disorders, DBT may help to manage anxiety as it teaches coping skills that involve building on your strengths, identifying unhelpful thoughts, practicing self-soothing, emotion regulation, and mindfulness, and managing post-traumatic stress.

Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) is another form of therapy that has been shown effective for a variety of anxiety disorders. ACT involves identifying your values in life and then acting in ways that match your values.

This form of therapy also teaches mindfulness using metaphors. For example, one metaphor that is described is to imagine that your negative thoughts are passengers on a bus you are driving. The passengers may say things you don't like, but you are the one driving the bus and you don't have to listen to them.

Art Therapy

Art therapy is a newer form of therapy for anxiety that requires more research to confirm its effectiveness. However, there is some evidence of the effectiveness of ACT for reducing anxiety. Art therapy involves either using art to express and process emotion or using art to practice mindfulness and relaxation.

Family Therapy

Family therapy can be helpful if one person in your family has an anxiety disorder that has affected the lives of other family members. Those supporting family members can learn how best to be of help. Often, caregivers can feel burdened as well, so family therapy can help every individual who is affected.

Psychoanalytic Therapy

This type of therapy involves examining your past experiences to determine how they influence your current anxiety. During psychoanalytic therapy, your therapist would help you to identify and process these experiences to reduce your current anxiety.

Interpersonal Therapy

Interpersonal therapy may be used if your anxiety relates primarily to your relations with other people, such as is the case with social anxiety disorder.

Bibliotherapy

Bibliotherapy uses literature to help you improve your life by providing information, support, and guidance in the form of reading activities via books and stories.

What to Expect From Anxiety Therapy

What can you expect from anxiety therapy? Below are some of the key points to keep in mind.

You will learn:

  • relaxation techniques
  • how to see situations from a different perspective
  • how to identify when you have anxiety
  • how to approach situations you fear in the best way
  • coping skills
  • problem-solving skills

Therapy may be short- or long-term depending on the severity of your symptoms.

Some people show improvement in as few as 8-10 sessions, particularly if you are working with a short-term therapy such as CBT.

How to Make Therapy Work for You

It's true that you will often feel worse before you feel better when trying to make a change, and being in therapy for anxiety is no exception. However, if you are persistent, you should see improvement.

In that vein, that are certain things you can do to make therapy work for you:

  • practice self-care to support therapy
  • make sure you have a social support system
  • practice healthy lifestyle choices
  • reduce stress in your life that makes your anxiety worse

In this way, you can see that putting in an effort and being present throughout the therapy process will have the biggest impact on how well it works for you.

When to See a Therapist for Anxiety

If you are experiencing anxiety that is interfering with different areas of your life, it is important to speak to a doctor. Only a medical or mental health professional can assess your symptoms to determine if they warrant a diagnosis and treatment. While worry is transient, clinical anxiety is a problem not likely to go away on its own.

A Word From Verywell

Anxiety therapy is not one specific technique. Instead, it refers to all forms of therapy that are used to treat anxiety. If you think you would benefit from anxiety therapy, it's best to first have your symptoms assessed so that a plan of action can be determined.

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