According to the National Institute of Mental Health, at any one time some 40 million people will suffer with an anxiety disorder that will last at least 6 months and worsen without treatment. Unfortunately people with the most prevalent mental disorders, such as anxiety, are among the least likely to seek treatment yet anxiety is a highly treatable condition and there is an increasing recognition of when and how to introduce the most appropriate therapies. Treatment for anxiety disorders have traditionally fallen into two main approaches – medication and psychological treatments.
The National Institute for Clinical Excellence (NICE) have produced clinical guidelines and research on the treatment of anxiety demonstrating that medication shouldn’t be the fist line of defence; instead they state that psychological therapy should be utilised first as it has the most evidence for the ‘longest duration of effect’. These so called ‘talking’ therapies aim to help people understand more about how their problems are affecting them and manage their thoughts, moods and behaviours more effectively. Amongst the most widely recognised and accepted therapies are Cognitive Behavioural Therapy (CBT), Hypnotherapy and Neuro Linguistic Programming (NLP).
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) is an empirical, action orientated approach. First developed in the 1950s by American Doctor Aaron T. Beck, it has become a major psycho-therapeutic alternative to medication. Beck identified a ‘Cognitive Problem Triad’- people’s negative view of themselves, the world and the future. The principles of CBT aim to encourage people to become more aware of the pattern of their thinking and their lives in general by monitoring their daily activities. The theme of taking action is all pervasive in CBT. It makes people focus on not only what they are doing that maintains their anxiety but what they are not doing to allow improvement. Approximately 80% of people with anxiety disorders respond to a short intense course of treatment and it has been suggested that most improvement in CBT occurs during the first 8 treatment sessions. Whilst not exactly a ‘quick fix’ this relatively brief treatment period is particularly useful when treating anxiety which is getting in the way of a sufferer’s general day to day functioning. In fact, there is evidence to suggest that CBT is an effective replacement strategy for those who wish to discontinue their medication or for those whose condition has not responded to medication. A review published in the Journal of Consulting and Clinical Psychology comparing CBT with medication treatment concluded that
CBT demonstrated an 87% improvement rate with only a 10% relapse rate compared with anti-anxiety medication’s 60% improvement rate and 90% relapse rate.
One minor drawback of CBT for some is that participants have to be self motivated and determined otherwise the set exercises and
‘homework’ could be seen as too much an effort. Patients definitely can’t be passive recipients of the treatment.
Hypnotherapy has its roots in ancient practices and there have been many schools of thoughts over the centuries; James Braid has been called the founder of hypnotherapy as we know it, and maybe the most influential post war hypnotherapist is Milton Erickson. It is basically the induction of an extremely relaxed state in which the participant is more susceptible to suggestion in which behavioural changes can be more easily affected. It focuses on the unconscious part of the mind using the power of suggestion; stories and/or metaphor to ensure new habits become engrained fully in the mind.
A recent review found compelling evidence that hypnosis is an efficacious treatment for anxiety.
The American Psychological Association note that there are plenty of scientific examples of the usefulness of clinical hypnosis and draw attention to one study where 75 % of the female participants reported significant relief from their symptoms, more than 80 % of whom were still symptom free in a follow up 6 years later. It is this sort of empirical evidence that is encouraging a growing number of people to try using Hypnotherapy to overcome anxiety. Cognitive hypnotherapy, that is hypnotherapy combined with CBT, is reported to be one of the most effective treatments, needing just 2 or 3 sessions to lay the foundation for change, and it should take only 1 session for a person to feel relaxed. One criticism is that its success depends on a person’s hypnotic suggestibility and some people simply cannot be hypnotized. It cannot make you do something you do not want to do, you have to want it to work and you have to participate with your full attention.
Neuro Linguistic Programming
Neuro Linguistic Programming (NLP) can be quite difficult to define. Developed in the early 1970s by Richard Bandler and John Grinder its main focus is on understanding how verbal and non verbal communication affects our brain. Its aim is to change the relationship between how people think and communicate and how they behave. In the case of anxiety the aim of NLP is to offer tools to reverse the cognitive distortions of anxiety and teach techniques to prevent the unconscious mind from creating phobic responses.
One of its most popular applications is in the treatment of panic attacks and phobias associated with anxiety.
One recent study of hospital patients who received NLP treatment to help with claustrophobia caused by MRI scanning found that over 75% of the patients were subsequently able to cope with the MRI procedure without claustrophobia. Many hypnotherapists use NLP style techniques to enhance the effectiveness of their treatment and it may work best in combination with other therapies. NLP has its supporters but while there is plenty of anecdotal evidence in its favour, there unfortunately seems to be scarce hard scientific evidence to back up its claims. Supporters of NLP argue that this is because most of the research into NLP was done in the early 1980s and 1990s based on gross oversimplification of one of its concepts, with very little research done in more recent decades in light of new research on psychological processes and interventions.
Which Therapy is most effective for Anxiety?
Analysis and psychoanalytical psychotherapy treatment can be expensive and labour intensive whereas therapies such as CBT, hypnotherapy and NLP are goal orientated, brief and focused, aiming to offer rapid and drug free anxiety intervention. All 3 encourage people to be vigilant about the way they think. Depending on the type and severity of the anxiety a well chosen combination of the principles of CBT, NLP and hypnotherapy will probably provide the most effective results. They are not one size fits all and success is dependent on a level of commitment and involvement on the part of the person seeking treatment. Most evidence seems to be in favour of CBT but that could probably be due to the fact that it is also the most researched. The therapist’s skill is vitally important in the success of the therapies and a good therapist will listen to their clients, assess their needs and adjust their treatment accordingly. They may use multi-modal treatment depending on whether their approach has a cognitive, behavioural, interpersonal or emotional focus. At the Therapy Lounge hypnotherapy is used to overcome anxiety, NLP and the principles of CBT are used in conjunction according to the needs of their clients. To overcome anxiety it has to be confronted and all 3 therapies test and challenge the reality of negative thoughts or beliefs and aim to show people not that they are being irrational but that they have become trapped in unhelpful ways of trying to stay ‘safe’. They all offer different practical techniques to help overcome anxiety and finding the right combination of treatment could mean anxiety is permanently dealt with.
This guest post was specially written for our blog by the experts from thetherapylounge.com
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