Experience Life - November 2009

person’s daily life, the more severe that classification is likely to be.

Although pharmaceutical drugs can help moderate our bodies’ physical response to stressful thoughts or stimuli, nonpharmaceutical treatments — like cognitive behavioral therapy (CBT) — are beginning to replace drugs as the preferred treatment for anxiety disorders.

For many, just recognizing the symptoms of anxiety for what they are — and realizing that they do not represent an immediate danger — can prevent an attack from worsening.

Unlike medications that attempt to suppress our physiological responses to perceived threats, CBT is aimed at correcting our perception of those threats, and thus encouraging a self-moderating response.

The first goal of CBT is simply education, says Abramowitz. “We teach people about their symptoms,” he explains. “We explain that when you feel nauseated, it’s not because you’re going to throw up; when your heart races, it’s not because you’re having a heart attack.” For many, just recognizing the symptoms of anxiety for what they are — and realizing that they do not represent an immediate danger — can prevent an attack from worsening.

The second phase of CBT focuses on exposure and response protection. Some CBT therapists actually place the sufferer in the situation that causes him or her fear — whether that situation is external, like playing with a large dog, or internal, like experiencing an accelerated heart rate. “When a person repeatedly confronts their fears, they learn that the outcomes they worry about aren’t nearly as likely as they think,” Abramowitz explains.

Moreover, they learn that the initial fight-or-flight response is transitory; anxiety eases when you’re able to stay in a situation and your fears aren’t realized.

It can take 10 to 15 sessions of CBT to produce lasting results, says Abramowitz, and the success rate is fairly high — as many as 70 percent of patients conquer their anxieties. (To find a cognitive-behavioral therapist near you, visit the National Association of Cognitive-Behavioral Therapists at http://nacbt.org/searchfortherapists.asp.)

ANXIETY AS A PHYSICAL CONDITION

The physical aspects of anxiety — our fight-or-flight response — are governed by the sympathetic nervous system. CBT works by essentially reprogramming our involuntary activation of this system. But other treatment approaches focus on the body’s parasympathetic nervous system, which regulates the healing, recharging part of the nervous system and helps shut off the fight-or-flight response.