Treatments for Generalized Anxiety Disorder include:
- Counseling for self or relationship to help cultivate trust, rest, and safety.
- Cognitive Behavioral Therapy for Generalized Anxiety Disorder – GAD:
Cognitive:
Identify basic beliefs and conditioning undergirding the impulse to worry. It’s helpful to explore your personal story to discover beliefs/thoughts related to distress.Thought logs and some techniques used in counseling meetings will help identify the cluster of habitual thoughts and beliefs that give worries energy. Discern if beliefs and self-talk are still as adaptive as they once were. Consider alternative self-talk and balancing thoughts, and practice behavior consistent with changed thoughts and aspirational beliefs.
Learn to discern “noise” of worry from useful problem solving related to problems that need attention. Practice turning down the noise of worry even though we can’t put on the breaks immediately.
Behavioral:
Relaxation training or daily meditative practice to bring the sympathetic nervous system to rest each day. Cumulative effects of daily relaxation allows the nervous system to rest in homeostasis. Within seven days of this practice, most are sleeping better and are able even to rest in improved concentration on daily tasks.
What if CBT is not my counselor’s approach or not to my liking?
Other therapies include: Narrative Therapy, Solution Focused Therapy, Supportive Therapy, Brief Therapy, Acceptance & Commitment Therapy, CDOI, FIT, Etc.
CBT was the first model of counseling to be studied for effectiveness. Prior to that counseling in general was repeatedly studied and found to be very effective for a wide range of distress. Since the original CBT validation research over thirty years ago, it has been touted as an evidenced based treatment. It was the first validated model because it was the first to be manualized – a step wise, “paint-by-numbers” linear approach to counseling. If a model is manualized and experimenters need to validate adherence to a manual, it is more likely to be incorporated into research because controlling variables between experimental conditions is of paramount importance.So CBT was the first model over the finish line in a parade of Evidence Based models to follow.
CBT was further popularized as the Evidence Base Treatment researchers asked the very important question of whether counseling or medication is more effective in treating anxiety and depression. Again, because CBT can be manualized, it was the counseling method used in the research experiments. Despite some important evidence to the contrary, physicians latched onto research that demonstrated combining treatment – medicine and CBT – gave a better outcome on average than medication alone or counseling alone, even though either treatment alone gave significant benefit. The common physician decision rules became: start with medication and titrate it up to a therapeutic dose, add CBT counseling if symptoms are not fully remitted or the patient is wanting/needing more benefit.
There is very good, and much ignored, news that developed since the early CBT research. The number of counseling models have exploded since the early years of CBT. With it, outcome studies have shown effectiveness equal to CBT. In fact, there is no compelling research evidence that CBT is superior to other models. That is not a knock against CBT. It is very effective, as are many other models. You can look for yourself. As news of research findings are published, check if CBT was measured against no treatment – often a waiting list or self help reading – or was CBT measured against another bonafied treatment model? We now have decades of research and meta-anaylses of that research substantiating the robust effectiveness of dozens of counseling models. So while CBT is effective and imminently understandable and teachable, it is not superior.
Feel free to shop for a counselor who makes sense to you. It should be someone who can listen, who respects you, and who takes a counseling approach that makes sense to you and is focused on your goals for counseling. For GAD, the goal is often to worry less, sleep better, have more energy or be able to relax, address life problems as they arise.
What Does Mindfulness Have to Do with Anxiety Treatment?
Mindfulness, rightfully understood, is a process of finding rest and a stable sense of wellbeing even in the midst of our active lives and the stress work, relationship, and family can present. Mindfulness does not mean self-consciousness in which we try to shut out thoughts and activities other than on which we are forcing ourselves to focus. Mindfulness opens us up to life from a grounding sense of gratitude and wellbeing and is not a technique strategically used to ward off a moment of pressing worry and distress.
Effective mindfulness involves a daily practice of becoming still and allowing the mind to become quiet. The body and mind are relaxed and alert. We check in to stillness and this moment, and do not check out of life. To the contrary, mindfulness does not exclude anything but allows us to open to life as it is. There are known physical and mental health benefits of such a meditative or biofeedback practice. Perhaps most important for those with GAD, a meditative pracitce can cultivate a sense of wellbeing and gratitude, allowing one to turn down the noise of worry and relax our tendencies to reach for food, alcohol, or other false hopes of security and comfort.