Steps of Cognitive Behavioral Therapy for Anxiety: Page 2

This is another example illustrating the basic steps of Cognitive Behavioral Therapy for Anxiety.

Step 1: Locate your Thoughts

Someone having a panic attack might experience the following thoughts:

“Oh my God, my heart is beating so fast. I’m going to die”

“I feel so nervous it’s hard to concentrate what will everyone think of me?”

“I can’t seem to stop my racing thoughts.  I’m going to go crazy!”

Step #2: Identify the Distortions

What distortion(s) are present?

“Jumping to conclusions” and probably “disqualifying the positive” are present.


To begin, jumping to conclusions refers to the tendency to make negative predictions even when there is no real evidence to support them. You have likely had your heart beat quickly before and you’re still here. In this instance making the prediction that you are going to die is clearly predicting the future.

I also mentioned that “disqualifying the positive” was likely present.  “Disqualifying the positive” refers to the tendency to forget all of the positive outcomes in your life and focus only on the negative.

In this example forgetting about all the times in the past when your heart beat quickly and you did not die. For example, when you exercise your heart beats quickly. Or perhaps you become very excited about something.  These things did not lead to a heart attack.

Step #3: Substituting Healthier Thoughts

Now that the distortions have been identified, the next step is to substitute healthier thoughts.

For example, here are some healthier thoughts…

Your hearts have beaten quickly and perhaps many times before and you did not die.

You might think about doing little personal research on your own to discover that a frequently shared experience between sufferers of panic attacks is the feeling (fear) of having a heart attack even though they were fine.

Step #4: Regular Practice

You should continue to work on your thoughts each day.  By restructuring your thoughts over time you can feel much better.

So you can probably appreciate that cognitive behavioral therapy for anxiety is highly recommended. In fact, researchers who comprehensively reviewed the relevant literature found that cognitive behavioral therapy for anxiety is the gold standard of treatment.