Worry, Anxiety and CBT Part one

Anxiety VS Worry

We all go through periods in our life when we worry more than at other times. However worry is normally appropriate and proportionate to the situation at the time. For example your child leaving home for the first time and wondering if they will be living of baked beans for the rest of their lives. These thoughts are not obsessional and do not stop you going about your day to day life. However someone with anxiety is crippled with worry and it effects their daily functioning. They won't get in a car because they are convinced they will be in an accident.

Some clients wake up in the morning with a sense of impending doom and panic. They find themselves obsessing over things they cannot control and there thought patterns go around in circles. Their thoughts feel relentless and it can feel as if they cannot even breathe at times. Some of these clients suffer from panic attacks and they start to hyperventilate. Many clients fall into avoidant behaviours to circumvent their fears and stop doing things like socialising or getting on public transport. This makes their anxiety even worse because they never gain evidence for the fact that these things are safe.
How we interpret the world

We all have thoughts all of the time. Some of them are so quick we do not even realise we are having them. An example of this would be changing gear whilst driving a car.

These are called automatic thoughts. A persons thoughts will be based on what is referred to in CBT as core beliefs. Core beliefs are mostly formed in childhood and are the beliefs we hold about ourselves and the world. We interpret the world according to them. The problem is that sometimes these beliefs are innacurate and no longer relevant.

Take the following example of two different people and how they could interpret a situation according to their thoughts and core beliefs.

Situation: I see my friend in the street and they do not acknowledge me.

Option one: They do not like me anymore, they ignored me, what if they have told everyone they don't like me and everyone is talking about me.

(Person A who holds a belief that they are unlikeable) In the future they are likely to start avoiding people or particular social gatherings.

Option two: They must not have seen me, they must be really busy at work and in a rush.

(Person B who holds a belief that they are likeable). This person is likely to carry on as usual and even if the person in the street had ignored them on purpose, it would not affect them as much because they know other people do like them.

Someone suffering from anxiety tends to suffer from what is referred to as cognitive distortions or faulty thinking based on core beliefs they hold about themselves or the world.



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