A generalised anxiety disorder (GAD) therapist works with clients to address excessive worry and anxiety that are characteristic of GAD. GAD is marked by constant tension, unease, and fear, impacting daily life. Unlike other anxiety disorders with specific triggers, GAD involves persistent anxiety across various issues and problems. These distinctions influence how a GAD therapist supports their clients.
What is Generalised Anxiety Disorder (GAD)?
- Definition: GAD involves excessive anxiety and worry about numerous events or activities, occurring more days than not for at least six months. The worry is challenging to control and is “clearly excessive”.
- Symptoms: Key symptoms include restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance.
- Impact: GAD can cause clinically significant distress or impaired functioning, making it difficult to hold a job or even leave the house in severe cases.
How GAD Differs from Other Anxiety Disorders
- Specificity of Triggers: Other anxiety disorders often relate to specific concerns, whereas GAD involves anxiety across a host of different issues.
- Constant Background Anxiety: People with panic disorder or agoraphobia may experience constant background anxiety, but GAD is characterised by this persistent state of anxiety in the absence of specific triggers.
- Reaction to Anxiety: The defining characteristic of GAD is the reaction to the anxiety itself, involving constant introspection, examination, and fighting against the anxious state.
Role of a GAD Therapist and Impact of Distinctions
- Addressing Core Processes: A GAD therapist focuses on the processes that turn normal anxiety into life-altering problems. They target experiential avoidance, where individuals attempt to control unwanted private experiences.
- Fostering Acceptance: Instead of symptom alleviation, therapy emphasises acceptance, mindfulness, values, and quality of life. Clients learn to accept anxious thoughts and feelings rather than trying to control them.
- Values-Based Action: Therapists encourage clients to identify their values and commit to actions aligned with those values, despite anxiety. The focus shifts from anxiety reduction to living a valued life.
- Managing Avoidance: The GAD therapist helps the client recognise avoidance patterns designed to prevent anxious thoughts and feelings. The therapist looks at how these actions are not allowing the client to live in accordance with what they truly care about.
- Techniques used by a GAD Therapist:
- Mindfulness and Defusion: Mindfulness techniques help clients observe thoughts and feelings without judgment. Defusion techniques help clients reframe statements and observe experiences with curiosity and compassion.
- FEEL Exercises: The GAD therapist may lead the client in guided FEEL exercises where they direct the client’s attention to bodily sensations, acknowledge discomfort, stay with it, breathe with it, accept the discomfort, and open up to it.
- Addressing Barriers: GAD therapists help clients address external barriers, such as lack of time or money, and internal barriers, such as anxiety-related thoughts and feelings.
A GAD therapist supports clients by addressing the core processes that perpetuate GAD, such as experiential avoidance and maladaptive reactions to anxiety. They use techniques to promote acceptance, mindfulness, and values-based action, helping clients to live meaningful lives despite their anxiety. Given the pervasive nature of GAD, the treatment focuses on undermining the dominance of solutions that sound reasonable, while revealing how former solutions are, in fact, problems themselves. Unlike therapies targeting specific anxiety triggers, a GAD therapist focuses on a client’s overall relationship with anxiety and their ability to pursue valued life goals.
Tags: Generalised Anxiety Disorder, GAD, Anxiety Therapist, Acceptance and Commitment Therapy, ACT, Mindfulness, Experiential Avoidance, Values-Based Action