- Positives: We know more about anxiety-based disorders than any other disorders
- Science gives explanations, evidence, authority, destigmatizes difficulties
- Concerns: It can be difficult to explain, answer questions
- Clients may feel a lack of responsibility
- Oversimplification is inevitable
- Don’t neglect the therapeutic relationship!
- Address the challenges of anxious clients
- Remember that strategies are effortful
- Guide the process using client’s goals
- Maintain motivation
- Define Neuroplasticity in everyday language
- Therapy is about creating a new self
- ”Rewiring” as an accessible concept for change
- Re-consolidation: the modification of emotional memories
- Amygdala – bottom-up triggering of emotion, physicality of anxiety
- Cortex – top-down emotion generation based in cognition
- Explain the two pathways to clients
- How anxiety is initiated in each pathway and how pathways influence each other
- Use illustrations to create concrete understanding
- Fight/flight/freeze responses
- The “language of the amygdala”
- Anxiety and the cortex
- Help clients recognize the two pathways to anxiety
- Sleep and the amygdala
- The influence of exercise
- Breathing techniques to reduce activation
- Relaxation, meditation, and yoga to modify responses
- Exposure as opportunities for the amygdala to learn
- Combatting avoidance
- When anxiety indicates that the amygdala can learn new responses
- Push through anxiety to change the amygdala
- ”Survival of the busiest” principle – strengthen or weaken specific circuitry
- The healthy (adaptive) use of worry in the cortex
- ”You can’t erase: You must replace.”
- Recognize and modify the impact of uncertainty
- Training correct uses of distraction
- Left hemisphere techniques – cognitive defusion, coping thoughts, fighting anticipation
- Right hemisphere techniques – imagery, music
- Mindfulness and anxiety resistances
- Medication’s effects in the rewiring process
- The myth of the chemical imbalance
- The danger of sedating the brain with benzodiazepines
- Promoting neuroplasticity with SSRIs, SNRIs
- The effectiveness of CBT and meds
- Anxiety is a component of many diagnoses (depression, substance abuse, etc.)
- Amygdala- and cortex-based techniques help in other disorders
- Targeting brain-based symptoms rather than disorders
- Worry, obsessions, rumination respond to similar cortex-based techniques
- Panic, phobic responses, and compulsions respond to amygdala-based techniques
- Empirical versus clinical and anecdotal evidence
- Clinical considerations for specific clients and settings
- Efficacy of particular interventions may vary