Cognitive behavioral therapy with mindfulness to treat anxiety

Anxiety is one of the main reasons people seek psychological help. Whether in the form of phobias, generalized anxiety, obsessions, panic attacks, stress anxiety, etc.

During my consultation in Las Palmas de Gran Canaria, I deal with people with anxiety disorders on a daily basis. It is a great effort that I make with my patients to keep anxiety from continuing to control their lives. And the effort is rewarded, because a very high percentage of them manage to achieve the well-being that they desperately needed. What can be done in therapy in these cases? Let’s see.

    What is the usual treatment for anxiety?

    Pathological anxiety has two main symptoms which are hot spots for treatment. One of them is worries or anxious thoughts. The other is overactivation (nervousness, tension, tachycardia, etc.) that accompanies the cognitive component.

    Traditional cognitive behavioral therapy focuses its treatment on these two components as follows:

    For physiological overactivation

    Relaxation techniques are used, Such as controlled breathing or progressive muscle relaxation. Exposure exercises are also performed, where possible, in situations that cause anxiety.

    As they approach anxious stimuli, they get used to them, reducing the feeling of nervousness.


    As for concerns, verbal cognitive restructuring and behavioral experiences they have shown great efficiency.

    With the help of restructuring, concerns begin to be recognized and identified. On the other hand, there is debate about intolerance of uncertainty and the need to cope with the feeling of not being able to control certain aspects of life. The usefulness of the concerns is also reassessed and the beliefs underlying them are worked on.

    Finally, behavioral experiments are created to expose the person to the results of the predictions of their concerns. Thanks to these experiences patient beliefs are denied, Which generally predict much worse results than what happens in the end.

    The usefulness of mindfulness

    Cognitive behavioral therapy for anxiety, in each of its manifestations, has been shown to be scientifically effective in a multitude of studies. Then … Why include mindfulness in treatment?

    The difficulty of controlling thoughts

    It is well known that trying to control or change thoughts is a difficult task. Sometimes we don’t remember something we want and at other times anxious thoughts come to our mind uncontrollably. In fact, the more we try to remember, the more we get stuck. I the more we try to forget, the more our thoughts are present.

    It is estimated that we have around 4000 thoughts during our waking state, which last only a few seconds and rarely have to do with the task at hand. These are automatic thoughts of all kinds, some neutral, some pleasant, most absurd, and some unpleasant.

    People with anxiety problems they tend to cling to unpleasant thoughts and recreate them over and over again, With an unpleasant mood.

      An alternative solution

      Many of the automatic thoughts that cause us anxiety, as well as some of the beliefs that govern our lives, can be reassessed and restructured. These changes occur thanks to the rationalization of certain thoughts and mental patterns results in an improvement in the quality of life and people’s well-being.

      But there are times when thoughts or beliefs cannot be changed, or it could lead to greater discomfort than the present. It was then that I discovered the extraordinary usefulness of third generation therapies.

      Acceptance and Commitment Therapy (ACT)

      ACT belongs to the latest generation of cognitive behavioral therapies and emphasizes the need to let go of control over internal events and accept experiences as they come. One of the most serious problems we suffer from is what is known as “experiential avoidance”. We insist on avoiding feeling or thinking unpleasant things and try to control them as we do with external events.

      If we want to stop watching tele5, just change the channel. If we want to stop thinking that our child will be in an accident when they go out to party in the car, and not worry about it, it’s more complicated.

      The result of avoiding all those emotions, thoughts and physical sensations that are unpleasant to us is to stop living and devote ourselves body and soul to fighting our “problem”. The effort in acceptance and commitment therapy is put into recovery or find a life full of meaning, based on individual values.

      For the management of intrusive thoughts, ACT has developed a technique called cognitive diffusion. One of the objectives of this technique is to show that thoughts are just that, thoughts or memories, and that they should not be confused with their referents (real events that cause fear or anxiety ).

      Cognitive diffusion is achieved when the patient achieves a more objective attitude and he moves away from his own thoughts, Thus decreasing the credibility and affection towards them, with a consequent improvement in mood.

      What does mindfulness bring?

      Certainly, we all already have a formed idea of ​​what mindfulness is. Its rise in recent years has led it to become part of mass culture. Everywhere there are classes, initiations and mindfulness therapists. It applies to almost everything and in any way, coming to sell itself as a comprehensive solution to any problem. But you have to be rigorous and careful, because the practice of any therapeutic technique must be supervised by professionals.

      Mindfulness is understood in mindfulness, and although there is no precise definition of the term, several researchers claim that it is an experience characterized by attention to the present moment, without judgment and with acceptance.

      Mindfulness seeks to connect with the here and now, simply by paying attention and being aware of what we are feeling, thinking and doing in the present moment. The mind is constantly wandering on uncertain paths to the future, which causes us anxiety, or the sunk moments of the past, which make us feel melancholy. This constant temporary oscillation of our mind causes us to let go of the only thing real to us, which is our ability to act in the present moment.

      Mindfulness in anxiety disorders

      This tool has proven to be a powerful ally of cognitive behavioral therapy for anxiety disorders, as it addresses aspects hitherto neglected.

      Physiological, emotional, cognitive and behavioral symptoms are linked to clinical anxiety., All surrounded by the situation of each person. Many times the problem of the anxious person is compounded precisely to avoid unpleasant experiences.

      Judging our thoughts, emotions or physical reactions as unpleasant and merging with these internal events, wanting to control them and avoid them at all costs, are the elements that keep anxiety disorders away.

      These anxiety symptoms are based on 3 cognitive biases of people with this problem:

      selective attention

      People who suffer from anxiety they focus their attention on potentially threatening stimuli, Losing additional important information around you that has nothing to do with your anxiety.

      bias interpretation

      It is also common for these people to interpret neutral or mildly threatening stimuli as catastrophic.

      Thinking towards the future

      In order to avoid the woes predicted by the cognitive biases described above, people with anxiety they spend most of their time living in “what could happen”, Instead of living here and now.

      The usefulness of mindfulness

      With the help of mindfulness we teach patients to refocus their care on site gift. Let them notice that they are focusing their attention on future thoughts, as much as they notice, bringing their attention back to current experiences.

      By applying mindfulness in the treatment of clinical anxiety, we may also be successful in working on behavioral or experiential avoidance, cognitive rigidity, and the limited repertoire of patient behavioral responses.

      The first thing to do is to expand awareness of the present moment and the present experiences. It causes a change of attitude towards life, Decrease the tendency to judge and control internal events.

      Practicing mindfulness helps us achieve the natural dissolution of our thoughts and emotions, leaving no “waste” or “footprints” in our mind. We see how these internal events appear before our observing consciousness, develop and disappear again.

      Updating is the key

      Psychology is a young science, along with evidence-based psychological treatments, and is constantly being updated. The latest therapeutic advances must be included in the daily work of psychologists to be able to offer the best service to patients.

      The union of cognitive behavioral therapy with the latest updates in contextual therapies, which also have proven scientific evidence, such as mindfulness and acceptance and engagement therapy, is a combination that increases the chances of success in therapy.

      The Serenity Prayer says, “… grant me the serenity to accept the things I cannot change, the courage to change the things I can change, and the wisdom to know the difference.”

      A professional psychologist, engaged in his work, can help you identify and change all possible thoughts and emotions, and know those that cannot be changed. Once you have identified the areas of your life that cannot be changed, it will help you accept them and focus on the present. On the other hand, he will work with you to improve your abilities, guide your life according to your values ​​and help you achieve the well-being that you dream of.

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