Anxiety disorders—ranging from social anxiety to specific phobias—affect roughly one in five Americans each year, according to the National Institute of Mental Health. In many cases, anxieties seriously interfere with everyday functioning and can damage relationships, professional prospects and overall quality of life.
Bethany Teachman, a professor and director of clinical training in UVA’s Department of Psychology, wants those with anxiety to know they are not doomed to live this way. Emphasizing the role of choice in response to any situation, she says, can help people actually change their thought patterns and therefore reduce anxiety and negative thinking. “Most of our lives, we are constantly deciding what meaning to apply to a situation,” says Teachman. “And that is actually a really liberating fact. When we make that decision about how we want to interpret a situation, we can dramatically change our feelings about it.”
In public speaking, for example, the audience’s feedback is open to multiple interpretations. “I can decide that people think what I’m saying is pretty dumb, and they wish I’d stop talking, or I can decide that they think what I’m saying is interesting, and they’re enjoying the talk,” Teachman says. “And those two interpretations will lead to very different emotional responses and consequent behaviors.”
Anxiety about a situation is uncomfortable, but not dangerous, Teachman says. The trick is to acknowledge anxiety without interpreting the situation as threatening. And once you learn to tolerate anxiety, it starts to go away. This method applies to all forms of anxiety, from panic disorders to phobias. “The goal is to plant flexibility,” Teachman says. “We don’t want people to always think positively, but to be able to figure out what’s needed to be effective in each situation.”
Well-researched interventions, including cognitive behavioral therapies, mindfulness, medications and exposure therapy, help treat anxiety and change thought patterns. In exposure therapy, for example, people overcome their anxieties by confronting them directly. People who fear heights, for example, might go to a high floor with their therapist and look out of a window.
But only one in three Americans with an anxiety disorder receive treatment in any given year, according to NIMH statistics, and that figure includes a large number of people whose treatment falls short of their needs because of limited access to qualified providers, costs, fear or embarrassment. Each year Americans lose at least $193 billion in potential earnings because of major mental illnesses, according to a 2008 study published by the American Journal of Psychiatry.
To address that problem, Teachman and her colleagues are creating tools that make effective treatment for anxiety disorders more widely accessible. Notably, they have been testing a computer-based form of therapy called interpretation training, which involves patients reading about multiple scenarios with positive spins on the source of their anxiety. In a study of 110 subjects, Teachman found that interpretation training worked as well as exposure therapy.
Over the long run, Teachman believes that interpretation training can reduce the barriers that often keep people from seeking treatment. “We would like to encourage people to talk about mental health more openly,” she says. “Just as you might say, ‘I have a dentist appointment today,’ you could also be comfortable saying, ‘I’m going to be working on my emotion regulation skills today.’”