|Our Treatment of Anxiety Disorders|
|Each person with anxiety is different, and for each person we create an individualized treatment plan. But there are some similarities that exists in our treatment. Let's use, as an example, someone who suffers from panic attacks.
The first session, and sometimes the first two sessions are spent in a careful assessment of the situation. What are the symptoms? When did they first occur? What other treatments -- both informal and formal -- have been tried and what was the result of these treatments? What is the family history of anxiety? The family history of other mental or physical disorders? What were the circumstances around the first panic attack? How has the disorder developed over time? How is it affecting the person's life? Is there any benefit in having these symptoms, such as increased sympathy from a loved one, getting out of unpleasant tasks, etc. What are the ongoing stressors in a person's life? What attempts have been made to control these sources of stress and how successful were they? And so on. . .
Out of this assessment, the clinician can make a diagnosis about what the disorder actually is. Sometimes individuals have come to us having already self-diagnosed. Upon a more careful assessment, however, we find that they are not suffering from what they think they are, but from a related clinical problem. Out of this assessment, the clinician will formulate a treatment plan and share that with the client.
Typically the treatment begins with a review of the life stressors that the person is facing. We try to work together to block out or mitigate these stressors, at least for the time being. This will allow the client to make some headway. Then we teach a graded series of relaxation exercises. We need to put into your hands the tools which will allow you to relax at will. These exercises, which have been thoroughly tested and researched, will provide you with the appropriate tools. Much of the treatment is taken up with the teaching and implementation of these methods of relaxation.
Relaxation addresses the physical aspects of anxiety like muscle tension and elevated heart rate, but relaxation doesn't address the very active mind that most anxiety suffers have. Because your thinking can send you into an anxiety attack, we then need to look at the kinds of thoughts that you run through your mind. Using cognitive behavior therapy, we give you techniques for controlling and changing the flow of your thoughts. This reduces the mental driver which sets you up to have an anxiety attack.
Throughout the course of treatment, you will be given very specific homework, usually relaxation exercises or thought diaries. To complete the treatment successfully, you need to make a commitment to do your homework. (Yes, we know its like being back in school again, but really -- its for your own good!)
Those patients who are committed to the therapy typically do very well. They report that their panic starts to subside in intensity, and in the frequency of the attacks. By the end of treatment, the vast majority report that they no longer have panic attacks. If they notice anxiety at all, they report that it is like a faint touch, where previously it was like a force-10 hurricane.
Some situations are more difficult to treat than others. For some, there is a secondary gain from the anxiety. They find that there is some benefit from the symptoms, so it is not so easy for them to let go of these symptoms, and these benefits. For others, the anxiety is tied up with unresolved childhood issues. These complications can lengthen the course of treatment, sometimes substantially.
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