Cognitive Therapy and NLP Approaches to Combat Depressive and Anxious Thinking

By Karen Hastings

Changing the way you think in order to improve the way you feel, forms the basis of cognitive approaches to mental-wellbeing. Cognitive therapies recognise that our thoughts can affect our understanding of the outside world.  Depressed people (i.e. people that practice depressed thoughts!) experience the world in a different way to others. For example, they may perceive colours less vibrantly, food can seem bland and unpleasant, and safe everyday situations can seem threatening. They often predict bad outcomes from actions and events where others would expect positive consequences. A depressed persons world is likely to be experienced significantly differently to a happy person’s.  However, to an observer their circumstances could appear the same.

Cognitive therapy and related approaches such as NLP (neuro-linguistic-programming) are very effective at helping people recognise the thinking habits behind problems such as depression, anxiety, panic disorders and phobias. There are many cognitive techniques for testing negative thinking patterns and developing new more adaptive ways of thinking.  If you are considering cognitive therapy, expect to commit to homework tasks and regular practise of these techniques.

Negative thoughts are usually fairly easily identifiable with the help of a therapist.  In order to bring about a more global change, it’s often necessary to go beyond the thoughts we have to the deeper levels of our cognition - our beliefs.

Most people rarely think about their beliefs, how they developed, their role in guiding your life or whether they are helpful and supportive.

That’s because our beliefs have often been with us for a very long time.  Very often we develop them in childhood.  For example, a child may learn that ‘dogs are dangerous’ or ‘dogs are friendly’, depending on his experiences related to dogs.  As that child grows up, it is likely that he will become more flexible in his belief about dogs, able to judge individual dogs for friendliness or dangerousness.  This happens in most areas of our lives, as the more rigid beliefs from childhood, evolve and become more flexible as we develop.

However, this is not always the case.  Sometimes negative beliefs develop due to trauma or consistent negative interactions or early life experiences. These beliefs often remain fixed in adulthood even though they hold the person back or negatively impact on their lives.  Often they are taken as the absolute truth.

Beliefs form the core of your identity.  Holding beliefs about yourself, your world and others that are unconstructive and not necessarily true, can be bad news for your self-esteem. Beliefs influence on your emotional experience and behaviour by colouring how you see the world.

Every belief you have is a generalisation or simplified way of viewing the world.  Generalisations by their very nature are distortions.  Often when I see clients for therapy it is possible to find a distorted belief behind the problem.  For example ‘I am worthless’ is a belief, which promotes depression.

Your beliefs can actually determine outcomes.  This is because your beliefs effect what you focus on or pay attention too. So for example, if you focus on being un-likeable, your unconscious mind will be on the lookout for examples of people not liking you and will find various ways to bring this to your attention.  Whilst this is going on, you are of course ignoring evidence that shows you are in fact liked by all sorts of people.

I practice NLP, CBT therapy in Edinburgh and I am also a hypnotherapist, Edinburgh.  People often come to see me with difficulties, which can be traced back to limiting beliefs e.g. “I am unattractive”, “I am a bad person”.  Of course, it is not always obvious to them that they are holding onto damaging beliefs about themselves and their world, which prevent them from growing and developing or doing things they want too.

NLP and CBT therapy and Hypnotherapy, Edinburgh has proven methods for empowering people to challenge and even eradicate illogical beliefs.  The result can mean seeing the world in new and fresh ways.

CBT and NLP for Agoraphobia

By Karen Hastings

Cognitive Behavioural Therapy (CBT) is considered to be extremely effective in helping people to overcome panic disorders, and this can usually be achieved within 8 sessions.  I use CBT at my practice in Edinburgh and have found it very useful in treating agoraphobia, particularly when used in conjunction with a newer cognitive therapy, Neuro Linguistic Programming (NLP).  This article details some of the  ways in which CBT and NLP are used during NLP Edinburgh to help clients achieve freedom from agoraphobia.

1. Cognitive Therapy – At NLP and CBT Edinburgh, people are supported to identify and change the distorted thinking patterns that maintain anxiety. Behind panic attacks and anxiety are negative thoughts.  These thoughts alone cannot cause anxiety, but the belief that they are true does cause anxiety.  The therapist works with the client to reduce belief in such thoughts, this in turn reduces anxiety.

2. Behavioural Therapy – This involves desensitizing your anxiety through gradual exposure to your feared situations.  The therapist offers practical support and activities may be carried out in the community, during these sessions.

3. Learning cognitive techniques to beat your panic – clients that come for NLP and CBT Edinburgh are taught specific techniques that can be used and that must be practiced in between sessions.  The challenge is using these techniques during times when you are experiencing panic and clients are supported to become competent at this.  Of course, once clients are competent they become panic free!

4. Practising – You will get out of therapy what you put in and mastering your panic will involve you carrying out practice in between sessions.  Typical practice assignments include keeping a ‘Beating Panic’ Journal’, carrying out practice related to your ‘going out and about’ goal and creating a routine that involves empowering ‘calm’ activities.  You will also be required to practice any coping techniques taught to you by the therapist, such as using your anchors (see below).

5. NLP Communication Model – Clients are taught NLP clean language techniques.  This means learning to think and communicate with your self in a way that supports being safe, confident, and relaxed.

6. NLP Change Techniques – NLP, which is an understanding of how we code experience in our brain, has a range of techniques, which can be used to reduce or eradicate the intensity of remembered experiences.  Its possible to take an unpleasant memory, examine how it is coded and then make changes so that it is no longer unpleasant and the emotion can just drain away. If you suffer from unpleasant memories or fears, an NLP therapist can help you deal with this, via submodality work.  These treatments are available from my therapy practice, where I use NLP Edinburgh.  You can also learn to be aware of the impact of how you code experience yourself.

7.  Anchoring For Emotional Balance - Anchors are naturally occurring associations between an external stimulus and a behavioural or emotional response.  They occur because the human mind constantly seeks to make sense of the environment by looking for patterns and associations between things. People learn to make negative associations between things.  In the case of agoraphobia this may be associating going for a walk to the corner shop with fear and panic.  NLP deliberately makes use of anchors in order to empower people to have control over their emotional states.  There are specific NLP techniques in which a stimulus is used to trigger and link an emotional state.  The stimulus is usually external and may be a sound or touch.  Through these techniques it is possible to for an individual to build up a resource of positive emotional states, which they can access in any situation in which they need them.  It is also possible to completely collapse negative anchors so that external stimuli that cause you negative emotional states will no longer be a problem. 

These are just some of the ways that NLP and CBT Edinburgh can be effective at empowering people to overcome agoraphobia and other panic disorders. 

How Are You Maintaining Your Anxiety?

 By Karen Hastings

Anxiety is a common experience and a reason that clients seek NLP in Edinburgh. Worries and anxieties are normal and familiar to all of us.  They are necessary to our survival as they prepare us for coping with stress and danger. When we perceive danger, changes take place in our body, in how we think and also in how we behave.  These changes are triggered by the release of the hormone adrenalin and are crucial as they prime us for action.

Problems arise when the stress response becomes chronic, or excessive and symptoms of long-term anxiety include the following:

Muscular discomfort – headaches – difficulty swallowing –stomach cramps – ringing ears – nausea – dizziness – shortness of breath.

If you are experiencing anxiety symptoms, NLP in Edinburgh can help you.

So what causes chronic anxiety?

The actual trigger for the stress response might be real or imagined, for example, a person with a social phobia may feel just as panicky at the thought of having to walk into a big party as actually walking into a big party.  Whether the trigger is a real or imagined threat, the key to persistent anxiety is you and the cycle that you maintain.  This usually takes three forms,

1. Bodily symptom cycles: worrying about the physical symptoms of anxiety so much that this worry re-triggers the stress response and the physical symptoms.

2. Biased thinking cycles: overestimating the threat of danger and underestimating your coping resources.  Common thinking biases include; black and white thinking, catastrophising; exaggerating, ignoring the positive.  Biased thinking can further increase distress and anxiety, which in turn enhances thinking distortions even more!

3. Behavioural response cycles: avoidance is a common response to anxiety, it is natural to want to escape to somewhere safe and comforting.  The problem with this is that avoidance keeps the problem going, as you will never get to learn that you can cope.

Which of these cycles best describes how you keep your anxiety going?  Once you have identified which cycle you tend to maintain you can begin to plan to break the cycle.

When clients come to see me at my practice in Aldbury, Edinburgh, I use NLP in Edinburgh in order to empower the client to break their anxiety cycle.  I have a range of techniques in my toolbox that are useful in breaking the anxiety cycle the person is maintaining. An example of techniques include the following:

1. Bodily symptom cycle: controlled breathing, relaxation training, expanding awareness techniques, hypnosis, psycho-education, introducing exercise as a coping strategy.

2. Biased thinking: belief change process, thought challenging, distraction, teaching use of clean language, communication model, sub-modality work, and hypnosis.

3. Problem Behaviour: graded exposure, goal setting, swish process, fast phobia cure, and problem-solving strategies.

I also work using NLP in Edinburgh to work with clients to develop coping strategies so that can be used in the longer term.  If you are experiencing anxiety that is impacting on your functioning and well being it may be useful to see a cognitive therapist.  Therapies that focus of changing negative patterns of thought are now considered key methods in overcoming anxiety, phobias and depression.  A range of cognitive approaches are available from NLP therapy in Edinburgh.

 Treatment for Generalised Anxiety Disorder

By Karen Hastings

One of the most common reasons that clients seek treatment at my NLP and CBT practice Edinburgh is for anxiety and panic related problems, such as generalised anxiety disorder, panic attacks and agoraphobia.  Often, panic attacks are associated with other conditions such as generalised anxiety, phobia or depression.  In this case, the appropriate course of action is to address these underlying issues first – the panic attacks usually subside, as these other issues are resolved.

Having worked in the NHS as a senior mental Health Occupational Therapist, I tended to come into contact with people experiencing what is considered to be severe mental health problems.  It is these people that the mental health system and services are geared towards supporting and rightly so.  However, until entering private practice, I was unaware of the number of people living day to day with the often, debilitating effects of panic and anxiety disorders, with what appears to be, little or no support from overstretched NHS services. 

NICE (National Institute for Clinical Excellence) recommends Cognitive Therapy for the treatment of anxiety, panic attacks and panic disorder. Their research has shown it to be more effective than any drug treatments.   Therapies such as Cognitive Behavioural Therapy (CBT) and Neuro-Linguistic Programming (NLP) involve the patient seeing a therapist on a one-to-one basis for hour-long sessions. The total treatment course is typically between 6 and 12 sessions, with one session a week.

During NLP and CBT Edinburgh, I work with people experiencing anxiety, panic attacks and agoraphobia, usually over an 8 week period, seeing them once a week.  This is flexible, and more or less sessions are carried out depending on the unique need of the individual.  Obviously reducing the cost of treatment for the client is to be aimed for, particularly as I often work with people who have stopped working due to their problem.

In between sessions the client is given homework to complete.  Support and encouragement via email is provided, if required.

What will you achieve through having NLP and CBT Edinburgh?

1. No More stinky thinking!

At CBT and NLP, Edinburgh, people are supported to identify and change the distorted thinking patterns that maintain anxiety. Behind panic attacks and anxiety are negative thoughts.  These thoughts alone cannot cause anxiety, but your belief in the truth of these thoughts, can cause anxiety.  The therapist works with the client to reduce belief in such thoughts, this in turn reduces anxiety.

2.Building your hierarchy– This involves desensitizing your anxiety through gradual exposure to your feared situations.  The therapist offers practical support and activities may be carried out in the community, during these sessions.

3. Learning strategies to master your anxiety and panic- clients that come for NLP and CBT Edinburgh are taught specific techniques that can be used and that must be practiced in between sessions.  The challenge is using these techniques during times when you are experiencing heightened panic and clients are supported to become competent at this.  Learning strategies can involve NLP techniques, such as sub-modality work, anchoring and clean language techniques.

4. Changing your focus – just one of the things that you will learn is to change your focus towards what you do want, rather then what you don’t want.  One of the things I have found is that people with anxiety and panic problems invest a large amount of their time trying to avoid and move away from anxiety and panic.  This is understandable.  However, what you will learn is that you are actually focusing on anxiety and panic, merely by the language and internal dialogue that you are using.  You will be taught to focus on what you are trying to achieve and will immediately experience benefits in how you feel emotionally.

I have found that clients that are really committed to mastering their anxiety and panic can experience the change they desire, by sticking to the 8 week CBT/NLP programme in Edinburgh.  It is rewarding for me to work with people with these problems because the results are usually very positive. 

Anxiety Treatment

By Karen Hastings

If you are an anxiety sufferer, I am sure that you will have read plenty of literature, on and off the internet about what anxiety is, what causes anxiety, what anxiety symptoms are and also information about the current anxiety treatments available.  Therefore, this article will not spend time talking about these issues.

Understanding about anxiety is the first step in you overcoming it.  However, the next and perhaps not as easy step, is to begin to become good at techniques that will allow you to master your anxiety or panic.  I say ‘not as easy step’, because this is the feedback that I often get from clients during my first consultation with them.  They often report to me that they have read so much about their problem that they know all there is to know.  The difficulty, they find, is putting into practice the techniques.  This is where the support of a therapist can be invaluable.

One of the more challenging, yet most effective techniques that a person with anxiety should know, is how to be mindful.  What this means is being aware of the types of thoughts you have and the internal dialogue you hold with yourself.  Being mindful means thinking about your thinking!! This article will discuss one way in which you can manage your anxiety by managing your thinking.

We know that the way we think can affect the way we feel physically and emotionally.  People suffering from anxiety for several years or more can develop unhelpful thinking habits.  Negative thinking habits have been found to activate the flight or fight response. 

The trouble with negative thoughts is that they are very persuasive.  Some of the characteristics of negative thoughts, is that they just ‘appear’ in your mind, they are unhelpful and stop you mastering anxiety, they are seductive, so that its easy to fall into the trap of believing them and they can seem overwhelming and difficult to dismiss from your mind.  Sometimes we are aware of these thoughts and sometimes we are not.  They can take the form of fleeting images or pictures in our minds, occurring automatically and disappearing quickly. 

One of the ways to deal with negative thoughts is to challenge them.  First you have to identify them.  This can be challenging itself! Particularly if they are automatic thoughts.  Spend time noting your thoughts, the situation they occurred in and how you felt.  Once you have begun to recognise when you are having negative or upsetting thoughts try the following one technique.  It involves challenging your thoughts by asking yourself a series of questions.  You will need to practice the process until it becomes a habit to not just accept your thoughts as truth.

Ask yourself the following questions:

1. What is the evidence

What evidence is there to support my thoughts?

What evidence is there against them?

Don’t just assume your thought is true, record the evidence for both sides of the argument.

2. Objective perspective

How would someone else view this situation?

How would I have viewed this situation at times when I have been strong and calm? 

3. Where does this thinking get me?

What is the effect of thinking the way I do? Does it help me or hold me back?  How does it do this?

4. What types of thinking error am I making?

People with anxiety tend to display several common thinking bias, some of which are listed below.  Try to identify the thinking distortions you may be making.

All or nothing thinking: ignoring the middle ground

Focusing on the negative: ignoring strengths or any positives

Jumping to conclusions/mind reading: predicting the future

Catastrophising: overestimating the chances of crises

Personalising: blaming self for something, which is not your fault

Living by rigid beliefs: fretting about how things ought/should/must be.

5. What can be done change my situation?

What solutions are being overlooked?  Make a list of what you can do to change your situation.

6.What is the worst possible outcome?

What is the worst thing that would happen and how bad would that really be?  Fantasy is usually much worse then reality! 

Further  information about depression, the treatment of depression and the role of CBT and NLP.

Panic Attacks and Panic Disorder

By Dr. Stephen Last

A panic attack is a sudden feeling of extreme anxiety accompanied by significant physical symptoms such as trembling, sweating and shortness of breath. They are usually accompanied by an overwhelming fear of catastrophe – the person may feel they are dying or suffering a heart attack, or they may fear they are going mad. They can occur in response to specific situations (such as crowded areas) or spontaneously and with no obvious cause. They are usually short-lived (lasting a few minutes) but are so unpleasant that a person may live in fear of it happening again – in many cases, this will lead to the person avoiding situations that they think will trigger an attack (“avoidance behaviour”).

Panic attacks quite commonly accompany other anxiety conditions such as generalised anxiety and specific phobias (particularly Agoraphobia – the fear of open spaces). However they can occur outwith these other conditions – a study in 1994 found that 3 people in every 100 had experienced panic attacks alone.

Panic Disorder is the term used by Psychiatrists for those psychological conditions in which panic attacks predominate.

Psychological Symptoms of Panic Attacks

              Intense anxiety

              Fear of dying

              Fear of losing control or going mad

              Depersonalisation (the unpleasant feeling that you are not “real” or are detached      from yourself)

              Derealisation (the unpleasant feeling that your environment is “fake” or you are an “actor in a play”)

Physical Symptoms of Panic Attacks

              Shortness of breath or feeling “smothered”

              Choking

              Palpitations (feeling the heart racing or beating irregularly)

              Chest pain

              Sweating

              Dizziness or feeling faint

              Nausea or abdominal discomfort

              Flushing of the skin or feeling chilled

              Trembling or shaking

The feeing of being unable to breath can lead to a compensatory increase in breathing rate (hyperventilation) by the person. This in turn can affect the body adversely, leading to both a worsening of the physical symptoms above and additional symptoms:

Physical Symptoms of Hyperventilation

              Tinnitus (ringing in the ears)

              Numbness or tingling sensations in the hands, feet and face

              Headache

              Weakness

              Spasms of the hand and foot muscles

In a panic attack, people will usually experience at least 4 of the above symptoms, although most experience many more than this. For a diagnosis of Panic Disorder, the person will experience at least 4 panic attacks in a 4-week period, or experience significant fear of a further attack (and exhibit avoidance behaviour) for 4 weeks following a single episode.

Treatment

If the panic attacks are associated with other conditions such as generalised anxiety, phobia or depression, then the appropriate course of action is to address these underlying issues first – the panic attacks should subside as these other issues are resolved.

If the panic attacks are the main problem, then (as with most psychological problems) two courses of action are available – drug treatment and psychological therapies.

The drug treatment of panic attacks limited. Sedative drugs such as the Benzodiazepines (e.g. Diazepam (Valium)) are very effective in the short term, but are highly addictive and can lead to dependence. Further, when these drugs are withdrawn, a resurgence of the panic is likely. Antidepressants, particularly the Selective Serotonin Reuptake Inhibitors (SSRIs) such as Citalopram (Cipramil) and Paroxetine (Seroxat), are licensed for use in panic disorder. They can cause an initial worsening of symptoms when first taken, and         can cause other side effects such as gastro-intestinal disturbance and sexual dysfunction. Drug treatments are not as effective as psychological therapies in these conditions.

NICE (National Institute for Clinical Excellence) recommends Cognitive Therapy for the treatment of panic attacks and panic disorder. Their research has shown it to be more effective than any drug treatments. Therapies such as Cognitive Behavioural Therapy (CBT) and Neuro-Linguistic Programming (NLP) involve the patient seeing a therapist on a one-to-one basis for hour-long sessions. The total treatment course is typically between 6 and 12 sessions, with one session a week. The therapies involve an explanation of the psychological and physical symptoms of panic attacks, and may involve the deliberate precipitation of a panic attack during a session. The aim is to reduce the fear associated with the physical symptoms – this fear is often a cause of the attacks itself and the associated avoidance behaviours. Once the fear of the panic attacks is reduced, the attacks themselves will lessen in frequency and severity and, hopefully, disappear altogether.

Despite the clear recommendations by NICE, the availability of Cognitive Therapy remains limited in the NHS. If your GP or local Mental Health Trust is unable to provide the appropriate treatment for your condition, they may be able to recommend a therapist in the private sector.

THE TREATMENT OF ANXIETY  -

Dr. Stephen Last

 Anxiety is common and usually normal – all of us have experienced the sensation at some point in our lives. It is usually precipitated by the situations we find ourselves in, situations that possess an element of fear for us – exam time, interviews, public speaking and so on. In such situations, the anxiety response is normal and can work in our favour. The heightened awareness and rush of adrenaline can improve our performance. Of course, if the degree of anxiety is excessive, the effect can be the opposite, and our performance suffers.

The point at which anxiety stops being an appropriate response and becomes a hindrance to us can be considered the point at which it becomes a problem, a condition. This inappropriateness is the fundamental aspect of anxiety when viewed as a psychological condition. Typically the anxiety response will be prolonged (i.e. not restricted to the precipitating situation) or severe (i.e. excessive anxiety given the situation) or a combination of both. Clearly, these judgements are arbitrary – one person’s excessive anxiety may be considered by another as appropriate or normal. This is a situation in which “the customer is always right” – if an individual feels their anxiety is excessive or prolonged, then that is, in fact, the case. Anxiety becomes a problem when it adversely affects the individual to the point that they recognise it as such.

The common symptoms of anxiety are well known to all of us. They can be divided into two categories - the psychological response (mediated by the brains neurotransmitters) and the physical response (mediated by the hormone adrenaline in the bloodstream).

Psychological features of anxiety response:  

                       Heightened response to stimuli (“jumpiness”)

                       Racing thoughts

                       Excessive worry or “tension”

                       Fear of losing control/dying/going mad (in severe cases)

Physical features of the anxiety response:

                       Palpitations (the sensation of the heart beating excessively or irregularly)

                       Shortness of breath

                       Faintness/dizziness

                       Shakiness/tremulousness

                       Sweating

                       Urge to urinate/defecate

                       Numbness of fingers (in severe cases)

                       Vomiting (in severe cases)

Many of us have experienced these features at various times in our lives. It is a matter of personal judgement if one feels they are excessive or prolonged. Some people will expect to feel breathless and nauseous prior to speaking publicly – others will find this intolerable. Some people may expect to be anxious for several weeks before an exam or interview – others will see this as a problem. Psychiatrists will diagnose anxiety as a mental condition if the individual’s symptoms cause them significant distress.

The anxiety response in humans is akin to the “flight or fight” response in animals. It is a survival mechanism precipitated by perceived threat – a surge of adrenaline is released into the blood by the adrenal cortex (just above the kidneys), which then acts on the body to provide the ability to fight or flee the threat (i.e. the heart pumps faster, breathing is increased). The mental correlate is a “speeding up” of thoughts (to allow quick decision making) and an increased sensitivity to the environment (to allow accurate and fast assessment of the situation). It is a very useful response - in animals.

Modern human beings (in the industrialised societies at least) no longer face the sort of threat that the flight or fight response is designed to meet. We aren’t likely to be eaten by predators or attacked by other humans. Our threats today are usually less life threatening – but they are still important to us. And an inappropriate anxiety response can hinder our ability to cope.

The treatment of anxiety can be divided into two categories – drug treatments and talking treatments (or therapies). The choice of treatment offered by the GP will depend on the nature and severity of the condition, on the availability of treatments and (hopefully) on the wishes of the patient.

The drug treatment of anxiety symptoms can be very effective – it can also be very unhelpful and lead to other problems.  The drug treatment of anxiety is at it’s best in those cases where the anxiety is limited to a discrete time or situation. Examples might include a trip to the dentist or a plane journey for a nervous flyer. Drugs are commonly used to reduce anxiety prior to operations (the “pre-med”). The drugs used in these situations are usually tranquillizers such as the Benzodiazepines (e.g. temazepam, lorazepam, diazepam). They are effective and act quickly. Unfortunately they are both sedative (therefore best not used before a speech or interview!) and highly addictive if taken regularly for more than a few weeks, the body becomes used to them and they no longer work unless the dose is constantly increased. Furthermore, if one tries to come off them after this period, one is likely to experience withdrawal symptoms – a return of the anxiety symptoms (but worse than before) or even convulsions. Once habituated to sedatives it is a long hard road to come off them. But this is not an issue with limited, short-term use.

Another drug that is frequently used to treat anxiety is a Beta-blocker (a medication used in cardiology to lower blood pressure and slow an abnormally fast heart rate) such as Atenolol. This is certainly less sedative than the benzodiazepines and is not addictive. It does have other side effects such as faintness/giddiness, lethargy, erectile dysfunction, and is very dangerous in overdose. Further, it is effective only on the physical symptoms of anxiety – the psychological symptoms are usually unaffected.

The final class of drugs available for the treatment of anxiety are the antidepressants. Some of these medications appear to have some efficacy in relieving anxiety symptoms as well as depression. They are typically the modern drugs and have fewer side effects than the older antidepressants, and are not considered to be addictive. They take longer to work than the benzodiazepines or a beta-blocker (e.g. weeks rather than hours).

Thus, drug treatments for anxiety are available and can be effective but they do have their down side. So what is available for those who whom such treatment is not appropriate or is ineffective, or those who prefer not to take tablets? There is the option of “talking therapies”.

There is a wide range of such therapies available, each with it’s own theory, method and applications. Therapies such as counselling and the traditional psychotherapies (e.g. psychoanalytic psychotherapy) are probably less suited to the treatment of anxiety than the more modern cognitive therapies such as Cognitive Behavioural Therapy (CBT) and Neuro-Linguistic Programming (NLP). These latter treatments focus less on the individuals past (and issues arising from it) and more on the “here and now”. They encourage the individual to become aware of how he or she thinks and feels, both in the anxiety-provoking situation(s) and in the normal course of life. It is usually possible to identify unhelpful patterns of thinking and reacting in people suffering from anxiety. These patterns serve to increase the anxiety response and thus increase the individual’s anxiety symptoms. Once such patterns have been recognised (individuals are usually unaware of them initially) it becomes possible to examine them and develop more useful and adaptive methods of thinking and reacting. This in turn will lessen the anxiety symptoms experienced.

Both CBT and NLP involve the client and therapist meeting on a one-to-one basis, typically for one-hour sessions. A course of therapy can last anything up to twenty or more sessions, though six to twelve sessions on a once - weekly basis is more typical. Such therapy involves a commitment by both parties. The therapist commits to regular sessions and will use their expertise to hep the client. The client commits to an intensive therapy that will challenge them mentally and frequently require work outside of the sessions e.g. the reading of literature recommended by the therapist, the monitoring and recording of their thoughts, feelings and behaviours in varying situations etc. An important aspect of the therapy is that the more the effort the client makes, the better the results.

Cognitive therapies are undoubtedly effective in the treatment of anxiety. Many psychiatrists consider such therapies as the “gold standard” in anxiety conditions – they are frequently more effective than drug treatments and do not have side effects. Furthermore, a course of cognitive therapy has the potential to help an individual for the remainder of their life. Once the techniques have been mastered, and the individual is aware of “problem” thinking and it’s solution, the techniques can be applied to any situation at any time in the future. A persons distressing anxiety may be a thing of the past.

Unfortunately, such therapies are not widely available on the NHS – a familiar story! If your GP is unable to refer you for the therapy on the NHS, he or she may be able to recommend a suitable private therapist.