31
Chapter 2
The Cognitive Model of Anxiety
In cognitive therapy for anxiety and depression patients are taught a very basic idiom:
“The way you think affects the way you feel.” This simple statement is the cornerstone
of cognitive theory and therapy of emotional disorders, and yet individuals often fail to
recognize how their thoughts affect their mood state. Given the experience of intense
and uncontrollable physiological arousal often present during acute anxiety, it is under-
standable why those who suffer with it may not recognize its cognitive basis. Notwith-
standing this failure in recognition, cognition does play an important mediational func-
tion between the situation and affect, as indicated in this diagram:
Triggering Situation →• Anxious Thought/Appraisal →• Anxious FeelingIndividuals usually assume that situations and not cognitions (i.e., appraisals) are
responsible for their anxiety. Take, for example, how you feel in the period before an
important exam. Anxiety will be high if you expect the exam to be difficult and you
doubt your level of preparation. On the other hand, if you expect the exam to be quite
easy or you are confident in your preparation, anxiety will be low. The same holds true
for public speaking. If you evaluate your audience as friendly and receptive to your
speech, your anxiety will be lower than if you evaluate the audience as critical, bored,
or rejecting of your talk. In each example it is not the situation (e.g., writing an exam,
giving a speech, or having a casual conversation) that determines the level of anxiety,
but rather how the situation is appraised or evaluated. It is the way we think that has a
powerful influence on whether we feel anxious or calm.
The cognitive perspective can help us understand some apparent contradictions in
anxiety disorders. How is it possible for a person to be so anxious over an irrational and
highly improbable threat (e.g., that I might suddenly stop breathing), and yet react with
ease and no apparent anxiety in the face of more realistic dangers (e.g., developing lung
cancer from a chronic nicotine addiction)? What accounts for the highly selective and
situationally specific nature of anxiety? Why is anxiety so persistent despite repeated
nonoccurrences of the anticipated danger?