Anxiety is a natural, useful emotion: it mobilises us in situations of real danger. The problem arises when anxiety becomes disproportionate, chronic, and starts to limit life.
Clinically significant anxiety differs from ordinary worry in three ways: it is disproportionate to the actual threat, persistent over time (it doesn't fade once the stressor is gone), and it interferes with daily functioning — work, relationships, sleep, physical wellbeing.
German clinical guidelines for anxiety disorders, revised in 2021 based on 495 randomised controlled trials, identify cognitive behavioural therapy as the psychological intervention with the highest level of evidence among all approaches to treating anxiety disorders. This applies to generalised anxiety disorder, panic disorder, social anxiety, and specific phobias.
The work usually combines several elements: cognitive restructuring — examining and testing anxious thoughts against reality; exposure — gradual, controlled contact with avoided situations; and training in specific skills for regulating physiological arousal.
The typical reaction to anxiety is to avoid whatever triggers it. But avoidance only provides short-term relief, while in the long run it maintains the disorder: the person never gets the experience that the situation is actually safe, and the circle of anxiety narrows life further and further.
CBT does not promise the complete disappearance of anxiety as an emotion — it remains a natural part of human experience. The goal is to bring anxiety back within limits where it no longer dictates decisions or restricts daily life.
I offer online consultations within the CBT approach. The first session is about understanding your request — no pressure, no obligations.
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