Each emotion has a specific purpose. The purpose of fear and anxiety are to defend oneself from perceived danger. For example, if a person is hiking and encounters a bear, the person will likely feel anxiety or fear (Emotions); feel energized or racing heart (Physical Feelings); focus their attention on the bear and have specific thoughts related to the danger (Thoughts); and engage in behaviors to defend themselves, such as fight, flight, or freeze (Behaviors).

Most of the things we become afraid or anxious of are learned; we learn to be afraid of specific objects or situations. This is often “associative learning” – meaning, our minds believe that specific objects or situations (e.g., social interactions) are associated with (or, predict) specific feared outcomes (e.g., social rejection, being disliked, being criticized). The same is true for safety: just like we can learn to believe a specific situation is dangerous, we can also learn to believe that the situation is safe (i.e., that the feared outcome does not occur in that situation like we thought it would).

The goal of anxiety treatment is to develop realistic anxiety, which often means reducing anxiety in anxious people. From a CBT perspective, this is done by targeting Behaviors and Thoughts.

The behavioral treatment in CBT for anxiety is called exposure therapy, which involves approaching the feared situation to learn whether the feared outcome occurs. Importantly, all exposures should be i) safe, ii) challenging (because they produce heightened expectations of dangerous outcomes occurring), and iii) agreed upon between the therapist and client. For example, exposure therapy for social anxiety disorder would involve engaging in specific social interactions to learn whether the feared outcome (e.g., social rejection) occurs. By approaching feared situations and learning that the feared outcome is less likely to occur or is less severe/intense than expected (if it does occur), anxiety reduces, and we learn these situations are safer than originally thought.

Additionally, the thoughts treatment in CBT for anxiety involves identifying anxious thoughts, examining their validity, and potentially modifying the thoughts to be more in line with the evidence (this is called “cognitive restructuring”). By changing thoughts that a person is in danger to thoughts that a person is actually safe (assuming the evidence supports the “safety” thought), anxiety usually reduces. Often, anxiety disorders lead people to believe the likelihood and magnitude of dangerous events are greater than reality. Thus, treatment involves adjusting one’s thinking to be more realistic and, as a result, anxiety often reduces.

Anxiety is a Function of Learning Safety vs Danger