The Layers of Healing Anxiety
CBT… DBT… somatic therapy… exposure therapy…
There are so many therapeutic approaches discussed to address anxiety. It can feel overwhelming to hear all these acronyms and wonder where to start in addressing the overthinking mind.
In my work as a therapist, I believe knowing how to address anxiety isn’t about picking which one, specific therapeutic orientation is the best, but instead it’s seeing all of these approaches as important layers to healing anxiety.
Heres a quick view of how we can meet anxiety through several lenses:
CBT (Cognitive Behavioral Therapy): Thoughts are not facts; can we acknowledge all the ways that our anxious thoughts can be inaccurate projections of what might happen due to our mind’s desire to over-protect us.
“What are all the ways I can remind myself that this outcome may not be likely to happen”
ACT (Acceptance and Commitment Therapy): Much of anxiety is an overestimation of threat, and an underestimation of our ability to cope with perceived outcomes. Our resistance to a situation we are fearing, or resistance to the emotions we are having, is what converts fear to chronic anxiety. Thus, when we radically accept that we can cope with this worst case scenario, it lessens the anxiety loop in our mind.
“How can I acknowledge the ways that even if this worst case scenario happened, I would be able to cope; what are all the ways I would still be okay”
Somatic Therapy/Nervous System: Though anxious thoughts are often the first things we notice, the “buttom-up” (vs “top-down”) theory of anxiety reminds us that anxiety often truly starts as a misguided sense of internal alarm that our bodies learned in reaction to trauma or chronic stress. The alarm goes off deeper in the nervous system, physiologically, though we have often learned to ignore it. Then, our minds scan around for what things it can latch onto to be anxious about (work or school performance, social standing, the future, etc).
“When I notice anxiety, what tools can I use to cue safety and ease to the body first, noticing my anxious thoughts as a place where my brain is trying to work out an older feeling”
Trauma-Informed Approaches: For many, anxiety is a learned response that our system automatically chose as a form of protection during a time we needed it to feel safe. By identifying past experiences that contributed to a tendency to be anxious, we remind ourselves that the anxiety may have less to do with the current situation at hand, and more to do with a learned coping behavior. When anxious, we can then honor this new insight, soothe ourselves on a more compassionate level, and use tools like EMDR to update our sense of safety.
“When along the way did my system sense I might have needed overthinking to attempt to keep me safe”.
This write up doesn’t begin to capture all the many layers we can explore in healing anxiety. However my hope is that it can be a reminder of the way these approaches can all hold some place in our healing.