The Vicious Cycle of Anxiety

downward spiralAccording to the cognitive behavioural therapy (CBT) approach to anxiety, one of the reasons that overcoming anxiety can be so difficult is that anxiety generates vicious cycles involving your physiological, cognitive, behavioural, and emotional domains. We looked at these four components of anxiety in a previous post. Now we’ll look at how they act together to form vicious cycles that create and maintain anxiety.
 
In the cognitive behavioural therapy (CBT) model of anxiety, the vicious cycle begins with an anxiety-provoking situation. This situation can be something external such as a work commitment, a trip, a social engagement, or any other event happening in the future that you’re worried about. Anxiety can also be provoked by something internal such as a physiological sensation, a thought about something you’re dreading, or an unpleasant emotion.

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Cognitive Fusion and Defusion in Acceptance & Commitment Therapy

 

In a previous post we looked at some ways to practice letting go of thoughts, but it can often be difficult to let of thoughts because they have such a powerful pull, especially when the thoughts are related to a strong emotion. In my post, What is Acceptance and Commitment Therapy?, we learned why acceptance is so important in ACT. Cognitive defusion is a way of accepting our thoughts, allowing them to pass into and out of our minds, without getting stuck in our heads.

Steven Hayes, who developed Acceptance and Commitment Therapy (ACT), coined the term “cognitive fusion” to describe times when we are so tightly stuck to our thoughts, we become “fused” to them. When we’re experiencing cognitive fusion, we can’t separate ourselves from our thoughts. Our thoughts become our reality. We feel removed from the world outside of our thoughts, removed from our senses, from what we’re doing, and even from the people around us.

The opposite of “cognitive fusion” is “cognitive defusion.” Cognitive defusion involves taking a step back from what’s going on in our minds, and detaching a little from our thoughts. In this state of defusion, we can observe our thoughts and other internal processes without getting lost in them, stuck in them or fused with them. We can simply notice our thoughts, watch them, accept them and let them go if we choose to.

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Watching Thoughts and Letting Them Go

 

In a recent post we looked at how mindfulness can help us let go of our thoughts when we get caught up in ruminating or worrying or just thinking in circles. Letting go of thoughts is never easy, however, and in this post we’ll look at how simply watching our thoughts can help us let them go.

Thoughts pop into our heads all the time, and usually we don’t pay any special attention to them: they enter and leave our minds all on their own, just like a car that drives into our line of sight, remains in our field of vision for a few moments, and then drives along and passes out of our line of sight again.

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Letting Go of Thoughts Mindfully

racing thoughtsIt’s easy to get swept away by our thoughts, especially in the face of strong emotions. We get stuck ruminating and dwelling about the past, filled with guilt or regret. Or our minds start racing and we can’t stop worrying about the future and imagining all the things that could go wrong. Or we replay conversations over and over again in our heads, trying to make sense of them or figure out what we could have said differently.

When our minds get going like this, not only is it exhausting; these patterns of thinking tend to make us feel bad, intensifying the emotions we’re already feeling and generating additional negative emotions as well. Because this experience is so unpleasant, it’s natural to want to these thoughts to stop, and to be able to prevent yourself from even having them in the first place. We often wind up trying to make these thoughts go away, and shut them out completely and make sure they don’t come back. But just like we can’t control our emotions or suppress our emotions, neither can we control or suppress our thoughts.

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STOPP and Be Mindful

 
 

STOP is a distress tolerance skill from dialectical behavior therapy we can use whenever we’re feeling overwhelmed by stress and anxiety or distressing emotions.

Often we allow our stress and anxiety and emotions to build and build all day without doing anything to calm them, trying to just ignore them and hoping they’ll go away. Then, when we finally can’t take it anymore and start feeling overwhelmed and desperate, things have often accumulated too much and begun to spiral downwards and it can be so hard to get any relief.

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Following Your Breath Mindfully

man meditating

Free Clip Art (CC BY-SA 4.0) from Wikimedia Commons

In a previous post about our breath we looked at the difference between abdominal breathing and breathing from your chest, and how abdominal breathing can help alleviate stress and calm your body, mind and emotions.

It’s as simple as bringing your attention to your breathing for a few minutes, or even just a few breaths. This is easier said than done, however, as our minds tend to wander a lot at the best of times, and when we’re in distress, it’s even more difficult to stay focused on our breath.

In the next few posts we’re going to practice some exercises to help keep your mind focused on your breathing, starting with Following Your Breathing By Counting Your Breaths.

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The Four Components of Anxiety

anxietyCognitive behvioural therapy (CBT), sometimes called cogntive therapy, is a type of thereapy that focuses on how various factors within us and our environment interact with each other to to produce and maintain many issues that people struggle with such as anxiety and depression.

In CBT/cognitive therapy, we recgonize that, in addition to your environment, there are generally four components that act together to create and maintain anxiety: the physiological, the cognitive, the behavioural, and the emotional. These are described below.

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Breathing In I Feel Calm, Breathing Out I Relax

monk meditating

Free Clip Art (CC BY-SA 4.0) from Wikimedia Commons

In previous posts we practiced Following Our Breathing By Counting Breaths and Following Your Breathing By Measuring Breaths and a Mindfulness of the Breath Meditation. Now we’re going to learn a great mindful breathing practice to help you calm yourself and relax.

Breathing In I Feel Calm, Breathing Out I Relax: Following your breath by silently repeating to yourself the phrase:

Breathing in I feel calm,
Breathing out I relax.

You can also shorten the phrases to:

In, Calm
Out, Relax

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Cognitive Behavioural Therapy (CBT) and Cognitve Therapy in Theory and Practice

cbtCcognitive behavioural therapy (CBT), or cognitive therapy, focuses on the relationships and connections between our thoughts, feelings, actions, and our body. This sounds simple, but what does it mean?

In the CBT/cognitive therapy model, we recognize that we are each affected by the environment in which we live. This environment involves both our current situations (family, friends, job, culture, various stressor and supports, etc.), as well as our past (our family history, past relationships, previous successes and failures, etc.).

Within our environment, there are four elements of ourselves that interact with each other:

  • Cognitive: thoughts, cognitions, beliefs, self-talk

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