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Overcoming Anxiety with CBT: A Step-by-Step Guide

Writer's picture: Dr. Emma HormozDr. Emma Hormoz
“Do not anticipate trouble, or worry about what may never happen. Keep in the sunlight.” – Benjamin Franklin


Anxiety is one of the most common mental health challenges, but it often feels isolating and overwhelming. It might show up as a racing heart before a presentation, a constant worry that something bad will happen, or an urge to avoid situations that feel too stressful. Left unchecked, anxiety can affect your relationships, work, and overall well-being.


Cognitive Behaviour Therapy (CBT) offers an effective, evidence-based approach to managing anxiety. By breaking the cycle of anxious thoughts, feelings, and behaviours, CBT helps you regain control and face challenges with confidence. Let’s explore how you can use CBT techniques to overcome anxiety, one step at a time.


Step 1: Recognising the Anxiety Cycle

Anxiety often follows a predictable pattern:

Trigger: An event or situation sparks a sense of fear or discomfort.

Thought: Negative thoughts, such as “I can’t handle this,” amplify the fear.

Feelings: These thoughts lead to physical sensations like a racing heart or shallow breathing.

Behaviour: In response, you might avoid the trigger, reinforcing the anxiety.


For instance, Gemma, a teacher, found herself avoiding parent-teacher conferences because she thought, “They’ll criticise me.” This avoidance made her anxiety worse. CBT teaches you to break this cycle by addressing each component.


Step 2: Identifying Negative Thought Patterns

CBT starts by helping you uncover the thought patterns that fuel your anxiety. Common distortions include:

Catastrophising: Thinking the worst will happen (“I’ll fail, and it will ruin everything”).

All-or-Nothing Thinking: Seeing situations as black or white (“If I’m not perfect, I’ve failed”).

Mind Reading: Assuming you know what others think (“They must think I’m incompetent”).


By identifying these distortions, you gain awareness of how your thoughts shape your feelings and behaviours.


Step 3: Challenging Unhelpful Thoughts

Once you recognise these patterns, CBT encourages you to question their accuracy. Ask yourself:

“What evidence supports this thought?”

“What evidence contradicts it?”

“What’s a more balanced perspective?”


Gemma, for example, reframed her thought from “They’ll criticise me” to “Most parents appreciate my effort, even if they have feedback.”This reduced her anxiety and encouraged her to approach the meetings with confidence.


Step 4: Gradual Exposure to Triggers

Avoidance is a key driver of anxiety, but facing your fears gradually and systematically can help you build confidence. This is called exposure therapy, a core component of CBT. Start small and work your way up. For Gemma, this meant beginning with short, one-on-one chats with parents before building up to larger meetings. Each success reinforced her belief that she could handle these situations.


Step 5: Managing Physical Symptoms

Anxiety doesn’t just live in your mind—it affects your body too. CBT incorporates relaxation techniques to help you manage physical symptoms, such as:

Deep Breathing: Inhale deeply for four seconds, hold for four, and exhale for four.

Progressive Muscle Relaxation: Tense and release each muscle group, one at a time, to reduce tension.

Mindful Observation: Focus on your surroundings to ground yourself in the present.


These techniques calm your nervous system, making it easier to address anxious thoughts.


Step 6: Building a Personalised Plan

CBT is a highly adaptable therapy, and your therapist will work with you to create a tailored anxiety management plan. This might include keeping a thought journal, practising relaxation exercises, and scheduling regular exposure tasks. The goal is to equip you with a toolkit of strategies you can use whenever anxiety arises.


Think about Elizabeth Gilbert’s memoir Eat, Pray, Love. When faced with overwhelming anxiety and life changes, she didn’t avoid her fears—she explored them, gradually learning how to cope and grow. CBT mirrors this approach, empowering you to confront your anxieties and emerge stronger.


Mark’s Story

Mark, a graphic designer, constantly worried about making mistakes at work. He avoided taking on challenging projects, fearing failure, which limited his career growth. Through CBT, Mark identified his core belief: “I’m not good enough.” He challenged this thought by listing evidence of his successes and gradually took on projects outside his comfort zone. Over time, his confidence grew, and his anxiety decreased.


Practical Tips for Overcoming Anxiety with CBT

1. Track Your Triggers: Keep a diary of situations that cause anxiety, along with your thoughts and feelings.

2. Reframe Thoughts: When a negative thought arises, ask yourself, “What’s a more balanced perspective?”

3. Face Your Fears Gradually: Start with small challenges and work your way up.

4. Practice Relaxation Daily: Build deep breathing or mindfulness into your routine to stay grounded.

5. Celebrate Progress: Acknowledge each step forward, no matter how small.


Want to Learn More?

• Discover 10 actionable strategies in “10 Ways CBT Can Help You Manage Stress.”


Anxiety can feel overwhelming, but it doesn’t have to control your life. CBT offers a step-by-step approach to understanding and managing your anxiety, helping you break free from the cycle of fear and avoidance. If you’re ready to overcome anxiety and build a more confident, balanced life, contact Arcadian Clinic today to start your journey.

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