Karen Kerschmann, LCSW

Cognitive Behavioral Therapy and Clinical Supervision


Kerschmann & Associates

Cognitive Behavioral Therapy and  Clinical Supervision

Kerschmann & Associates

Cognitive Behavioral Therapy and  Clinical Supervision

Understanding the Biology of Stress Symptoms: Cognitive Therapy in San Diego

by | Jun 17, 2024 | Uncategorized

How Does a Therapist Treat Anxiety Disorder? An Introduction to CBT Skills

If you are reading this, chances are you already know that symptoms of stress can feel overwhelming, and if untreated can evolve into an anxiety disorder. The good news is  understanding the biological roots can be the first step towards success.  In this video,  ‘Master Your Mind: Essential CBT Skills for Anxiety Symptoms’, Dr. Rosalie Zuniga from Postpartum Wellness and I discuss what information I provide to my clients in the first stages of anxiety treatment. If you want to know about the mind body connection when you experience anxiety symptoms, check out the first part of this video to dive into the biology of stress. If you’d like to try some practical strategies for managing anxiety disorder, you can find more content in the second part. Curious, but not ready to watch the whole video? You can find an overview below.


The Biological Roots of Anxiety Disorders

Anxiety is more than an emotion, it’s an interplay of biology and psychology. The ‘fight, flight, freeze, fawn’ response is a naturalWhen the Stress Response is activated and fed by continuous thoughts, it will create anxiety symptoms instinct we have to stress or danger. This is also known as the ‘stress response’. In the modern world this is not particularly useful. In very few situations this phenomenon may be helpful (if a bear is chasing you). However, when we ruminate about our fears, our brain believes we are actually in physical danger and if it persists can evolve into an anxiety disorder.


Anxiety Symptoms

The symptoms of anxiety can vary but have some specific themes:

  1. Excessive Worry: Constant, uncontrollable worry about everyday things.
  2. Physical Anxiety Symptoms: These can include increased heart rate, sweating, trembling, dizziness, and shortness of breath.
  3. Trouble Concentrating: Difficulty focusing on tasks or making decisions.
  4. Sleep Problems: Trouble falling asleep, staying asleep, or restless sleep.
  5. Avoidance: Avoiding situations that cause anxiety, which can impact daily life and activities.
  6. Panic Attacks: Sudden episodes of intense fear or discomfort, often accompanied by physical symptoms like chest pain or a feeling of choking.

It’s the Thought that Counts

As you have learned, the biological reactioni to specific triggers creates the stress response. It’s just as important to recognize that avoidance of triggers and catastrophizing will feed the belief that we can’t handle our difficult emotions, which leads to anxiety.  Below is a helpful equation from Dr. Aaron Beck, the father of Cognitive Behavioral Therapy (CBT)

Dangerous Thinking + Helpless Thinking = Level of Anxiety Symptoms

Dangerous Thinking:

Imagine someone who experiences a setback at work, such as not receiving a promotion they expected. They might engage in dangerous thinking by catastrophizing the situation. For instance:

“I failed, which confirms I’m not good enough. What if people find out? Everyone at work will know I’m incompetent.”

Helpless Thinking:

Helpless thinking involves a belief that whatever the imagined catastrophe is, they will not be able to handle it.

Using the same situation, this person may think, ‘I am so embarrassed and now I have to go to work after this rejection. I’ll be in the bathroom crying all day. I will sit in silence in meetings and I won’t be able to be of any use now because I’ll be a mess. I don’t think I’m going to be able to date because I’ll just keep thinking about how inferior I am.’

CBT in Action:

The video ‘Transform Your Anxiety Symptoms: CBT Skills to Help You Feel Better’ discusses a few interventions, such as ‘Decatastrophizing the Fear (Worst Case Scenario), and the ‘What Ifs’ to examine and test dangerous thoughts.

Although in a stressed state we overpredict dangerous outcomes, the reality is that the worst case can happen. When we anticipate we can’t handle the worst-case scenario our helpless thinking is kicking in. I will ask my clients, ‘How could you cope in a way that is healthy and strong?’ ‘Is there a way you visualize managing the catastrophe in a way you would be proud of?’ My clients who come to me for anxiety treatment in San Diego often will hear me joke that we are not the fragile flowers we believe we are. All humans can survive and thrive under difficult circumstances, and this is a vital understanding to manage anxious thoughts.

Where to Find More Information: Therapy in San Diego

For more details about this insightful session and to explore additional resources, visit Therapy in San Diego and Postpartum Wellness. If you are curious about your anxiety symptoms and wonder if you would benefit from treatment, head to Anxiety Treatment in San Diego – Assessment to see where you land on the anxiety disorder scale.