Cognitive Therapy for Children

There are several subgroups of Anxiety Disorders, with different causes and treatment.

Anxiety disorders are a serious social and financial concern to American business, since they cost the country more than $42 billion a year in healthcare costs and lost productivity, according to “The Economic Burden of Anxiety Disorders,” a study published in the Journal of Clinical Psychiatry.

More than $22.84 billion is spent on healthcare services, as those with anxiety disorders seek relief for emotional distress and physical symptoms.

Sufferers are 300 to 500 percent more likely to go to the doctor and 600 percent more likely to be hospitalized for psychiatric disorders than non-sufferers.

Anxiety disorders are the most common psychiatric illness and affect both children and adults.

They develop from an interaction of numerous risk factors, including personality, genetics, brain chemistry, and life stress. Approximately 19 million adult Americans suffer from anxiety disorders. Anxiety disorders are highly treatable, yet only about one-third of those suffering from them receive treatment.

The main feature of Generalized Anxiety Disorder is excessive, unrealistic and uncontrollable worry about everyday events.

This constant worry affects daily functioning and brings physical symptoms. GAD can occur with other anxiety disorders, depressive disorders, or substance abuse.

It can be misdiagnosed because it lacks some of the dramatic symptoms, such as unprovoked attacks of panic, that are seen with other anxiety disorders. For a diagnosis to be made, uncontrollable worrying occur more days than not for at least 6 months.

The focus of GAD is fluid, shifting unpredictably from job issues, finances, health of both self and family, and smaller issues such as chores, car repairs and being late for appointments.

The intensity, duration and frequency of the worry are disproportionate to the issue and interferes with the sufferer’s daily life. Physical symptoms can include muscle tension, sweating, gastrointestinal symptoms such as diarrhea and/or nausea, cold and clammy palms, the feeling of having a “lump in the throat” and difficulty swallowing.

Sufferers are irritable and complain about feeling on edge, tire easily tired and have trouble sleeping.

Obsessive-Compulsive Disorder is characterized by persistent, recurring thoughts (obsessions) that reflect exaggerated anxiety or fears; typical obsessions include worry about being contaminated or fears of behaving improperly or acting violently.

The obsessions may cause the individual to perform a rituals or routines to relieve the anxiety, such as excessive handwashing, checking appliances, repeating phrases or hoarding.

People with Panic Disorder suffer severe acute attacks of panic for no apparant reason, which may mimic the symptoms of a heart attack or cause them to feel they are losing their minds.

Symptoms include heart palpitations, chest pain or discomfort, sweating, trembling, tingling sensations, feeling of choking, fear of dying, fear of losing control, and feelings of unreality.

Panic disorder is often accompanied by agoraphobia, in which people are afraid of having a panic attack in a public place, so they become afraid to leave the safety of their controlled home environment.

Posttraumatic Stress Disorder can follow a traumatic event such as a sexual or physical assault, witnessing a death, the unexpected death of a loved one, or natural disaster.

There are three main symptoms associated with PTSD: “reliving” of the traumatic event (such as flashbacks and nightmares); avoidance behaviors (such as avoiding places and other reminders related to the trauma) and emotional numbing (detachment from others); and physiological arousal such difficulty sleeping, irritability or poor concentration.

Social Anxiety Disorder is characterized by severe anxiety about being judged by others or behaving in a way that might bring ridicule or embarrassment. This intense anxiety may lead to extreme shyness and avoidance of social situations.

Physical symptoms associated with this disorder include faintness, heart palpitations, blushing and profuse sweating.

Anxiety disorders also include Specific Phobias, an intense and unreasonable fear of specific objects or situations, such as spiders, dogs, or heights.

The disproportionate level of fear is recognized by the sufferer as being irrational. It can lead to the avoidance of common, everyday situations.

Patients often have more than one anxiety disorder, and sometimes other illness as well such as depression or substance abuse.
Treatment of anxiety disorders includes support groups, cognitive behavioral therapy (CBT), exposure therapy, anxiety management and relaxation techniques, and psychotherapy.

Drugs therapy used to treat anxiety disorders includes benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs) and beta-blockers.

Often a combination of the two therapies is more useful than one exclusively. Up to 90 percent of patients will show improvement of their symptom from medical treatment.

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. If you have OCD, you have repeated, upsetting thoughts called obsessions. You do the same thing over and over again to try to make the thoughts go away. Those repeated actions are called compulsions.
Obsessions seen in OCD vary widely from person to person. Some examples of common OCD obsessions are:
~ exaggerated fears of contamination/germs from contact with people or everyday items
~ nagging doubts about having locked the windows or the doors to the home, car, or garage
~ excessive concerns about having turned off the stove, hair dryer, coffee pot, or other household appliances
~ overwhelming urges to arrange items in a particular order so that they are “just right”
~ fears of committing a harmful, violent, or immoral action
Other compulsions include washing your hands, counting, fear of being hurt, checking on things or cleaning. Untreated, OCD can take over your life. Researchers think brain circuits may not work properly in people who have OCD. It tends to run in families. The symptoms often begin in children or teens.
Science plays a great deal in how anxious you might feel. But in this case it is not biology but chemistry that can impact you. The amount of serotonin or adrenaline or any combination of hormones can determine how you act and react. Since the brain is the center of all the activity of the nervous system, whatever is released into it will produce a specific behavior. When certain chemicals are elevated, it causes the nervous system to go into a state of panic, and you will be extremely anxious and frazzled as a result. Because of these occurrences, there are a wide variety of counterproductive chemicals that have been created, and are prescribed to people with chronic anxiety issues.
What can be done?
Cognitive-Behavioral Therapy (CBT) is an empirically supported treatment that focuses on patterns of thinking that are maladaptive and the beliefs that underlie such thinking. For example, a person who is depressed may have the belief, “I’m worthless,” and a person with a phobia may have the belief, “I am in danger.” While the person in distress likely holds such beliefs with great conviction, with a therapist’s help, the individual is encouraged to view such beliefs as hypotheses rather than facts and to test out such beliefs by running experiments. Furthermore, those in distress are encouraged to monitor and log thoughts that pop into their minds in order to enable them to determine what patterns of biases in thinking may exist and to develop more adaptive alternatives to their thoughts.
Many psychiatrists feel that the only effective treatment for OCD involves medication with psychiatric drugs like Clomipramine, Prozac or other SSRI’s (drugs which prevent the uptake of serotonin). While psychiatric drug therapy can often relieve the symptoms of OCD, there are associated risks of side effects as well as an effect on overall health. This often results in the individual having to take a variety of different prescription drugs, which is both expensive and not ideal from a health point of view.
It is important to realize that treatment with psychiatric drugs is not the only answer.
Many people are using aromatherapy – natures cure for anxiety and depression. Essential oils, the pure essence of a plant, have been found to provide both psychological and physical benefits. Essential oils that are inhaled into the lungs offer both psychological and physical benefits. Not only does the aroma of the natural essential oil stimulate the brain to trigger a reaction, but when inhaled into the lungs, the natural ingredients supply therapeutic benefit. Using lavender essential oil to help ease insomnia is a prominent example.

To establish precedence, allow me to say this: “We are all prone to panic attacks”.  What singles you out is the intensity with which you experience your own panic attack, as it mostly would vary from how I might experience mine. However way we might experience these attacks, it does not become acute panic attacks until it radically alters the way we go about our day to day activities. Even though we all encounter situations that make us afraid and gets our hearts pumping, acute panic attack is different in that its source is not logically apparent – this is what makes it worse than normal panic in comparison! For example, in the case of normal panic, our heart beat goes back to its normal rate (once the cause of its increased rate has been identified and dealt with), whereas because there is no readily apparent reason for the fear we experience in the case of acute panic attack, that irrational fear remains with us. This is the condition that has come to be called acute panic attack.The good news is that, while acute panic attack is a critical condition, there exist quite a number of cures for it. Just bear in mind that what works for me may not necessary be what works for you even though you will be hard pressed not to find a cure for your acute panic attack from the top 10 most effective cures for acute panic attack which I have enumerated below.1. A very effective way to cure your acute panic attack is through psychotherapy. This will help you drastically minimize the power of the symptoms while also curing the ailment as well. 2. If 100,000 people try a method and say it works, will you believe them? Well, it’s worth considering. After trying The Linden Method, over one hundred thousand people say they have benefited from this effective method. 3. Sertraline, Paroxetine and Clonazepam are acute panic disorder drugs that have been tested and approved by the Food and Drug Administration. 4. Recently promoted as the best ebook to hit the digital bookshelves is Panic Away, an ebook by bestselling author Joe Barry. Joe Barry uses the One Move Technique™ to show you step-by-step how you can eradicate your acute panic attacks beginning today! As a previous sufferer of panic attack himself, Joe Barry writes from the vantage point of one who feels your pain. 5. Is time a factor in your life? Well, fret no more because Mark Pasay has come out with his radically effective “Ease Out of Fear” – Handling your acute panic attacks just became “faster” as Ease Out of Fear shows you how to do so by spending just three minutes only every day.6. Lucinda Bassett’s Attacking Anxiety and Depression is another program worthy of noting. A complete guide on coping acute with acute panic attacks, this program contains exhaustive materials which include: a 250 page book, 3 DVDs, 16 audio cassettes, and 16 ready reference. 7. The most generally accepted and employed treatment for acute panic attacks is cognitive behavioral therapy (CBT). Where acute panic attack therapy is concerned, it ranks amongst the best of the best. This is most widely accepted and used treatment for acute panic attacks. 8. One of the leading clinical psychologists for Native Remedies is the developer of Pure Calm, a natural drug remedy for acute panic attacks having no negative harmful side effects and also useable by both adults and children.9. Holo Think employs audio tracks that help relax your brain using binaural beats. These meditational sound tracks help you cope with your acute panic attacks.10. Jon Mercer who is also a former sufferer of acute panic attack has developed a system for tackling the condition which he calls The Easy Calm. The Easy Calm is a 10 part video series which you can easily download to your computer.

Panic attacks are common to us all.  What is different is the degree of these attacks, as it is different from one person to the next. Nevertheless, panic attack becomes “acute” when our normal day-to-day living is affected drastically by this condition. Although it is natural for everyone of us to experience overwhelming feelings of panic and anxiety when we are confronted with threatening situations, acute panic attacks are made worse by the fact that no obvious reason can be pointed to as the cause for its occurrence!  Naturally, after the incidence that caused our initial fear passes, so does our fear but with acute panic attack, there is no reprieve because there was no rational cause for the acute panic in the first instance.On the other hand, there exists “light at the end of the tunnel” for sufferers of acute panic attacks as there are quite a number of treatments that are available for acute panic attacks. All we need to know about these treatments are that their results vary from person-to-person, therefore what may work for one, may not necessary work for the other. Below you will find the top 10 most effective acute panic attacks cure, just be sure to allow yourself adequate time in which to realistically respond to these treatments – before you begin to panic!1. The intensity of your acute panic attack can be minimized by psychotherapy. Psychotherapy also clears the disorder as well.2. The Panic Away eBook: Developed by Joe Barry, this ebook teaches you how to employ the One Move Technique™ which helps you learn to work with your acute panic attack. One Move Technique™ was developed by Joe Barry who was an acute panic attacks sufferer himself.3. One of the best cures for acute panic attacks is cognitive behavioral therapy (CBT). It is also arguably the most widely accepted remedies for acute panic attacks.4. Also worthy of mention are the drugs for acute panic disorder (Sertraline, Paroxetine and Clonazepam) approved by the Food and Drug Administration. 5. Ease Out of Fear: Developed by Mark Pasay, this system shows you how you can manage your acute panic attacks by investing three minutes only daily.6. You can also download Jon Mercer’s 10 part video series – downloadable onto your hard drive – called The Easy Calm. For a long while Jon Mercer experienced acute panic attacks and as a result, he has developed The Easy Calm, a very potent system, to assist people who are currently suffering from the same condition.7. Another guide that reveals how you can cope with your acute panic attacks is Lucinda Bassett’s Attacking Anxiety and Depression. This guide is complete and exhaustive,  containing 3 DVDs, 16 ready reference cards, 16 audio cassettes, and a 250 page book. 8. Another very effective program worth trying out is The Linden Method – Its effectiveness has been attested to by over one hundred thousand people who claim to have benefited from its revealed system. 9. If you are into music, you might want to check out Holo Think. Holo Think is a compilation of sounds that are meditative in nature. These sound tracks helps to calm your brain through the use of binaural beats which helps you cope with acute panic attack.10. Pure Calm – Is a natural acute panic attack cure which also doesn’t have any harmful side effects thereby making it a potential remedy or both adults and children. It was developed by one of the leading clinical psychologists for Native Remedies.

Shyness and social anxiety can develop even from infancy. Everyone can remember a time when they felt shy or embarrassed at school. Perhaps you have a bad memory of being told off in front of the class? Or perhaps a time when you had to perform on stage with your parents watching you?Even babies can feel shy and embarrassed. Often babies are much more reserved around people they are not familiar with. As children grow up, they frequently face criticism and new experiences that can be daunting. Going through puberty can be a difficult period and can greatly change the behavior as well as the physiology of a child.Teenagers start feeling things physically and mentally, that are new to them. They become self-conscious around their peers and more attention to their appearance. Everyone knows what it feels like to be shy. Situations such as talking to someone important, going on a date and attending a social event can make a person feel nervous and shy.When a person has constant anticipation of doing something embarrassing in front of others they might have social anxiety disorder. Sufferers fear social situations because of possible humiliation and embarrassment, which makes everyday life hard to cope with. They may even feel anxious walking down a street.Physical symptoms include blushing, profuse sweating, shaky voice, shaking and dizziness. Symptoms of social anxiety can worsen if the sufferer is in an emotional state or in poor health. Fatigue, worry and stress can exacerbate their condition. Each social experience might also produce different levels of anxiety. For instance, visiting a family member would not create feelings of anxiety compared to going on a first date.Social phobia can often be seen as shyness but they are not the same. Sufferers of social phobia will do anything to try and avoid being in the spotlight of others. When a person experiences negative social situations frequently, shyness can become a learned response that can further develop into social anxiety disorder.Fears and anxiety only intensify when similar bad experiences arise and only reinforce a mental association. Most sufferers develop fears from one bad experience that is followed by others. Now when a similar situation arises they immediately link it to their past bad experiences and that’s when they start to panic.Facing your fears can sometimes work in overcoming certain fears but when it comes to social phobia it needs to be gradual process. In addition deep subconscious changes to a person’s behavior are needed. Therapies such as hypnosis and CBT deal with the aspect of adjusting thought patterns and behavior.One overlooked aspect of reducing social anxiety includes improving physical health. Taking care of your body through exercise and eating well can help reduce stress and anxiety. More energy and better health will only help boost self-confidence and positvity.

Here is an essential principle of Mental ToughnessWe all experience frustration when our needs, wants and demands are not met, or when we are faced with obstacles that impede our progress. Frustration is a fact of life; therefore our ability to tolerate frustration is crucial to the successful achievement of our long-term goals.When we are easily frustrated and upset, we are said to have, Low Frustration Tolerance (LFT). If, on the other hand, we are less disturbed or upset by short-term frustrations, and persevere through difficulties, we are said to have High Frustration Tolerance (HFT). Developing High Frustration Tolerance is vital to good mental health and a key element of Mental Toughness.We all know that in our everyday lives, we will face obstacles, difficulties and hassles. People will let us down, trains won’t run, cars won’t start, we will have to queue and wait to be served, items will be out of stock and call centres will be busy. Amazingly enough, we habitually demand that these things do not happen, and that life should always be… the way we want it… easy, fast and without any hassle. So we may often complain, bleat, moan and rage. We may cry and whine that we are being “stressed out” or scream that we can’t stand it! The psychologist, Albert Ellis, called this can’t-stand-it-itis.Having Mental Toughness means, that we must accept responsibility for our thoughts, emotions and behaviour. If we have Low Frustration Tolerance (LFT) it is within our power and within our control to change the beliefs that cause us to feel frustrated.Here are some of the common beliefs that cause LFTI must not be frustratedI cannot stand to be inconvenienced.My life should be easyThings should always work properlyIt’s awful when things don’t go my wayI must be comfortable at all timesI must not be deprived of what I wantI can’t stand to do things that are boring or unpleasant I cannot stand to endure poor service, stupidity and lack of attention Here’s an example. Many people get frustrated when queuing and waiting at supermarket checkouts but with some people their frustration gets way out of proportion. Some people get so angry at not being served quickly, that after a few minutes of huffing, puffing and tutting, they finally throw a tantrum, dump their groceries on the floor and run out swearing at everyone… It’s hardly grown up behaviour is it? Also, they will still need to get their food at some point, so it’s not pragmatic and goal directed behaviour either… Not big, not clever.Here are some common thoughts that people have in this instance I cannot stand to queue and waitI’ll be here forever; I CAN’T STAND IT!I cannot stand waiting for slow and idiotic peopleThis is really boring and dreadfulI’ll go mad if they don’t move faster If I don’t get out of here my head will explodeI must be served right away, NOW!Here are some common beliefsIt’s terrible to have to stand and wait in the 21st centuryWhy can’t they organise things effectivelyIt’s awful to waste my time like thisPeople should focus on what they’re doing and move fasterThere should be more tills open for my convenience My time must always be spent efficientlyThere should be a separate queue for idiotsDoes any of this seem familiar? (my contact details are below). An effective way to combat Low Frustration Tolerance is to dispute the thoughts and beliefs that underpin it. Again, the focus is on preferring not demanding. Here are some coping statements for supermarket queuing or waiting in traffic.Get a grip; it’s not life or deathIt’s inconvenient but I can cope with itOf course I can stand it, it’s really not that badSometimes things don’t go my way. TOUGH!There is no law of the universe that says things must be the way I want them I don’t like it but I can handle itI would prefer not to queue but it’s not a disaster if I have toIt’s a hassle but I can live with itDry your eyes and stop cryingGet real; I won’t be here foreverStop whining and whingingAs well as disputing our thoughts and beliefs, we can also use behavioural disputing. Behavioural disputing is a great way to test whether we really “could not stand it”, or whether we would really go mad and our heads explode. To do this we could choose the longest and slowest checkout queue and when we got near to the front leave the queue and go to the back again. Similarly when in traffic queues rather than weave in and out to the “faster lanes” we could stay in the slowest lane and gain tolerance and control over frustration.Small children are used to having their needs and demands met; they are inexperienced and when faced with frustrations, they cry, scream and throw tantrums. As we get older and become adults, we learn that frustration is a normal, everyday part of life. Therefore, we need to develop High Frustration Tolerance, persist through difficulties and have Mental Toughness.Kind RegardsPhil Pearl DCH, DHP, MCH, GHR Reg Clinical Hypnotherapist Mental Toughness Hypnotherapy 10 Harley Street London W1G 9PF Tel: 020 7467 8548 phil@mental-toughness.co.uk www.mental-toughness.co.uk

In our mission to maintain mental toughness and mental strength we need to look at and dispute the errors in our thinking. These “thinking errors” are referred to as inferences by cognitive therapists. Inferences are assumptions of what we think is going on, has happened or will happen. They are statements of what we believe are the facts and go beyond the immediate and observable evidence. They can, be true or false, helpful or unhelpful, rational or irrational. Inferences are often gross distortions of reality. This article focuses on one of the most common and unhelpful forms of inferences called “Black and White” thinking.As suggested in the name, black and white thinking occurs when we think of things as being polarised to either one extreme or the other, without acknowledging or taking into account the possibility of any grey areas or middle ground. Such asThe boss is always right. If you don’t love me, you must hate me. If you are not smart, then you must be stupid. If you are not thin, then you are fat. If you are not for us, then you are against us.                                                                 If it’s not true, then it’s a lie

All or nothingStay or goRight or wrong Yes or noGood or evilExcellent or awfulLove or hateWinners or losersHere’s an everyday example. A student may view an exam result of 95% or above as evidence that he is intelligent, whereas a score of 85% will prove that he is brainless and thick. As we can see from this example, black and white thinking is common in those of us with perfectionist traits and can lead to feelings of inferiority. Black and white thinking can also lead to anxiety and low self-worth. For example, if we are at a social event and someone we find attractive doesn’t make eye contact, we may jump to the negative conclusion that we are disliked and ugly. However, if they smile at us, we may jump to the opposite conclusion and see this as proof, that we are desirable and worthwhile.Sometimes, when we are stressed and emotionally overwhelmed we may fall into black and white thinking. When we are anxious and cannot think and reason clearly, we may opt for an “either…or…” solution. Doing this may give us quick relief from our distress and bring a temporary end to our discomfort but we may have lost the chance to come up with a more flexible, practical or helpful solution. This is the self-defeating thinking that we used as frustrated children, when our thinking was less developed. When people are stressed they often regress and “throw their toys out of the pram”. For example: “If I can’t have designer trainers, I don’t want anything”,”If I’m in goal, I’m not playing… it’s my ball and I’m going home”"If you don’t call me, you don’t care about me”"I want my stapler or I can’t work”"Who took my chair, I’m leaving”"I must have my mug or no coffee”…boo hoo…sob, sob…whinge, whinge…” If this sounds like your office, my details are below.During these times of global recession and uncertainty, it is understandable that some people may get overwhelmed and distressed. However, we must resist the urge to revert to simplistic and polarised thinking. In a recession we need progressive thinking rather than regressive thinking. It’s also worth bearing in mind, that black and white thinking is used in cults were no alternatives are given and freethinking is not allowed. Stay flexible, remain creative, adapt and survive RegardsPhil Pearl

Anxiety disorders are one of the most common psychiatric illnesses affecting both children and adults.  There are about 40 million known cases in the United States alone.  These disorders usually develop from a complex set of risk factors which may include personality, brain chemistry, genetics, and life events.  Though anxiety disorders may be derived from so many factors, they are highly treatable.  However, perhaps because of the stigma attached to anxiety disorders, only about one in three people afflicted actually receive any type of treatment.

It is important to know that the phrase “anxiety disorder” is an umbrella term for more specialized disorders including Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), Panic Disorder, Posttraumatic Stress Disorder (PTSD), Social Anxiety Disorder (Social Phobia), and Specific Phobias.  Regardless of what specific anxiety disorder a person has, they can be quite debilitating with a variety of symptoms.  In most cases, anxiety disorders present themselves with other mental disorders such as depression.

The symptoms of anxiety orders may manifest themselves at an early age or start suddenly, perhaps after a triggering event.  During high stress periods, anxiety disorder symptoms may present themselves more frequently or with greater severity.  Symptoms include sweating, headache, muscle spasms, hypertension, palpitations, fatigue, and exhaustion to name a few.

As mentioned, anxiety disorders are highly treatable.  Patients suffering from anxiety orders may be treated by psychosocial therapies, medication, or a combination of both.  Psychosocial therapies are usually attempted first and include Cognitive-Behavioral Therapy (CBT), anxiety management, relaxation therapies, exposure therapy, and psychotherapy.  These therapies always involve working closely with a mental health professional, usually a psychiatrist, psychologist or social worker.  During such therapies, patients and professionals discover what the source of the anxiety disorder is and how to deal with it.

Cognitive-Behavioral Therapy is one of the most useful of the therapies for anxiety disorders.  CBT actually helps people change their thinking patterns so that their reactions to anxiety-provoking situations become less severe.  Successful CBT can make patients understand that their panic or anxiety attack is not really a heart attack

Many times, anxiety disorders are treated with not only psychotherapies but also with medications.  The drugs most commonly associated with anxiety disorder treatment include SSRIs, which are selective serotonin reuptake inhibitors, beta blockers, benzodiazepines, tricyclic antidepressants, and MAOIs, which are monoamine oxidase inhibitors.  Medication alone will not cure anxiety disorders, but will help keep them under control.

The most successful treatments of anxiety disorders involve the combination of medication and psychotherapy.  Many doctors will prescribe medication shortly after diagnosis so that the symptoms are alleviated quickly (usually within 4 to 6 weeks) and allows the psychotherapy protocol time to become effective.