Halima Begum, Content Team Academic

Anxiety, much like any other disorder, is that it has always existed. The only difference now is that people are more accepting and tolerant of it. Historically, it was just known as “stress” or “tensions” and there were few treatments available. What few treatment options there were are now considered outrageous.  However, as understanding and acceptance of anxiety has increased, treatments have changed significantly over time.

Gradual Exposure Therapy

One of the main treatments for anxiety that arose in the 1950s was fear exposure therapy (Cleveland Clinic, 2024). This was performed in one of two ways. The first way is gradual exposure to what is feared. The patient and the psychiatrist would create a hierarchy of stimuli that the patient believes that they can endure, the last one being the fear itself. Then they would slowly  work through it until the patient gets so used to  the stimuli that it doesn’t cause any discomfort for the patient.

This form of exposure therapy is linked to the idea of classical conditioning. Classical conditioning is the explanation that states that we learn through association and therefore develop fears the same way  The most well-known experiment demonstrating Classical Conditioning is Pavlov’s Dogs experiment from 1902 (Saul McLeod, 2023). This experiment explores the idea that we all have natural responses to certain stimuli – most often fear – and that we can learn to associate two stimuli (a natural and a conditioned stimulus) to produce the same reaction. Over time, the natural stimulus is no longer needed, and the conditioned stimulus alone can trigger the natural response. For example, consider a fear of the dark. Many people watch horror films in the dark; in this case, the horror film (natural stimulus) becomes paired with darkness (conditioned stimulus), leading to a learned fear response even when the natural stimulus is no longer present.

Flooding

A more extreme form of exposure therapy is known as flooding therapy (Saul McLeod, 2023). This is considered more unethical than gradual exposure therapy because very little control is given to the patient. This form of therapy includes the patient being placed in a situation where their fear is at its peak and they can’t leave this situation. By doing this, the patient should realise that what they fear is not as bad as they thought it would be and naturally the body will calm down. As bold as it may be, in many instances those who suffer with claustrophobia may be encouraged to go through this form of therapy. This form of therapy was also based on Classical Conditioning but focuses more on targeting the responses than gradual exposure therapy.

 Classical Conditioning is a logical theory to explain not only how anxiety forms but also how it is maintained, as it often revolves around “what if” thinking. For instance, if someone wants to do something, past experiences might make them hesitant or cause them to overthink that decision because they associate a negative reaction from others with their actions. This creates a cycle of overthinking and nervousness over simple, everyday situations, paired with the belief that a negative response is not just possible, but inevitable in the mind of someone with anxiety.

Cognitive Behaviour Therapy

A more recent form of therapy used is Cognitive Behaviour Therapy (CBT) (Mayo Clinic). Much like Gradual Exposure Therapy, CBT is much more ethical than flooding because it allows the patient more control. CBT is mainly about changing the beliefs of an individual by making them see another perspective. Firstly, the patient has to come to terms with their disorder, in this case anxiety, and be able to explain their troubles with it in their day-to-day life. Then, the patient would identify their beliefs and emotions around their troubles. After this is identified, it is encouraged for the patient to conduct self-awareness tasks when their anxiety arises so that they themselves can  identify their triggers . Finally, the patient is asked to challenge their thinking and belief system tochallenge their triggers .

As mentioned before,  CBT is quite ethical as it gives the patient a lot of autonomy and control. The main thing that drives this form of therapy is communication and awareness. The patient is sufficiently able to identify what they believe their triggers are, what they think causes these triggers and how they think they can tackle it. To support this,  it is encouraged by the psychologist for the patient to keep a journal. This not only benefits the patient by letting them get out their worries on paper, but also shows them their thought process on paper.

Key Takeaways

Anxiety can be treated through many ways. However, therapies where the patient has the most control are probably the most beneficial. This could be because the patient can go at their own pace when it comes to treatment and they won’t be rushed.  Furthermore, if someone has more power over something, they will be more inclined to fully commit to it. In order for change to successfully occur, the patient themself has to really want to act on it.

Treatments for any disorders or health problems have evolved over time mainly because we have found more effective and efficient methods . This can clearly be seen with the change in anxiety treatments. Rather than giving the psychiatrist a lot of power, as was the case in gradual exposure therapy and flooding, the patient  tends to have more control in therapies like CBT This, paired with the reason that these forms of treatments don’t stigmatise anxiety, could be the reason as to why these treatments are more popular. Also, a lot of these treatments include a patient doing a lot of the work themselves at their own pace, no one is hovering over them and forcing them to into uncomfortable situations It makes the patient feel not only like they have control ,but it also doesn’t  diminish their sense of self.

Bibliography

Cleveland Clinic, Exposure Therapy, 2024

<https://my.clevelandclinic.org/health/treatments/25067-exposure-therapy>

Mayo Clinic, Cognitive Behaviour Therapy

<https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610>

Saul McLeod, Flooding in Psychology: Implosion Therapy, 2023

<https://www.simplypsychology.org/flooding.html>

Saul McLeod, Pavlov’s Dogs Experiment & Pavlovian Conditioned Response, 2023

<https://www.simplypsychology.org/pavlov.html#:~:text=In%20Pavlov’s%20famous%20experiments%

20with,of%20generalization%20in%20classical%20conditioning.>