An Introduction to Cognitive-Behavioral Therapy

The National Institute of Mental Health states, "Clinical experience suggests that for many patients with panic disorder, a combination of CBT and medication may be the best treatment." Quite simply, cognitive-behavioral therapy or CBT is a combination of two kinds of therapy: cognitive and behavioral.

In behavioral therapy, people learn how to change behavior. You may have already heard of the most common behavioral techniques used in the treatment of anxiety disorders: desensitization, relaxation and breathing exercises.

Cognitive therapy focuses on thoughts, assumptions and beliefs. With cognitive therapy, people may learn to recognize and change faulty or maladaptive thinking patterns. Cognitive therapy is not about "positive thinking" in the sense that you must always think happy thoughts. It's a way to gain control over racing, repetitive thoughts which often feed or trigger anxiety.

The two therapies often are used together because they are beneficial to each other. For example, in the midst of extreme anxiety, it may feel impossible to gain control over your thoughts and apply cognitive therapy techniques. Therefore, a behavioral technique such as deep breathing may help you calm down and focus on your thinking.

Although the NIMH suggests CBT as a treatment for anxiety disorders, it is not necessarily the best and only treatment for everyone. The NIMH makes these important points about CBT:

• You should be a motivated person. CBT involves hard work. You will feel uncomfortable at times. You will have to do a lot of work outside of therapy. The harder you work, the better chance you have of recovering.

• You should find a specially trained therapist. Be absolutely sure you are going to get what you're paying for! You will be sorely disappointed and quite frustrated if you don't.

With these cautions in mind, it's important to note that many psychotherapists use a combination of CBT and other techniques. You may have a real need for "talk" therapy as well as a need for delving into your past. That's why it's so important to ask a therapist up front what your treatment plan will be (and the therapist will probably need to evaluate you first).

In addition, as the NIMH points out, it may be difficult to find a cognitive-behavioral therapist where you live. If that is the case for you, find the best therapist you can, and work on cognitive-behavioral techniques on your own. Two excellent self-help books which apply these techniques are:

• Edmund J. Bourne's The Anxiety & Phobia Workbook
• David D. Burns' The Feeling Good Handbook

Remember, though, there is no substitution for the help of a trained professional. You owe it to yourself to find the best therapist for you!