Cognitive Therapy of Anxiety Disorders

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30 COGNITIVE THEORY AND RESEARCH ON ANXIETY


difficult. At the same time anxiety is often acquired through the organism’s interaction
with the environment even though this learning process may occur outside awareness
and beyond rational consideration. And yet cognitive mediation such as expectancies,
interpretations, beliefs, and memories play a critical role in the development and persis-
tence of anxiety. As a subjective experience, anxiety may feel like a storm that surges
and recedes throughout the day. Relief from this state of personal turmoil can be a
potent motivator even when it elicits response patterns, such as escape and avoidance,
that are ultimately counterproductive to the vital interests of the individual.
Despite its complexity, we have argued in this chapter that cognition plays a key role
in understanding both normal and abnormal states of anxiety. The essence of maladap-
tive anxiety is a faulty or exaggerated interpretation of threat to an anticipated situation
or circumstance that is perceived to have significance for the person’s vital resources.
In the last two decades substantial progress has been made in elucidating the cognitive
structures and processes of anxiety. Based on the cognitive model of anxiety first pro-
posed by Beck et al. (1985), this book presents a more refined, elaborated, and extended
cognitive formulation that incorporates major advances made within cognitive- clinical
research of anxiety. A systematic evaluation of the empirical status of this reformulation
is presented along with theory- driven strategies for cognitive assessment and treatment.
In subsequent chapters disorder- specific cognitive theories, research, and treatment are
presented for the major forms of anxiety disorders: panic disorder, social phobia, GAD,
OCD, and PTSD. It is our contention that the cognitive perspective continues to hold
much promise for the advancement of our understanding of anxiety and the provision
of innovative treatment approaches.

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