Integrative Approaches to Treating Generalised Anxiety Disorder (GAD)

Integrative Approaches to Treating Generalised Anxiety Disorder (GAD)

Introduction:

A condition which seems to be becoming more prevalent in hypno-psychotherapists offices is Generalised Anxiety Disorder (GAD). GAD is generally presented by clients with continual anxiety which does not seem to end. Generally people with this find relaxation difficult, which can cause certain difficulties when using progressive relaxation inductions or the National College’s CRC protocol. However, this does not stop hypno-psychotherapy being a very effective intervention when working with GAD.

Key Intervention Strategies:

As your clients will be in an agitated state when suffering from GAD, it would not be appropriate to simply go straight into hypno-psychotherapy. The first step in treatment is to take appropriate time to help to educate your clients regarding their condition. Often clients feel that they are the only person to suffer with this condition. This can be especially true as there does not seem to be a common cause or a trigger which sets off the anxiety response.

The key to switching out of an anxiety state is to accept it fully. Remaining in the present and accepting your anxiety cause it to disappear.

A: Accept the anxiety. Welcome it. Don’t fight it. Replace your rejection, anger, and hatred of it with acceptance. By resisting, you’re prolonging the unpleasantness of it. Instead, flow with it. Don’t make it responsible for how you think, feel, and act.

W: Watch your anxiety. Look at it without judgment – not good, not bad. Rate it on a 0-to-10 scale and watch it go up and down. Be detached. Remember, you’re not your anxiety. The more you can separate yourself from the experience, the more you can just watch it.

A: Act with the anxiety. Act as if you aren’t anxious. Function with it. Slow down if you have to, but keep going. Breathe slowly and normally. If you run from the situation your anxiety will go down, but your fear will go up. If you stay, both your anxiety and your fear will go down.

R: Repeat the steps. Continue to accept your anxiety, watch it, and act with it until it goes down to a comfortable level. And it will. Just keep repeating these three steps: accept, watch, and act with it.

E: Expect the best. What you fear the most rarely happens. Recognize that a certain amount of anxiety is normal. By expecting future anxiety you’re putting yourself in a good position to accept it when it comes again.

Adapted from: Anxiety Disorders and Phobias: A Cognitive Perspective, by Aaron Beck and Gary Emery

Therapy for generalized anxiety disorder (GAD)

Therapy is a key component of treatment for generalized anxiety disorder. Many studies show that therapy is as effective as medication for most people. And best of all, therapy for generalized anxiety disorder (GAD) is side-effect free.

Cognitive-behavioural therapy (CBT) is one type of therapy that is particularly helpful in the treatment of generalized anxiety disorder (GAD). Cognitive-behavioural therapy examines distortions in our ways of looking at the world and ourselves. You therapist will help you identify automatic negative thoughts that contribute to your anxiety. For example, if you catastrophize—always imagining the worst possible outcome in any given situation—you might challenge this tendency through questions such as, “What is the likelihood that this worst-case scenario will actually come true?” and “What are some positive outcomes that are more likely to happen?”.

Cognitive-behavioural therapy for GAD involves five components:

• Education. CBT involves learning about generalized anxiety disorder (GAD). It also teaches you how to distinguish between helpful and unhelpful worry. An increased understanding of your anxiety encourages a more accepting and proactive response to it.
• Monitoring. In CBT for generalized anxiety disorder (GAD), you learn to monitor your anxiety, including what triggers it, the specific things you worry about, and the severity and length of a particular episode. This helps you get perspective, as well as track your progress.
• Physical control strategies. Deep breathing and progressive muscle relaxation help decrease the physical over-arousal of the “fight or flight” response that maintains the state of fear and anxiety. CBT for generalized anxiety disorder (GAD) trains you in these techniques.
• Cognitive control strategies. Through CBT, you learn to realistically evaluate and alter the thinking patterns that contribute to generalized anxiety disorder (GAD). As you challenge these negative thoughts, your fears will begin to subside. CBT also teaches you to test the beliefs you have about worry itself, such as “Worry is uncontrollable” or “If I worry, bad things are less likely to happen.”
• Behavioural strategies. Instead of avoiding situations you fear, CBT teaches you to tackle them head on. You may start by imagining the thing you’re most afraid of. By focusing on your fears without trying to avoid or escape them, you will begin to feel more in control and less anxious. Time management and problem-solving skills are also effective behavioral techniques for generalized anxiety disorder (GAD).

Psychodynamic Psychotherapy

There are a variety of sub-theories underneath this style — all of which have some connection to Freudian psychoanalytic psychotherapy. The main theory is that forces in the unconscious (likely related to our past) can influence the way we experience the world, often leading to anxiety. Since it involves talking through feelings and searching for answers, the methods used by these professionals are similar to the other styles of therapy. There is less research support for this type of therapy, but that is likely due to the difficulty of studying this approach in comparison with CBT — rather than it being ineffective.

Humanistic/Existential Therapies

A final style of psychotherapy for anxiety would be from this perspective, which represents a variety of theories. Most therapists doing any form of this therapy would have an orientation and style unique to them, with the focus of the content being on the therapeutic relationship, creating meaning in the client’s life and working with client strengths to create change. This type of therapy can take longer than CBT and also has been less researched in anxiety disorder — likely because it is very difficult to study since each case is treated uniquely.

“Whoever has learned to be anxious in the right way has learned the ultimate.”—Søren Kierkegaard, The Concept of Anxiety

“Anxiety is the Dizziness of Freedom”—Søren Kierkegaard, The Concept of Anxiety

Hypno-Psychotherapy Treatment

Hypno-psychotherapy assists patients with anxiety disorders by treating their symptoms as well as uncovering and releasing the root causes for the anxiety. Hypnopsychtherapy is an especially effective treatment when dealing with pain or anxiety from impending medical or dental procedures. Many studies report that hypnosis reduces anxiety before surgery and enhances recovery afterward by giving the patient a feeling of self-control.

The goal of hypno-psychotherapy is to change the negative fixed ideas that fuel anxiety by replacing them with positive, realistic coping thoughts that are imprinted into the subconscious mind.

For anxiety disorders, hypno-psychotherapy can help uncover the root causes for the condition so they can be brought into awareness and processed. Patients can explore experiences or negative fixed ideas that are now triggering anxiety, reprocess the memories, and reframe them to desensitize their emotional responses to the anxiety triggers.