Cognitive behavioral therapy with Mindfulness to treat anxiety

These are some of the tools used in therapy to treat anxiety in patients.

Anxiety is one of the main reasons why people ask for psychological help.. Whether in the form of phobias, generalized anxiety, obsessions, panic attacks, anxiety derived from stress, etc..

In my office in Las Palmas de Gran Canaria I see people with anxiety disorders every day. It is a great effort that I make with my patients to prevent anxiety from controlling their lives. And the effort is rewarded, since a very high percentage of them manage to achieve the wellbeing they needed so much. What can be done in therapy in these cases? Let's see it.

What is the usual treatment of anxiety?

Pathological anxiety has two main symptoms that are the focus of treatment. One is anxious worries or anxiogenic thoughts. The other is the overactivation (nervousness, tension, tachycardia, etc.) that accompanies the cognitive component.

Traditional cognitive-behavioral therapy focuses its treatment on these two components as follows:

For physiological overactivation.

Relaxation techniques are usedFor physiological overactivation, relaxation techniques such as controlled breathing or progressive Muscle relaxation are used. Exposure exercises are also performed, when possible, to the situations that provoke anxiety.

By means of the approximation to the anxiogenic stimuli a habituation to these is produced, lowering the sensation of nervousness.

Concerns

Concerning worries, verbal cognitive restructuring and behavioral experiments have shown great efficacy. have shown great efficacy.

With the help of restructuring, worries begin to be recognized and identified. On the other hand, intolerance to uncertainty and the need to face the feeling of not being able to control certain aspects of life are discussed. The usefulness of worries is also reevaluated and the beliefs that sustain them are worked on.

Finally, behavioral experiments are created to expose the person to the results of the predictions of his or her worries. Thanks to these experiments the patients' beliefs are disconfirmed.The usefulness of Mindfulness in the treatment of the patient's worries is not only in the treatment itself, but also in the treatment of the patient's own worries.

The usefulness of Mindfulness

Cognitive-behavioral therapy for anxiety, in each of its manifestations, has been scientifically proven effective in a multitude of studies. So... Why include Mindfulness in the treatment?

The difficulty of controlling thoughts

It is well known that trying to control or change thoughts is an arduous task. Sometimes we fail to remember something we want to remember and sometimes anxious thoughts come to our mind uncontrollably. In fact, the harder we try to remember, the more we block ourselves. Y the more we try to forget, the more the thoughts are present in our minds..

It is estimated that we have about 4,000 thoughts during our waking state, which last only a few seconds, and rarely have anything to do with the task at hand. They are automatic thoughts of all kinds, some neutral, others pleasant, many of them absurd and others unpleasant.

People with anxiety problems tend to get hooked on unpleasant thoughts and recreate them over and over again, along with a dysfunctional mood.together with an unpleasant state of mind.

An alternative solution

Many of the automatic thoughts that cause us distress, as well as some of the beliefs that govern our lives, can be reevaluated and restructured. These changes that occur thanks to the rationalization of certain thoughts and mental rationalization of certain thoughts and mental schemes result in an improvement in the quality of life and well-being of people. and well-being of people.

But there are times when thoughts or beliefs cannot be changed, or doing so may lead to greater discomfort than the current one. This is where I have found the extraordinary usefulness of third generation therapies.

Acceptance and Commitment Therapy (ACT)

ACT belongs to the latest generation of cognitive-behavioral therapies, and emphasizes the need to let go of control of internal events and to accept experiences as they come. accept experiences as they come. One of the most serious problems we suffer from is the so-called "experiential avoidance". We try to avoid feeling or thinking unpleasant things and try to control them as we do with external events.

If we want to stop watching TV5, we just change the channel. If we want to stop thinking that our son will have an accident when he goes out partying with the car, and not feel anguish about it, that is more complicated.

The result of avoiding at all costs these emotions, thoughts and physical sensations that we find unpleasant, is to stop living in order to dedicate ourselves body and soul to fight against our "problem". The effort in Acceptance and Commitment Therapy is put in recovering or finding a meaningful life, based on finding a meaningful life, based on the values of each person..

For the management of intrusive thoughts, ACT has developed a technique called cognitive defusion. a technique called cognitive defusion. One of the goals of this technique is to show that thoughts are just that, thoughts or memories, and that they should not be confused with their referents (real events that provoke fear or anxiety).

Cognitive defusion is achieved when the patient attains a more objective attitude and takes distance from his or her own thoughtsthus decreasing credibility and attachment to these thoughts, with a consequent improvement in mood.

What does Mindfulness contribute?

Surely we all already have an idea of what Mindfulness is. Its boom in recent years has caused it to become part of mass culture. Everywhere there are courses, initiations and mindfulness therapists. It is applied to almost everything and in any way, coming to be sold as a global solution to any problem. But we must be rigorous and cautious, since the practice of any therapeutic technique must be supervised by professionals.

Mindfulness is understood as full consciousness and, although there is no precise definition of the term, various researchers affirm that it is an experience characterized by attention to the present moment, without judgment and with acceptance of the present..

Mindfulness aims to connect with the here and now, simply by paying attention and being aware of what we are feeling, thinking and doing in the present moment. The mind constantly wanders through the uncertain paths of the future, which causes us anxiety, or the unrecoverable moments of the past, which make us feel melancholy. This constant temporal back-and-forth of our mind leads us to abandon the only thing that is real for us, which is our ability to act in the present moment.

Mindfulness in Anxiety Disorders

This tool has proven to be a powerful ally of Cognitive Behavioral Therapy for anxiety disorders, since it contemplates aspects that until now were neglected.

In clinical anxiety, physiological, emotional, cognitive and behavioral symptoms are related, all surrounded by the circumstances of each person.all surrounded by the circumstances of each person. In numerous occasions, the problem of the anxious person is aggravated by precisely avoiding unpleasant experiences.

Judging our thoughts, emotions or physical reactions as unpleasant, and merging with these internal events, wanting to control and avoid them at all costs, are the elements that maintain anxiety disorders.

These symptoms of anxiety are based on 3 cognitive biases presented by people with this problem:

Selective attention

People suffering from anxiety focus their attention on potential threatening stimuliThe patient's anxiety, missing important additional information occurring around him/her that has nothing to do with his/her anxiety.

Interpretative bias

It is also common for these people to interpret neutral or slightly threatening stimuli as catastrophic.

Future-focused thinking

In order to avoid the misfortunes that the cognitive biases described above predict, anxious people spend most of their time living in the future. spend most of their time dwelling on "what could happen" instead of living in the here and now.instead of living in the here and now.

The usefulness of Mindfulness

With the help of Mindfulness we teach patients to refocus their attention on the present moment.. We make them bring their attention back to present experiences as soon as they notice that they are focusing their attention on thoughts of the future.

By applying Mindfulness in the treatment of clinical anxiety, we can also work on behavioral or experiential avoidance, cognitive rigidity and the patient's limited repertoire of behavioral responses.

The first thing that is done is to expand awareness of the present moment and the experiences that occur there. This causes a change of attitude towards lifeThis causes a change in attitude towards life, decreasing the tendency to judge and control internal events.

The practice of mindfulness helps us to realize the natural dissolution of our thoughts and emotions, without leaving "residues" or "traces" in our mind. We see these internal events appear before our observing awareness, unfold, and disappear again.

Updating is the key

Psychology is a young science, as are evidence-based psychological treatments, and they are constantly being updated. It is necessary to include the latest therapeutic advances in the daily work of psychologists in order to provide the best service to patients.

The union of cognitive-behavioral therapy with the latest updates in contextual therapies, which also have proven scientific evidence, such as Mindfulness and Acceptance and Commitment Therapy, is a combination that increases the chances of success. a combination that increases the chances of success in therapy. in therapy.

The serenity prayer says "... grant me the serenity to accept the things I cannot change, the courage to change the things I can change and the wisdom to know the difference".

A professional psychologist, committed to his work, can help you to identify and change the thoughts and emotions that are possible, and to know the ones that cannot be changed. Once you have identified the aspects of your life that cannot be changed, she will help you to accept them and focus on the present. On the other hand, she will work with you to enhance your capabilities, guiding your life based on your values, and helping you to achieve the well-being you long for.