Cognitive Behavior Therapy (CBT) & Anxiety: Part 3 of 4

anxiety disorder and therapy

I disliked the thought of anti-anxiety medications, so instead my therapist introduced me to Cognitive Behavioral Therapy (CBT).

CBT is not your stereotypical lie-on-the-couch therapy.  It is extremely intense and very hands-on. My therapist and I discussed how anxiety affected my life, and we worked on the tools to help me change the way I thought about my anxiety disorder.  We set a goal for my CBT therapy:  I was supposed to change my “negative thoughts into positive thoughts” by the time I graduated college.

I have to admit, CBT was very hard for me at the beginning.  I had to completely erase my recurring thought of having a panic attack in public or getting sick in public.  I had lived with my disorder for a couple of years before I started therapy, so I was accustomed to thinking a certain way.  For example, if I started to feel sick at a party, I automatically thought I was going to get sick (i.e. vomit, diarrhea.)  During the first year of therapy, my therapist and I had a recurring conversation:

Me:  I’m going to get sick in public.

Therapist:  Has that ever happened before?


So realistically, even if you feel sick, you probably won’t get sick.

I don’t want to get sick in public.

What will happen if you get sick in public?

I will have to find a bathroom.

So if you get sick in public, you will find a bathroom until you feel better.

My therapist had to constantly remind me that if I get sick in public, it wasn’t a big deal.  Everyone gets sick.  One of the best pieces of advice that still sticks with me 15 years later is that even if I get sick in public, it’s not as though I was ever going to see those people again.  Somehow, that thought always made me feel better.  My family physician encouraged me to carry Xanax with me in case of panic attacks but my therapist, aware of my aversion to medication, taught me the CBT breathing technique.

The CBT breathing technique concentrates on breathing through a panic attack.  My therapist encouraged me to go out in public and try the technique, but I kept making excuses as to why I couldn’t go out.  She finally gave me an ultimatum: go out and try the breathing technique or I had to find another therapist.  Obviously, I chose to go out.

It wasn’t easy.  The first time I went out, had a panic attack and didn’t leave, I felt like a new woman.

I decided to go to the mall with my roommate for a casual shopping trip however, I didn’t drive.  That was a huge deal for me because I felt like my car was my escape.  As long as I was in control of the method of transportation, I never really felt panic.  I can’t even explain how that makes sense, but it worked for me.  On this occasion, however, I let my roommate drive.  Sure enough, as soon as we pulled into the mall parking lot, I felt the beginnings of a panic attack.  It was time to use the techniques I learned from my therapist.

I was having a panic attack and it was okay. I focused solely on breathing through the panic attack.  I counted each breath.  Once the panic episode was over, I felt as though I had conquered the world.  I faced my worst fear and I didn’t leave.  From that point on, I began to feel my confidence coming back.

By the time I graduated, I realized:

I was going to have to accept my anxiety disorder for the rest of my life – and it was okay.

There were going to be ups and downs.  I was going to have panic attacks again but at least I had the tools to work through them.  CBT might not work for everyone but my advice is to try it at least once.