Anxiety treatment; from guided relaxation to talking therapies and CBT

man meditating in front of cartoon brain
Dr Elaine Ryan
Written by Dr Elaine Ryan Psychologist and Founder of MoodSmith® Elaine obtained her Dr in Psychology from the University of Surrey and has worked in psychology for 20 years. Dr Ryan specialises in Intrusive Thoughts, OCD and anxiety-related conditions.

If you have just been diagnosed with anxiety, this page is to help you choose what anxiety treatment will work best for you.  If you have read my main page on anxiety, you will know that different experiences of anxiety need different types of treatment, and I am going to talk to you about that now.

In the video above, you can see 2 main ways that anxiety can be created, and I shall discuss treatment for both amygdala-based anxiety and anxiety that occurs more through your thought processes.

Amydgala based treatment for anxiety

Quick explanation: where you get anxious for seemingly no reason or in the same situations.

If you are currently working your way through my course, you will have come across a section that explains how your brain can learn to be anxious. This is mostly due to amygdala based anxiety. This means that your amygdala has learnt to deliver a stress response in situations where you get anxious, and you need to teach your brain that there is no need for a stress response; you are not in any danger.

If you have not come across the amygdala before, for now, you can think of it like a fire alarm that sets off anxiety when your brain thinks that you are in danger.

Treatment need for this type of anxiety includes

  • Relaxation
  • Meditation
  • Exposure

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Exposure Based Treatment

Rationale for exposure based anxiety treatment

If you are getting anxious in certain situations, you can think of this as your brain has developed a path where the situation triggers an alarm bell to ring to give you anxiety.

anxiety treatment

The situation could be anything from speaking up in public or getting anxious when the focus of attention is on getting anxious in the same places, such as shopping or driving, anywhere you repeatedly feel anxious.

The exposure-based treatment allows you to correct this pathway and create new learning, where your brain no longer identifies these situations as being worthy of anxiety.

Why exposure based treatment is important

It creates new learning in your brain, which not only has an impact on how you feel but also on what you do; your behaviours.

Let’s take an example of someone getting anxious giving presentations at work. If you get anxious every time you have to do this (or something similar), your amygdala is ringing an alarm bell to create anxiety.

I am guessing that you are affected emotionally, but you might have noticed that you have changed your behaviours. You might avoid meetings or any situations where you feel you will be the focus of attention or might be judged in some way. At least 3 things are going on here.

  • The automatic anxiety; coming from your amygdala
  • Avoidance of situations that might trigger your anxiety, and
  • The fear of being judged, or any other thought processes that are not nice for you. I will talk about this later as this falls under a more conscious form of anxiety, which requires CBT.

To get over this, you need exposure-based treatment to give your brain a chance to learn that these situations are not threatening for you.

Anything that you repeatedly do is like practice and helps your brain to learn. At the moment, the things you are doing could be keeping your anxiety going, for example.

  • Repeatedly getting anxiety in the same situations
  • Repeatedly avoiding those situations
  • Repeatedly worrying about them before they happen

You want to create a new learning where

You can be in the situation and remain calm, thereby not needing to avoid them or worry about them.

How this is achieved

Repeat exposing yourself to the things that make you anxious (as opposed to avoiding them) and practising remaining relaxed or at least not running away from them.

I’ve noticed over the years that when I mention exposure-based treatment, some people understandably do not like the sound of this but hear me out.

You may not like the idea at present as it provokes an anxious response from you, but when you start with relaxation training or meditation, it starts to become easier as you learn the skill to relax your body and quiet your mind.

This is why exposure-based treatment should also be combined with some form of relaxation training.

Relaxation as an anxiety treatment

On my main anxiety page, you will have read that the anxiety you feel comes from the activation of your sympathetic nervous system.

For example, continuing with the giving a presentation example above. When you walk into the room, and your heart is pounding, your face is beetroot, and your mouth is so dry that you can hardly speak, this is your sympathetic nervous system preparing you for danger.

This all occurs outside of your control; it is an automatic response, but you can learn to tame it by activating your parasympathetic nervous system, which will help you to relax.

This is why relaxation is important in combination with exposure treatment, as you can voluntarily calm your body in the situations which previously gave you anxiety.

Types of relaxation for anxiety treatment

Guided relaxation

Progressive Muscle Relaxation

Often with anxiety, your muscles can become tense, and you are no longer aware of this. If you are getting anxious, this is your sympathetic nervous system preparing you for danger. Your muscles are prepared for fight or flight.

The problem with anxiety though, is that this can result in tight, painful muscles.

Progressive muscle relaxation encourages you to relax all of your muscle groups from your head to your toes.

It is also to encourage activation of your built-in relaxation response, the parasympathetic nervous system.

You can do this independently, or you can use guided muscle relaxation, like the Mp3’s in my course.

Relaxation using your breath

Using your breath as an anxiety treatment is often overlooked by people because they think it is too simplistic. But you are missing a gem.

As I mentioned before, you cannot control the automatic anxiety that comes from your amygdala, but you can counteract it with your own relaxation response, and one of the ways to do this is to use your breath.

Again this can be guided or done by yourself. There are different ways to do this. You can use

  • Diaphragmatic Breathing, or
  • Controlled Breathing

In doing so, you are learning a new skill, which with practice, will become your automatic response!

So far, I have been telling you about anxiety treatments that will help with more automatic forms of anxiety. Still, even these usually have a period of worry time before or leave you feeling like a failure, or not good enough, or in fear of being judged, and this requires an additional type of anxiety treatment know as CBT.

Even with amygdala based anxiety, you probably need to do the following as you might start to worry about situations in the future where you might get anxious, and this has more to do with your thinking brain. This is more under your conscious control, it that it is not an automatic response like amygdala based anxiety, and this is where talking therapies and useful.

Anxiety Treatment: Talking Therapy

Many people are referred to some like myself, a psychologist, to undertake anxiety treatment using what is called ‘Talking Therapy.’

Talking Therapy is where you undertake treatment while talking to a professional who will use suitable therapy models to help you.

Cognitive Behavioural Therapy CBT

CBT is one of the best known and widely researched anxiety treatments. I have a more detailed post on CBT here but the main points are below.

CBT helps to treat anxiety by;

  • working with, and changing thoughts that are contributing to your anxiety,
  • changing behaviours (you things that you do) that are contributing to your anxiety.

There are also different talking therapies that people use to treat anxiety, but they are not NICE guidance. I am a psychologist who trained in the UK and used the NICE guidance to reference what has been shown to work best.

I shall mention some other talking therapies below, but their efficacy as anxiety treatments is not as good as CBT.

Person Centred

Person-centred counselling is non-directive, which means the counsellor will not give advice, tell you what to do, or give strategies.  This type of therapy gives you space to talk without any formal guidance from the therapist.

Psychoanalysis

Psychoanalysis is a long term therapy, often occurring 2 or 3 times a week and looks to things that may have happened in your early years that make you anxious now.

Self Help Anxiety Treatment


Would you like my help?

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Retrain Your Brain: Anxiety Masterclass
I have an online course that is available to start now
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Online self-help

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