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Excerpted from When Panic Attacks by David Burns. Copyright © 2006 by David Burns. Excerpted by permission of Random House, Inc.  All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. HTML and web pages copyright © by SpiritSite.com.
 

"So we have four radically different theories about the causes and cures for anxiety. Which theory is correct?"

  David Burns, When Panic Attacks, Part 3

If you're lonely and struggling with shyness, what would it be worth to you to feel relaxed and spontaneous around other people so you could easily engage anyone, anywhere, in a rewarding conversation? And if you're suffering from phobias, panic attacks, or obsessions and compulsions, what would it be worth to you if I could show you how to defeat these fears for good?

These goals may seem impossible, especially if you've been struggling with anxiety or depression for years, but I'm convinced that you can defeat your fears without pills or lengthy therapy. That may not be the message that you're used to hearing. If you go to your doctor, she or he may tell you that you've got a chemical imbalance in your brain and that you'll have to take a pill to correct it. Yet the latest research confirms what my clinical experience has taught me over the years: You can defeat your fears without drugs.(1) All you'll need is a little courage, your own common sense, and the techniques in this book.

There are many theories about the causes of anxiety, but we'll focus on four of them:

The Cognitive Model is based on the idea that negative thoughts cause anxiety. "Cognition" is simply a fancy word for a thought. Every time you feel anxious or afraid, it's because you're telling yourself that something terrible is about to happen. For example, if you have a fear of flying and the plane runs into turbulence, you may panic because you think, "This plane is about to crash!" Then you imagine passengers screaming as the plane crashes toward the earth in a ball of flames. Your fear does not result from the turbulence but from the negative messages you give yourself. When you change the way you think, you can change the way you feel.

The Exposure Model is based on the idea that avoidance is the cause of all anxiety. In other words, you feel anxious because you're avoiding the thing you fear. If you're afraid of heights, you probably avoid ladders, high mountain trails, or glass elevators. If you feel shy, you probably avoid people. According to this theory, the moment you stop running and confront the monster you fear the most, you'll defeat your fears. It's like telling a bully "Take your best shot. I'm not running away from you any longer!"

The Hidden Emotion Model is based on the idea that niceness is the cause of all anxiety. People who are prone to anxiety are nearly always people-pleasers who fear conflict and negative feelings like anger. When you feel upset, you sweep your problems under the rug because you don't want to upset anyone. You do this so quickly and automatically that you're not even aware you're doing it. Then your negative feelings resurface in disguised form, as anxiety, worries, fears, or feelings of panic. When you expose the hidden feelings and solve the problem that's bugging you, often your anxiety will disappear.

The Biological Model is based on the idea that anxiety and depression result from a chemical imbalance in the brain and that you'll have to take a pill to correct it. Two types of medications are generally recommended: the minor tranquilizers, such as Xanax, Ativan, and Valium, and the antidepressants, such as Prozac, Paxil, and Zoloft. Your doctor may tell you that these medications represent the only truly effective treatment for depression and anxiety and that you'll need to keep taking them for the rest of your life, in much the same way that individuals suffering from diabetes will have to take insulin shots forever to regulate their blood sugar.

So we have four radically different theories about the causes and cures for anxiety. Which theory is correct? According to the Cognitive Model, you'll have to change the way you think. According to the Exposure Model, you'll have to stop running and confront your fears. According to the Hidden Emotion Model, you'll have to express your feelings. And according to the Biological Model, you'll have to take a pill.

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