50 COGNITIVE THEORY AND RESEARCH ON ANXIETY
Clinician Guideline 2.14
Emphasize the elimination of safety- seeking behavior in cognitive therapy of anxiety disor-
ders.Constructive Mode Thinking
The presence of strategic elaborative thinking provides an opportunity for more con-
structive, reality-based reappraisal of perceived threat. It is possible that problem- solving
strategies could be considered during secondary elaboration rather than more immedi-
ate reflexive responses aimed at self- protection or escape. Access to more realistic coping
resources is represented by schemas of the constructive mode. Constructive mode sche-
mas are primarily acquired through life experiences and promote productive activities
aimed at increasing (not protecting) the vital resources of the individual (D. A. Clark
et al., 1999). Our ability to engage in reflective thought, to be self- conscious and evalu-
ative of our own thoughts (i.e., metacognition), to problem-solve, and to reevaluate a
perspective based on contradictory evidence is attributable to activation of the construc-
tive schemas.
Beck et al. (1985, 2005) proposed that anxiety is characterized by two systems, one
of which is an automatic primal inhibitory system that occurs in response to primal
threat mode activation. This system tends to be immediate and reflexive, and is aimed
at self- protection and defense. A second system, called the anxiety reduction system, is
slower, more elaborative, and processes more complete information about a situation.
The presence of anxiety can motivate a person to mobilize the more strategic processes
of anxiety reduction.
The problem in anxiety disorders, however, is that the initial automatic reflexive
(inhibitory) system activated by the primal threat mode tends to dominate information
processing and block access to more elaborative anxiety- reducing strategies represented
in the constructive schemas. Once the inhibitory system aimed at self- protection and
immediate threat reduction is activated, it is very difficult for the highly anxious person
to shift to more reflective, constructive thinking. One of the aims of cognitive therapy
is to help the anxious patient engage in more constructive mode thinking as a means of
achieving longer term reduction of anxiety.
Clinician Guideline 2.15
Encourage the development of constructive mode thinking in anxious patients to achieve
more enduring reduction in anxiety.Initiation of Worry
Beck and Clark (1997) proposed that worry is a product of the secondary, elaborative
reappraisal process triggered by primal threat mode activation (see p. 393 for a defini-
tion of worry). In nonanxious states worry can be an adaptive process that leads to