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The Cycle of Anxiety

When a person avoids a feared situation—whether through physical avoidance, the use of drugs and alcohol, or otherwise—the uncomfortable symptoms of anxiety quickly fade away.

Unfortunately, the relief doesn't last long. And next time, the anxiety will be worse. The brain thinks: "Last time I avoided this situation, and that felt good." The desire to avoid a situation becomes increasingly difficult to resist.

Many anxiety treatments, such as CBT and exposure therapies, work by breaking the cycle of anxiety and avoidance. Clients are encouraged to face the source of their anxieties, which has the opposite outcome of avoiding them. When faced head-on, anxiety will eventually shrink, and the desire for avoidance diminishes.

The Cycle of Anxiety worksheet illustrates this concept with a diagram and simple explanations of each step. Use this tool to teach clients the basics of anxiety, the rationale behind exposure therapies, and the importance of overcoming avoidance.

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1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

2. Mkrtchian, A., Aylward, J., Dayan, P., Roiser, J. P., & Robinson, O. J. (2017). Modeling avoidance in mood and anxiety disorders using reinforcement learning. Biological psychiatry, 82(7), 532-539.

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