Anxiety, when severe, can be highly debilitating. Even for those who experience mild symptoms of an anxiety disorder, the effects can interfere with their daily functioning, and place a burden on themselves and those who care for them.
Whether it is generalized anxiety disorder, social anxiety, or panic disorder, it can disrupt your life physically, mentally, and emotionally. With 19% of Americans suffering from anxiety, it is the most diagnosed psychological problem in the United States today.[1] Luckily, a variety of techniques and therapies can help. Here are the best therapy treatments to help alleviate your anxiety and help you get on with your life.
Cognitive Behavioral Therapy (CBT)
CBT is by far the most studied type of psychotherapy for treating anxiety. As its name suggests, it focuses on changing maladaptive thoughts and instituting behaviors to help reduce anxiety symptoms. It has been consistently proven to reduce the symptoms of anxiety.[2]
CBT includes cognitive restructuring, as well as exposure and relaxation exercises.
Cognitive Restructuring
Put simply, CBT suggests that distorted thinking leads people to experience anxious feelings, blow thoughts out of proportion, and worry. Therapists help patients think more realistically, leading to less anxiety.
Exposure
Exposure is the process of confronting anxiety-provoking situations. By confronting, rather than avoiding, the patient learns that the situation is not as frightening as it may have initially appeared. Exposure is sometimes performed as a separate therapy but is often included under CBT.
Relaxation
Relaxation is the opposite of anxiety. If you can perform exercises to help you relax (e.g., deep breathing) then your anxiety will be significantly reduced. Like exposure, relaxation can be done separately from CBT, but it is often used in this therapy.
Acceptance and Commitment Therapy (ACT)
ACT is a more recent but rapidly growing psychotherapy. It is similar to CBT in that the focus is on thoughts and behaviors that maintain anxiety, but the approach is different. The goals are accepting unwanted thoughts and a commitment to life values.
Accepting Unwanted Thoughts
In ACT, the goal is to accept, rather than change, anxiety-provoking thoughts. Once you accept them, you can “let them go” so they will not cause further anxiety. Patients learn to recognize that a thought does not have to lead to distressing feelings unless we give it that power. This process is known as cognitive diffusion.
Mindfulness
One of the main components of ACT is the use of mindfulness. Mindfulness is about considering present thoughts without judgment, making it a perfect tool to achieve acceptance. It is also commonly employed as a therapeutic exercise in CBT and Dialectical Behavior Therapy (DBT), which we will discuss shortly.
Commitment to Value Increasing Behavior
The goal here is to take action to meet your values, not just to overcome anxiety. Rather than focusing on symptom reduction, patients learn to pursue satisfaction. Methods for this are similar to those in CBT (e.g., exposure).
Dialectical Behavior Therapy (DBT)
Another offshoot of CBT, DBT was originally developed by Marsha Linehan for patients with borderline personality disorder. Adapted to treat anxiety and other mental health issues, DBT focuses on skills to enhance mindfulness, emotion regulation, distress tolerance, and relationship stability. DBT is a comprehensive treatment—it includes individual and group therapy with additional consultation and coaching.
Emotion Regulation
Emotion regulation helps you reduce your vulnerability to negative emotions and counteract unpleasant feelings. One way to cope with negative emotions is by going against your instincts in anxiety-inducing situations. Patients are encouraged to confront situations rather than follow their initial urge to avoid them. With consistent confrontation, anxiety will reduce over time.
Distress Tolerance
Distress tolerance is a valuable DBT tool. Patients learn to deal with uncomfortable feelings and endure anxiety-provoking situations. Distraction is a classic example. While it is not a long-term anxiety cure, it is a skill that can get you through intense periods of anxiety, such as a panic attack.
Eye Movement Desensitization and Reprocessing (EMDR)
Originally introduced as a treatment for trauma, EMDR also treats anxiety and other difficult issues. In EMDR, the patient is asked to visually track the therapist’s fingers as they remember an anxious or painful thought. The tracking decreases the intensity of the anxiety-producing thought and, therefore, allows the patient to process it more easily.
EDMR allows patients to confront worries that would otherwise be too powerful to approach. Anxious people have a strong urge to avoid situations that induce anxiety. Unfortunately, avoidance only leads to increased levels of worry. EDMR makes important issues more palatable.
EMDR remains somewhat controversial because it is not easily understood. However, despite its mysteriousness, research continues to find it an effective treatment for trauma and anxiety.[3]
Psychodynamic Therapies
Psychodynamic therapy believes that past experiences and relationships cause present dysfunction. Instead of being problem-focused, it emphasizes overall individual functioning.
Psychodynamic therapy emphasizes parent-child relationships and early experiences in personality development. According to psychodynamic theory, anxiety issues may be the result of a maladaptive upbringing and unhealthy caregiver attachment. By resolving these inner conflicts, psychodynamic therapy can help alleviate anxiety.[4]
The goal is to increase self-awareness of unconscious psychological processes. People can make a positive change by gathering insight into their problems. The relationship with the therapist is critical for honest communication and exploration.
Similar to EMDR, psychodynamic therapy can be hard to unravel. It is not as structured as other therapies and can be difficult to replicate. In addition, treatment usually takes longer and can be more intensive. For example, it is not uncommon for a patient to attend multiple sessions a week for many months if not years. Because it is hard to operationalize, it has not been the subject of as much anxiety research as CBT or its related treatments.
Short-Term Psychodynamic Psychotherapy (STPP)
STPP was created to make psychodynamic therapy more accessible. Time-limited and manualized, STPP retains the basic principles of psychodynamic therapy in a briefer format. As with traditional psychodynamic therapy, the aim is to uncover the sources of specific feelings.[5]
Because of its brevity, a therapist must quickly gain the patient’s trust to effectively examine past events that prevent optimal functioning. STPP can treat both depression and anxiety.
Interpersonal Therapy (IPT)
IPT focuses on current relationship patterns as the cause of psychological dysfunction. The goal is to address relationship problems which will, in turn, help resolve interpersonal conflict and psychological issues. Because it’s focused on relationships, it is often used to treat social phobias but it can address any anxiety brought about by interpersonal problems. IPT is a psychodynamic therapy, although there is some controversy as to whether it belongs under that category.[6]
Which Therapy is Right for You?
These evidence-based therapies have the potential to greatly improve your quality of life and help mitigate your anxious thoughts. Most therapists try to integrate more than one type of treatment depending on the needs of the patient. For example, it is common for a therapist who primarily uses psychodynamic principles to introduce certain CBT concepts into their work. Whatever type of therapy you choose, you can be sure that working with a licensed mental health professional will help you achieve your goals of overcoming anxiety.
References
- Facts & Statistics | Anxiety and Depression Association of America, ADAA. (2021). The Anxiety and Depression Association of America. https://adaa.org/understanding-anxiety/facts-statistics
- Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in clinical neuroscience, 17(3), 337–346. https://doi.org/10.31887/DCNS.2015.17.3/akaczkurkin
- Bhandari, S. (2019, September 3). EMDR: Eye Movement Desensitization and Reprocessing. WebMD. https://www.webmd.com/mental-health/emdr-what-is-it
- Slavin-Mulford, J., & Hilsenroth, M. J. (2011). Evidence-Based Psychodynamic Treatments for Anxiety Disorders: A Review. Psychodynamic Psychotherapy Research, 117–137. https://doi.org/10.1007/978-1-60761-792-1_7
- Ho, C., & Adcock, L. (2017). Short-Term Psychodynamic Psychotherapy for the Treatment of Mental Illness: A Review of Clinical Effectiveness and Guidelines. Canadian Agency for Drugs and Technologies in Health.
- Markowitz, J. C., Svartberg, M., & Swartz, H. A. (1998). Is IPT time-limited psychodynamic psychotherapy? The Journal of psychotherapy practice and research, 7(3), 185–195.
MS Broudy is a psychologist, writer, and consultant. He has a Ph.D. in Clinical Psychology and a master’s degree in Social Psychology. He has spent over 20 years providing therapy and assessment services for a diverse set of clients. MS specializes in writing about mental health, parenting, and wellness. He has his own blog, mentalspokes.com, where he writes about psychological issues.