Acceptance operationalized in exposure tx of anxiety

The acceptance/mindfulness link is pronounced in cbt for anxiety (eg Barlow's panic treatment, Heimberg's social phobia). Here, exposure, the focus on awareness of the unpleasant experience, while blocking the behaviors of escape is central to the treatment. It is quite similar to the practice of meditation. Additionally, in cognitive restructuring, the awareness of the flow of thoughts through the mind becomes a tool for the 3 column type work of identifying automatic thoughts. With patients, I sometimes formulate the goal as being able to allow automatic thoughts, without reinfecting oneself with yet more anxiety. When this is accomplished, the return to a non-aroused state approaches the normal experience of, for example, thinking you see a snake, recognizing it to be a rope or stick, and quickly calming down.

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