Cognitive Behavioral Therapy: Best non-med treatment for anxiety and stress problems

I’m not sure when anxiety started for me or even why? But I remember being socially anxious as early as middle school and I had my first panic attack when I was in high school. My parents took me to the local emergency room during my first panic attack because I thought I was having a heart attack and was going to die. Once we got there they ran a bunch of tests before telling me it was “just” a panic attack. They basically gave me some xanax and sent me home.

The next day I had an appointment with my regular doctor and he wrote me a prescription for xanax and told me to take one whenever I felt an attack coming on and I would be fine. They worked so well at eliminating my anxiety that sometimes I would fall asleep soon after taking one. Over time I began taking them more and more often and the time between attacks began to become less and less to where I was having them nearly everyday and my life was coming to a screeching halt. My grades started to drop and my social life was becoming a memory, so my parents convinced me to see a psychiatrist.

The psychiatrist was a nice woman who told me along with my anxiety I had become severely depressed and she wanted me to reduce my intake of xanax and go on some anti-depressants. It took awhile to find an anti-depressant that I both tolerated and that worked well for me. After several month of trial and error we found that Zoloft worked the best for me. I made great progress for the next two and a half years before my anxieties (and later panic attacks) came back. She changed me from med to med with little success and I eventually left her and went to other doctors for help.

I tried everything that was recommended from therapy to yoga to hypnosis to Tai Chi to various relaxation exercises as well as strenuous exercise, all while still on a cocktail of meds. Many of these things were somewhat helpful, but none was able to get me out of my new funk or eliminate the awful panic attacks that had returned. I literally had to muddle through the next couple of years of my life as best I could on meds.

Then in 2006 I heard about CBT (Cognitive Behavioral Therapy) and joined a group. Prior to the first meeting they had us purchase a CBT book called Been There, Done That? DO THIS! By Sam Obitz. The book was written by a guy who had suffered for over a decade before getting better using CBT and it was supposed to give us confidence. As I started reading the book I didn’t relate to it because the author came from a troubled childhood and mine was anything but that, because I had a close family. But as I continued reading I started seeing myself in it and my confidence began to grow. Once I got to the sections on thinking errors that cause most anxiety and the TEA Form exercise, I could have written several of the examples he used from my own life experience.

How does CBT work?

CBT is based on finding the main thinking errors you habitually make (often without even being aware you are making them) and then correcting with them more realistic and objective thoughts. There are ten thinking errors that commonly cause most of the anxiety that we feel and once you begin to change the way you think about events in your life your anxiety will begin to subside. The main exercise used to accomplish this is a simple exercise called the TEA Form which stands for Thought-Error-Analysis. You just need a piece of paper and a pencil to do them. There is a column for each letter (T-E-A) and under the T you write the thought that is causing you to be upset or anxious. Then under the E you write down one or more of the common thinking errors that are in that thought. Then in the A column you analyze what was inaccurate in the thought under T and write a new more objective thought to replace the original thought. Once you begin to do this daily you will eventually start to think this way naturally and begin to notice your anxiety is fading away.

As simple as this all sounds it is unnatural at first. I struggled in my early attempts at filling in the A column and I did not start to feel comfortable doing this exercise until I was about six weeks into my group. However, once I got over that hump they became easier to do and my progress began to accelerate. The big difference I noticed in CBT versus traditional therapy was that instead of relying so heavily on the therapist, in CBT they teach you to help yourself. If you don’t do the TEA forms and other exercises they recommend between the sessions you don’t make much progress, but if you stick with it you develop new habits that pay off for you in your daily life.

I have not had a panic attack since my group ended at the end of July in 2006 and I have been completely med-free for well over two years. I still start most of my days spending a few minutes countering the thoughts that I wake up with in my head in a TEA form. The new thinking habits are becoming more and more ingrained and natural to me. At the end of my group my therapist told all of us not to thank her, but to thank ourselves because we did all the hard work. She also said that if we embrace the TEA form and make it part of our daily routine, we would never have to see her again professionally. So far that has been true for me.

I recommend CBT and the TEA forms to people all the time and have seen them help all sorts of people over the past few years. I truly believe that anyone who is self-motivated and willing to put some effort into helping themselves will find a large measure of success using CBT.