Psychological Self-Help

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Al-Kubaisy, Marks, Logsdail, & Marks (1992) compared self-
exposure with therapist-assisted exposure for reducing phobias. They
found both procedures worked about equally well, so the therapist
added very little. These researchers believe exposure is all that is
needed to treat a specific phobia. One area yielding good results
involves computer-assisted treatment programs in which travelers with
flight phobia are gradually exposed to scary video scenes, such as
boarding, taking off, having turbulence, landing, etc. until the fears are
reduced (Bornas, Tortella-Feliu, Llabrs & Fullana, 2001). There are
several "Virtual Reality" treatment centers in this country and Europe.
They usually teach methods for managing anxiety--deep breathing,
muscle relaxation, calming thoughts, etc. Then the patient practices in
the lab coping with technically recreated scary situations. Between
70% and 90% of flight phobic people become able to fly without
significant anxiety after 8-10 sessions ($115 to $150 per session). The
technology is available for treating several fears, besides flying,
including fear of heights, public speaking, and storms. Virtual reality
programs for other fears will soon be available. For information, call
Behavioral Medicine at West Virginia University--304-341-1500). 
The cognitive theory says that illogical thoughts create anxiety.
Even before facing the scary situation, there are self-defeating
thoughts: "I will fail," "they will laugh," etc. Once in the situation, we
tell ourselves we are doing poorly or looking silly. Afterwards, we think
about all the awful consequences of what we have done. All these
thoughts snowball and make us anxious. By correcting the thoughts
and reasoning, we lower the anxiety, and the vicious circle can
hopefully be broken. That is what cognitive therapies try to do: faulty
perceptions (misperceptions, being obsessed with or exaggerating the
seriousness of a problem, seeing things as black and white or only
seeing the negative) are corrected, irrational ideas (unrealistic
expectations of self, others, or the world) are challenged, and faulty
conclusions ("they won't like me" or "I can't do that") are reassessed.
Barlow, Rapee & Brown (1992) found that relaxation and cognitive
therapy were better than no treatment at all for anxiety, but the drop
out rate was high and the patients continued to be unduly tense.
Obviously, treatment methods for general anxiety haven't been
perfected, but progress is being made (for more promising treatment
for Type A personalities, see the personality and health section below). 
Sometimes we can learn to see the problem differently, "reframe"
it, e.g. fear of approaching someone becomes "excitement;" stress
before an exam becomes a "challenge;" anxiety about a job interview
becomes "eagerness." The anxious person must learn to see the
situation and think about it accurately; he/she must try to master it. 
Books and Web sites
There are a number of good self-help books for anxiety and
fears which usually take either the conditioning or the cognitive
approach: Bourne, 2000 and 1995 (the anxiety reduction book most
often recommended); Ellis, 2000; Kennerley, 1997; Peurifoy, 1995
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