Can psychological counseling treat anxiety disorders?

For anxiety disorders that meet clinical diagnostic standards, standardized psychological counseling is one of the core treatments. However, there is no unified answer to whether it can achieve the "cure" effect that everyone expects. It must be comprehensively judged based on factors such as the severity of the disease, the timing of intervention, personal cooperation, and the appropriate counseling school.

Among the hundreds of anxiety cases I have had clinical contact with, there is a 28-year-old Internet operator girl who impressed me deeply. She was diagnosed with generalized anxiety disorder six months ago. Her heartbeat was pounding and she broke out in cold sweats while sitting at her desk. When it was her turn to report, her mind went blank. At first, she also felt that psychological counseling was just "chatting" and was useless, so the psychiatrist prescribed a small dose of anti-anxiety medication. She was given medication and was referred for cognitive behavioral therapy (CBT). She was very cooperative and completed every homework assignment carefully. After almost 12 consultations, her anxiety self-rating scale score dropped to the normal range. Now she occasionally feels a little flustered when she stays up all night to work on a big project. She can calm down in ten minutes by adjusting the abdominal breathing she learned during the consultation, and she no longer needs regular follow-up consultations.

At present, clinical prevention and treatment guidelines for anxiety disorders at home and abroad clearly state that for mild to moderate anxiety disorders, individual psychological counseling intervention is preferred. Commonly used cognitive behavioral therapy and acceptance and commitment therapy (ACT) are supported by a large amount of evidence-based data. The long-term prognosis is even better than medication alone, and the recurrence rate is lower.

But this definitely does not mean that psychological counseling is useful for all anxiety disorders, and don’t deify it casually. For example, during a severe anxiety attack, the patient has already experienced severe physical reactions, such as insomnia for one or two consecutive weeks, panic attacks two or three times a week, and even difficulty going out. At this time, the patient does not take medication and only consults, which will delay the condition. Clinically, it is generally recommended to take anti-anxiety drugs for a period of time to suppress the acute symptoms, and then cooperate with psychological consultation to adjust cognitive and behavioral patterns, so that the effect will be better.

Nowadays, many people on the Internet say that psychological counseling is completely an IQ tax. To be honest, many times it is because of irregular traps. I once met an older brother who had been diagnosed with panic disorder for three years. When he first came here, he had the expectation that "one consultation would completely eradicate it." He couldn't listen when I told him about the setting up of the consultation and the approximate course of treatment. After three attempts, he still felt flustered occasionally, so he stopped right away. He turned around and bought an online audio course that said "7 days to cure anxiety." He spent tens of thousands of dollars, but the frequency of attacks increased from once every half month to twice a week. There are also many people who are simply looking for unqualified "emotional mentors" and "life mentors". They talk about nothing but nonsense. Not only is it ineffective, but it also consumes everyone's trust in formal consultation.

In fact, the treatment of anxiety disorder is a bit like tuning an old radio with a problem. The medicine is to temporarily eliminate the crackling noise so that you can hear the normal sound clearly, while the psychological consultation is to help you find the cause of the frequency deviation and slowly adjust the knob to the correct position. No one is better than the other, the only difference is that the adaptation is inappropriate.

There is no need to be too strict about the standard of "cure". Anxiety itself is a normal emotional reaction of human beings. Even if the symptoms completely disappear after intervention, when subsequent major stress events such as the death of a loved one or unemployment are encountered, mood swings may reappear, just like catching a cold after a cold. At this time, you can find a counselor for adjustment in time to avoid developing a serious disorder. In fact, the intervention effect is very good.