Podcast:
“Anxiety as a Mental Game”

The Anxiety Disorders Association of America (ADAA) offers monthly podcasts on various topics. If you are interested in listening to my thoughts about how we can treat anxiety disorders as a mental game, here’s an opportunity. This is an October 2009 podcast.   http://www.adaa.org/podcast/archived.asp?id=19

Self-Help Update:
How Do You Know You Are Succeeding?

I think that we are best served when we purposely think and act aggressively toward the experiences that intimidate us, if our goal is to get past them. If you are looking to get past your anxiety, here are some principles to consider.

You’ll know you are succeeding if you:

• Actively look for frequent opportunities to practice provoking anxiety & doubt
• Challenge your tendency to focus on unrealistic consequences
• Think of ways to cope with those consequences, whether realistic or unrealistic
• Notice your negative & fearful thoughts without getting caught up in them, & accept them without having to get rid of them
• Commit to practice the goals of:
• wanting to be uncomfortable & uncertain
• wanting discomfort & doubt to be strong
• wanting discomfort & doubt to last
• Expect & accept that your distress & doubt might cause you to perform any chosen task at a sub-optimal level
• When you end any practice of facing your fears, support your courage & effort, regardless of what you accomplish

Back in my June-July 2009 Update, I wrote a Self-Help Update called “Talking to Anxiety.”  Read through that article again. (If you haven’t read it, you won’t get this AT ALL.) Then here are the principles to apply:

• Externalize your exaggerated fears
• Mentally speak to them directly as “panic,” worry” or “anxiety”
• Make a request of that fear which is opposite of what it expects (“Give me more” vs. “Go away”)
• After you make a request of your anxiety, return to your chosen task
•  You can notice your discomfort, but don’t react to them. Focus on your valued task instead.
• Know that giving instructions to your anxiety is a paradoxical maneuver to train your body-&-mind to stop protecting you unnecessarily 
• Honestly attempt to master this strategy as way to move toward distress & doubt without resistance
• Accept & expect that distress or worries can grab your attention again within moments         
•  You may have to apply this same strategy numerous times within a matter of minutes
• Consistently practice this skill over time, without requiring that it alter what you are thinking or feeling (“Is it working?!”)
•  Looking for immediate changes in your experience actually contributes to you remaining stuck
• With practice over time, notice that using this protocol alters your relationship with distress & doubt
  •   You become less intimidated by sensations & less reactive to worries

Book Update:
Cognitive Therapy of Anxiety Disorders

Cognitive Therapy of Anxiety Disorders: Science & Practice, by David A. Clark, Ph.D. & Aaron T. Beck, M.D., (628 pages, hardback), New York: Guilford Press, 2010.
 
This is only the third book that I have labeled as a “classic.”  It is in fine company, with one by David Barlow, Ph.D. and another by John March, M.D.

Aaron Beck is considered the father of cognitive therapy. I had the honor of having him serve as my dissertation external advisor way back in 1978. I have considered myself a cognitive therapist since that time.  David A. Clark has done an outstanding job (I believe he called it “painstaking”) over the past four years of reviewing, evaluating and synthesizing the enormous research and clinical literature on the cognitive perspective toward anxiety. Beck published his first book on the cognitive treatment model for the anxiety disorders in 1985.  This new book updates and refines Anxiety Disorders and Phobias: A Cognitive Perspective based on two decades of further research. The great news for practitioners is just how useful this book is.  Don’t be scared off by the “science” in the subtitle; there is no question that this is a practical treatment manual.  In fact, the last five chapters are really mini treatment manuals for panic disorder, social phobia, GAD, OCD, and PTSD.  Plus you’ll find rating scales, checklists, structured diaries—almost forty reproducible handouts and forms. In every chapter you will find "Clinician Guidelines." Each is a boxed-in few sentences that reinforce key points. They serve as a great way for experienced clinicians to scan through sections of this sizable book and settle in on passages that expand their comprehension.  If you are ready to sharpen your clinical skills, you will truly appreciate this book.

Table of Contents

I. Cognitive Theory and Research on Anxiety
1. Anxiety: A Common but Multifaceted Condition
2. The Cognitive Model of Anxiety
3. Empirical Status of the Cognitive Model of Anxiety
4. Vulnerability to Anxiety

II. Cognitive Therapy of Anxiety: Assessment and Intervention Strategies
5. Cognitive Assessment and Case Formulation
6. Cognitive Interventions for Anxiety
7. Behavioral Interventions: A Cognitive Perspective

III. Cognitive Theory and Treatment of Specific Anxiety Disorders
8. Cognitive Therapy of Panic Disorder
9. Cognitive Therapy of Social Phobia
10. Cognitive Therapy of Generalized Anxiety Disorder
11. Cognitive Therapy of Obsessive-Compulsive Disorder
12. Cognitive Therapy of Posttraumatic Stress Disorder