Tomás Santa Cecilia: "Cognitive-behavioral therapy has proven to be very effective in cases of anxiety".

A psychologist with a multifaceted career explains how to overcome stress and anxiety.

Anxiety is one of the most frequent pathologies among the adult population. We live in a society marked by rushing, high demands and little time to rest and reflect.

All this is a breeding ground for the appearance of psychological disorders such as stress or anxiety, which imply that the affected person lives in a permanent state of alert, worry and uneasiness.

Interview with psychologist Tomás Santa Cecilia

With the aim of delving into the causes and possible treatments of anxiety, we have talked to Tomás Santa Cecilia, a psychologist from Madrid with an outstanding career and who has effectively treated hundreds of clinical cases.

We have not missed the opportunity to learn more in detail what anxiety is and how we can manage and treat it.

Bertrand Regader: What are the main reasons why people with anxiety problems go to a psychologist?

Tomás Santa Cecilia: If we consider anxiety as a natural emotional reaction when a person finds himself in a certain situation that constitutes a risk or a demand from the environment, then we can assure that anxiety becomes a state that affects his well-being, understanding emotional well-being as a state of calm and tranquility, which is what we all aspire to.

When it is a demand of the environment, anxiety is maintained until we find a way to solve such demand; for example: to finish a committed task, to execute a job that we are urgently asked to do...

In other cases, anxiety occurs when we live in a situation of uncertainty, of doubts about what may happen, without it being up to us what to do. A good example is the anxiety that is activated before a lottery draw or what bingo or other gambling players feel.

This emotional state of uncertainty can be paralyzing for many people. For others, on the other hand, it can be a challenge, which is one of the most important differences. For this reason, it is important to determine at what point the demands of the environment, our thoughts, desires, tastes or expectations are an obstacle to progress in the work, family, social or personal sphere. It is at this point where we can count on a professional psychologist.

Many times it is assumed that anxiety always comes from outside the subject, from the environment. In what ways do we tend to feed anxiety through our actions and thoughts?

As I mentioned before, if we take into account that anxiety is defined as a feeling, an emotion, and that it depends to a great extent on how we interpret the environment and how we think about the situation we are living, then we can say that it is of utmost importance to know how to interpret our relationship with the environment in a healthy way.

The healthy way of doing so is established by our value system, our beliefs and, in short, by our learning history.

In your opinion, is there a tendency to assume that anxiety burnout over long periods of time is something normal? Is there a lack of awareness that it is a real problem that deserves to be treated?

Undoubtedly, we live in a rather complicated social moment, we have strenuous work rhythms. Once we finish at work, we get in the car and, traffic jam. Then at the supermarket, then we get home and we have to start with family commitments: homework, dinners, baths, etc.

And it is at the end of the night or in the wee hours of the morning when we decide to rest, many watching television: an action movie, a frenetic debate on soccer or politics; no matter the subject, it is impossible for our body and brain to relax. This pace is impossible to keep up if we do not have the right strategies or skills to manage our time and the demands we receive or make on ourselves.

I always make people reflect on the Western movies of 30 years ago and the current action movies. This is a clear example of the pace we are going at. Watching one of the Westerns of 30 years ago is an excellent strategy to relax, but how many of us can stand this slow, leisurely pace?

Cognitive-behavioral methodology is the type of psychological intervention with the most scientific support for its effectiveness in solving people's problems. What is known about its effects on people with anxiety problems?

Cognitive-behavioral approaches have been shown to be highly effective for anxiety because the main basis for working with people is simple. People are taught that their way of interpreting environmental demands influences their emotional state.

In the same way, they are educated to process these demands or stimuli and to make decisions based on appropriate values and beliefs so that they can regain and maintain their well-being. At the same time, we educate them to make the right decisions in stressful situations. It is remarkable the fact that insurance companies only take care of the bills for professional assistance with this methodology.

What are the main stages of this form of psychological work?

The main work involves teaching people to become aware of their emotions and to relate them not so much to what happens to them in life, but to how they think, how they value these situations. "It is not outside, but inside us, where the weather is good or bad".

The psychologist teaches people to know their emotions, to understand them, to manage them efficiently, to not be afraid to express feelings and, in general, to think and act assertively.

Many people have scales of values or beliefs that, from my point of view, do not allow them to live calmly and peacefully. On many occasions the environment creates conditions that provoke emotional reactions that are detrimental to well-being, as may be the case in the workplace; let us not forget that 30% of sick leave in Spain is caused by stress. However, the environment has always threatened human beings. Faced with the demands of the environment, we can only acquire certain skills: new ways of thinking to make more effective decisions and neutralize the anxiety associated with stress.

What made you become interested in this type of methodology, and what advantages does it have compared to others?

The first was the University: I studied at the Universidad Autónoma de Madrid and this model was already being used more than 20 years ago. The second important source has been my work in recent years. I have been dedicated for many years to the prevention of traffic accidents, I still am, and it is in this area where I was able to apply this methodology.

I met drivers who drank alcohol and then took the car, others did not wear their seat belts and many of them did not care about the penalties, the fines. I had to apply the cognitive-behavioral methodology, creating awareness campaigns to change habits so that drivers would be convinced that wearing a seat belt could save their lives.

We have gone from 5,600 deaths on the roads in the last 20 years to less than half this past year, and one of the main strategies has been psychoeducation, I have no doubt. And finally, a non-university Professional Master's Degree in advanced behavioral methodology with the ALBOR-COHS Group, a reference in Spain, with more than 35 years of experience in this field.

Regarding stress and anxiety, approximately how long does it take for the first results of cognitive-behavioral therapy to appear? And when does the moment of maximum effectiveness arrive?

It all depends on the person's interest to change and the professional with whom you work, there are people who learn very quickly and others whose learning is slow. In any case, the result is what matters, not so much the time.

I always say the same thing, you don't get there faster by running, life is a long-distance race and many times with obstacles.

In this sense, I believe that we have to go through 5 phases: learning the knowledge, understanding it, internalizing the key messages, practice and automation, and it is in this last phase that we obtain maximum effectiveness.

To this specific question, a more concrete answer would be to indicate that four months of professional assistance is usually the average time to achieve the desired results.

Beyond the progress that can be made in the anxiety sessions, what can people do on a day-to-day basis to improve their situation? And what can their family members do?

I usually recommend three great and powerful habits that are extremely effective: learn to breathe, learn to go to bed to sleep, not to watch TV, and practice a non-strenuous sport, the latter is important.