Anxiety is part of the human condition. It requires treatment when it causes severe distress and disrupts normal functioning. It can be viewed as a disorder in its own right or as a symptom of an underlying problem. Severe anxiety usually requires medication. Mild to moderate anxiety can be treated with nonpharmacological means.
Behavioral Therapy
Obsessive compulsive disorder, or OCD, is one type of anxiety disorder that is best treated by behavioral therapy. This type of therapy works by exposing the patient to an unpleasant stimulus that he usually tries to avoid, for example dirt. The anxiety level will initially increase, but with continued exposure, it will diminish significantly. This therapy is difficult for patients since it exposes them to precisely the thing they try so hard to avoid.
Psychodynamic Psychotherapy
This type of therapy is based on the model of anxiety as a symptom, of either an unconscious problem or a real life stressor. Psychodynamic therapy is open-ended talk therapy that can last several years, with one to two meetings a week. Over the course of time, the causes for anxiety are brought to light. Knowing and understanding are in themselves helpful in decreasing the level of anxiety. The main long-term benefit is an increased ability to tolerate anxiety. The goal is not to eliminate anxiety, but to decrease it and learn to cope with it better.
Hypnotherapy
Hypnosis is a useful therapy for specific phobias, for example fear of flying or performance anxiety. The hypnotist helps the patient enter a state of deep relaxation. While in this state, the patient is given hypnotic suggestions. For example, a person with fear of flying will be guided in their imagination through the whole sequence of boarding the plane, take off, flying and landing. The therapist helps the patient relax through all this. The goal is to carry over this state of relaxation to the actual flight.
Relaxation
Relaxation is a technique that overlaps to some degree with hypnosis. It is often done initially with a therapist and then continued by the patient on his own. The patient learns to relax the entire body while imagining pleasant things. Relaxation is beneficial for chronic and acute anxiety. It can be used in the hospital setting to help patients cope with their medical illness.
Biofeedback
Biofeedback uses an external machine to give feedback about the body's state of arousal, a state that reflects the degree of anxiety the person is experiencing. For example, a thermometer is attached to a finger. As the patient relaxes, the temperature of the extremities increases and the thermometer will show the temperature rising. Focusing on an external parameter helps overcome the difficulty many have to simply relax.
References
- "Psychodynamic Psychiatry"; Glen Gabbard; 2000
- "Kaplan and Sadock's Comprehensive Textbook of Psychiatry"; Virginia Sadock and Ruiz Pedro; 2009
