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Index
Title Copyright Dedication Contents List of Figures and Tables Preface Acknowledgments 1 Why Details Make a Difference
Introduction Reasonable Goals Techniques Are Not the Answer
2 The Basics
Three General Characteristics of Highly Anxious People Anxiety Feels Dangerous How an Anxiety Disorder Differs from Plain Anxiety The Three Types of Triggers The Defining Aspect of an Anxiety Disorder The Basic Principle: Identify and Treat Avoidance
3 A Contemporary View of Anxiety Disorders
Sensitivity and Anxiety A Discussion of Causation Insight: Cause Versus Maintenance Primary Versus Secondary Gains Studies on Causation The Dilemma of Insight Consequences of Affect Intolerance The Value of Talking about Anxiety Symptoms A Direct Approach to Treating Anxiety Disorders The Neurological Perspective: Role of the Amygdala in Sensitization The Value of Exposure The Fear-maintaining Cycle Avoidance, Resistance, Neutralization The Phenomenology of Anxiety: Anxiety Alters Consciousness With Anxiety, Common Sense Makes No Sense The Paradoxical Attitude
4 The Therapeutic Attitude of Acceptance
Approaching Anxiety Mindfully Embracing Anxiety The Role of the Therapist Teaching Metaphors Essential Elements to the Therapeutic Attitude of Acceptance
5 Getting Started
The First Contact Must Instill Hope Immediate Help: Embed Information in Your Questions Get the Details Find Out What They Have Tried Introduce the New Paradigm: Offer a More Profound Change Than Techniques Provide Information and Answer Questions
6 Techniques Your Patients Have Probably Already Tried and Misunderstood: What They Are and How to Make Them Helpful
The Problem with Techniques How Techniques Can Be Helpful Techniques Are Temporary Help, Not Goals Emergency Coping Techniques That Can Be Helpful: “What Is,” Not “What If?” Anxiety Management Tricks That Easily Backfire Diaphragmatic Breathing Anxiety Management in Cases of Real Danger, Not False Messages Some Issues in Determining Patient Progress
7 Diagnoses: An Annotated Tour of the Anxiety Disorders
Specific Phobias Panic Disorder Social Anxiety Disorder Obsessive-compulsive Disorder Generalized Anxiety Disorder Traumatic Anxieties
8 Exposure: The Active Ingredient
Exposure in the History of Psychotherapy Exposure Therapy Is More Than “Just Do It” Role of the Therapist During Exposure: What to Say and Do Exposure Can Be an Intrinsic Part of Diagnosis and Assessment Exposure for Patients with Obsessive-compulsive Disorder: Exposure and Response Prevention OCD with Purely Mental Obsessions and Compulsions The Right Way to Practice Exposure
9 The Curious Case of Worry
Varieties of the Worry Experience A Caveat: Generalized Anxiety Disorder—Rarely a Stand-alone Diagnosis Worry Is Not an Affect: It Is Thinking—And Thoughts Are Not Facts Productive Versus Unproductive Worry An Important Insight: Some Worry Thoughts Raise Anxiety and Some Lower It The Therapeutic Perspective on Worry About Worry and Time: The Role of Urgency Evaluating Worry Rumination: A Different Kind of Worrying Coping with Worry: What Doesn’t Work Coping with Worry: Strategies That Work
10 Unwanted Intrusive Thoughts: All Bark and No Bite
How Unwanted Intrusive Thoughts are Maintained Living with Joy Despite Unwanted Intrusive Thoughts Treating Unwanted Intrusive Thoughts Issues for Therapists: Varieties of Presentation Issues for Therapists: Therapist Anxiety and a New Construct Exposure to Unwanted Intrusive Thoughts
11 Classic Pitfalls: Common Mistakes Non-Specialists Make
Pitfall Number 1: Turning the Causation Arrow Around Pitfall Number 2: Pathological Doubt OCD—Misidentifying OCD Thoughts as Issues and the Seduction of Co-compulsions Pitfall Number 3: Intrusive Thoughts or Doubts about Sexual Orientation or Identity—Misdiagnosing OCD Thoughts as a Sexual Issue Pitfall Number 4: Get Your Feelings Out Pitfall Number 5: Mistakes in the Application of Exposure-based Treatment
12 Another View of Resistance: Issues that Interfere with Treatment
When People Come Back Without Doing Home Practice Anticipatory Anxiety: When People Need Help Getting over the Hump The Reassurance Junkie: When People Are Constant Callers
13 Some Hard to Treat Problems: A New Perspective
Illness Worries (Health Anxiety and Hypochondria) Scrupulosity (Religious and Secular) Emetophobia (Fear of Vomiting) Paruresis (Shy Bladder Syndrome)
14 Relapse Prevention
Anxiety Disorders Are Chronic Intermittent Disorders: They Come Back The Most Enduring Recovery Is When Symptoms Do Not Matter Search and Destroy: The Role of Subtle Avoidance The Role of Psychotherapy in Relapse Prevention The Proper Place for Stress Management Finally
Appendix 1 Additional Metaphors Appendix 2 A Summary of the Labeling Process That Can Be Given to Patients Appendix 3 How to Learn Diaphragmatic Breathing Appendix 4 Anxiety Diary Index
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