Does anxiety stop you living the life you want?

Anxiety can be an issue in many areas of daily life, interfering with daily activities such as work, relationships and education. Anxiety has become a prevalent mental health issue in society today, affecting people of all ages, genders, and backgrounds. According to the World Health Organization (WHO), an estimated 264 million people worldwide suffer from anxiety disorders, making it one of the most prevalent mental health disorders globally.


Anxiety has become such a major issue that even the government is at a loss about how to handle it. Their solution is to try to force people suffering from anxiety back into work by reducing benefits and making it more difficult to get sick notes. Attacking a very sensitive issue with a sledgehammer could make the situation even more challenging for this increasing societal issue, leaving people experiencing anxiety increasingly desperate for help.

So what can you do about it?

There are many therapeutic approaches to working with anxiety. Cognitive behavioural therapy (CBT) has become one of the most popular approaches over the last couple of decades. This is largely because research suggests it can offer rapid results, which makes it more affordable than longer-term therapies.

The principle of CBT states that our thoughts, feelings, and behaviours are interconnected. For example, a feeling of anxiety might be preceded by a thought such as ‘I’m going to be rejected’. This thought and feeling, in turn, influence behaviour. This could involve avoiding situations or engaging in ‘safety behaviours’ that we believe could stop our worst fears from coming true. The behaviours and feelings can reinforce the negative thought and the complete cycle becomes intensified.

Traditionally, CBT therapists would help their clients become aware of ‘cognitive distortions’. For example, ‘I will never get a job’ would be an example of ‘fortunetelling’, or ‘nobody likes me’ would be ‘overgeneralising’ or ‘mind reading’. Once the cognitive distortions are identified, the therapist would then help the client learn how to think in a more helpful or balanced way.

CBT may also involve behavioural experiments, where clients engage in activities to ‘test’ the validity of biased thinking, or exposure where clients learn to engage with activities that had triggered the anxiety and fear.

Although Cognitive behavioural therapy can be effective for many people, I frequently hear therapists’ frustration that clients often only seem to experience short-term benefits from CBT and the anxiety often returns.

The approach of integrative counselling and psychotherapy is to tailor therapy according to the individual client’s issue and circumstances. Rather than focusing on one modality, such as CBT, counsellors and psychotherapists trained integratively learn to draw upon distinct elements from a range of therapeutic modalities.

People have very different lives and experiences. Their experience of anxiety will also be unique. The approach of treating a ‘diagnosis’ such as anxiety with a specific ‘protocol’ such as CBT may not consider the individual processes influencing the experience of anxiety.

Integrative practitioners should explore in more depth the individual experience of anxiety and the processes that create and maintain it. This can help lead to long-term success for clients in achieving their outcomes.

Acceptance and commitment therapy (ACT) is one approach that is increasing in popularity and effectiveness for helping clients experiencing anxiety. Although many categorise ACT as ‘3rd wave’ CBT, it takes a completely different approach. ACT allows for the integration of different ways of working, so integrative counsellors can draw on their existing knowledge and experience.

Rather than look at challenging thoughts, ACT explores how to develop different ways of relating to thoughts and feelings. Challenging your thoughts can become a constant struggle because we unfortunately cannot ‘delete’ thoughts. The goal of ACT is to help clients increase their psychological flexibility and live more meaningful lives. Our mind’s instinct is to avoid the source of our anxieties and fears, however often those sources of pain are areas we care about deeply.

An ACT therapist will help clients learn how to relate differently to their thoughts and feelings, so rather than anxiety ruling their lives, they can engage in what really matters to them.

To conclude, an integrative therapeutic way of working with clients, focusing on the processes involved in anxiety and tailoring the approach according to the client, may offer greater hope for people suffering from this challenging mental health condition.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Enfield EN1 & London N14
Written by Tom MacKay, MSc, ADHP(NC), Dip EHP(NLP), UKCP
Enfield EN1 & London N14

I am a dedicated therapist working with individuals presenting a diverse range of issues. My approach is integrative to help find the best way of working with the person.

I have been working as a psychotherapist for almost 20 years, and am a senior lecturer in Counselling and Coaching on the MSc/PGDip course at the University of East London.

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