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Excerpted from When Panic Attacks by David Burns. Copyright © 2006 by David Burns. Excerpted by permission of Random House, Inc.  All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. HTML and web pages copyright © by SpiritSite.com.

"When you change the way you think, you can change the way you feel."

  David Burns, When Panic Attacks, Part 4

All four theories have their advocates. I believe that the first three theories are correct, and I use Cognitive Techniques, Exposure Techniques, and the Hidden Emotion Technique with every anxious person I treat. The Biological Model is much more controversial. Although I began my career as a full-time psychopharmacologist and treated all my patients with drugs, I strongly prefer the new, drug-free treatment methods for anxiety and depression. In my experience, they're far more effective, they work much faster, and they're also superior in the long run because you'll have the tools you need to overcome painful mood swings for the rest of your life.

However, it's not an either/or type of situation. If you and your doctor feel that medications are necessary, or if you strongly prefer to be treated with an antidepressant, you can use a combination of drugs plus psychotherapy. But for the millions of people who haven't been cured by pills, as well as those who strongly prefer to be treated without them, the development of these new, drug-free methods should be good news. Let's see how they work.

The Cognitive Model

The Cognitive Model is based on three simple ideas:

1. You feel the way you think.

2. When you're anxious, you're fooling yourself. Anxiety results from distorted, illogical thoughts. It's a mental con.

3. When you change the way you think, you can change the way you feel.

The French philosopher Descartes once said, "I think, therefore I am." The techniques in this book are based on a slightly different idea: "I think, therefore I fear." In other words, anxiety results from your thoughts, or cognitions.

For example, you're probably having thoughts about what you're reading at this very moment. You could be thinking "This is just another stupid self-help book. What a rip-off!" If so, you're probably feeling disappointed, frustrated, or even annoyed.

Or you might be thinking, "This book couldn't possibly help me. My problems are way too severe." If so, you're probably feeling discouraged and hopeless. Or you might be thinking "Hey, this looks interesting, and it makes sense. Maybe it could help me." If so, you're probably feeling excited and curious.

In each case, the situation is exactly the same. Every reader is reading the same thing. Your feelings about what you're reading will result entirely from the way you're thinking, not from the words on the page.

We constantly interpret what's happening, but we're not aware that we're doing this because it's automatic. The thoughts just flow across our minds, but they have the power to create strong positive and negative emotions.

Cognitive Therapy* is based on the idea that each type of thought, or cognition, creates a certain kind of feeling. Dr. Aaron Beck, from the University of Pennsylvania School of Medicine, has called this the Theory of Cognitive Specificity. For example, if you feel sad or depressed, you're probably telling yourself that you've lost someone you love or something important to your sense of self-esteem. If you feel guilty or ashamed, you're telling yourself that you're bad or that you've violated your own personal values. If you feel hopeless, you're telling yourself that things will never change. And if you feel angry, you're telling yourself that someone is treating you unfairly or trying to take advantage of you. You may also be telling yourself that the other person is a self-centered jerk.

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