The essential goal of cognitive therapy is to understand the realities of an anxiety-provoking situation and to respond to reality with new actions based on reasonable expectations.
- First, the patient must learn how to recognize anxious reactions and thoughts as they occur. One way of accomplishing this is by keeping a daily diary that reports the occurrences of anxiety attacks and any thoughts and events associated with them. A patient with OCD, for instance, may record repetitive thoughts.
- These entrenched and automatic reactions and thoughts must be challenged and understood. Again, using the OCD example, one approach is to record and play back the words of the repetitive thoughts, over exposing the patient to the thoughts and reducing their effect. One effective approach for patients with generalized anxiety disorder targets their intolerance of uncertainty and helps them develop methods to cope with it.
- Patients are usually given behavioural homework assignments to help them change their behaviour. For example, a person with generalized social phobia may be asked to buy an item and then return it the next day. As the patient performs this action, they observe any unrealistic fears and thoughts triggered by such an event.
- As the patient continues with self-observation, they begin to perceive the false assumptions that underlie the anxiety. For example, patients with OCD may learn to recognize that their heightened sense of responsibility for preventing harm in non-threatening situations is not necessary or even useful.
- At that point, the patient can begin substituting new ways of coping with the feared objects and situations.
…and they’re happier as well as being healthier!