Cognitive behavioral therapy for anxiety and PTSD

Cognitive behavioral therapy is vastly underutilized is mental health care treatment and I want to discuss what it is used for and how cognitive behavioral therapy works.  Cognitive behavioral therapy was the product of mastermind psychologist Dr. Aaron Beck and today is first line treatment for all anxiety disorders, OCD, PTSD and even insomnia.  So what is cognitive behavioral therapy and why should we use it?

“The way we think dictates the way we feel-thus changing the way we think can change the way we feel.” is the premise that describes what cognitive behavioral therapy is all about. Unfortunately many therapists are not trained in cognitive behavioral therapy and thus do not offer it to patients. Instead the majority of  therapists are providing whats known as “supportive” therapy which is usually nothing more than being available for a patient to sit and talk to, with no real goal, structure or premise. Another great evidenced based type of therapy is psychodynamic therapy which serves a different, although often overlapping purpose to cognitive therapy, however most practitioners do not practice this either.  Cognitive behavioral therapy is a first-line, evidenced based treatment for all anxiety disorders, panic, OCD, PTSD and insomnia. In addition it is effective for depression and grief either alone or in conjunction with psychodynamic therapy.

Before choosing a therapist, its important to decide which type of therapy you ultimately want. Not all  therapists are equal unfortunately and it is not that one person is better necessarily, but rather some types of therapies are significantly more effective, more evidenced based and ultimately more appropriate for some patients; cognitive behavioral therapy is one of these.  The best Phoenix therapists will offer a broad range of evidence based treatments and will refer you to another provider if they do not offer cognitive therapy and that is what is best for you.

Ultimately cognitive behavioral therapy typically lasts 10-20 sessions of 1 hour, on a weekly basis. Therapists who do  cognitive behavioral therapy will guide you through your thought patterns, challenge maladaptive , negative and “automatic” thoughts which are all the source of anxiety and depression in many people.  The goal in cognitive behavioral therapy is to accept and embrace your anxiety or panic, rather than avoid it.  Most therapists teach avoidance or comfort techniques such as deep relaxation skills etc when in reality this is the worst thing you can do for actually treating an anxiety disorder.Phoenix therapists doing proper cognitive behavioral therapy will walk you through a series of anxiety-provoking thoughts and events, discuss your irrational thoughts such as anxiety is harmful, you are having a heart attack, anxiety is dangerous etc and confront those thoughts in a structured matter. Over time you learn to recognize these maladaptive thoughts and learn they are irrational and thus you learn than anxiety itself is simply an irrational symptoms of irrational thinking. correct the thinking and the anxiety disappears. Same goes for depression. Over 80 percent of people show a good sustained response to cognitive behavioral therapy vs other non-evidence based therapies like supportive/talk therapy which shows no difference from placebo in studies.

Many therapists are also using EMDR instead of cognitive behavioral therapy which is not appropriate given the much higher level of evidence and effectiveness of cognitive behavioral therapy over EMDR. EMDR is a good addition but not replacement for cognitive behavioral therapy. So bottom line is if you are struggling with any anxiety, panic, PTSD or OCD and you have tried several therapists or are currently seeing a therapist and are not getting strict cognitive behavioral therapists you need to seek out a new therapist who can utilize this effective technique.

As one of the only  therapists who is a psychiatrist as well, I am able to prescribe medications in addition to treating patients with evidenced based cognitive behavioral therapy which maximizes their response to treatment. I utilize this with all my patients struggling with agoraphobia, panic, anxiety, OCD and PTSD with great success and I encourage anyone struggling with these disorders to seek out an experience cognitive behavioral therapy expert.

Please don’t hesitate to email or contact me with questions

Michael Yasinski MD