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Unformatted text preview: f sometimes unbearable uncertainty—is, according to this
theory, how people with generalized anxiety disorder feel all the time.
According to this theory, people with generalized anxiety disorder keep
worrying and worrying in efforts to find “correct” solutions for their various
problems and to restore certainty to their situations. However, because they can
never really be sure that a given solution is a correct one, they are always left
to grapple with intolerable levels of uncertainty, triggering new rounds of worrying and new efforts to find correct solutions. Like the metacognitive theory
of worry, considerable research supports this theory. Studies have found, for
example, that people with generalized anxiety disorder display greater levels of
intolerance of uncertainty than people with normal degrees of anxiety (Dugas
et al., 2009, 2005, 2002).
Finally, a third new explanation for generalized anxiety disorder, the avoidance
theory, developed by researcher Thomas Borkovec, suggests that people with this
disorder have greater bodily arousal (higher heart rate, perspiration, respiration)
than other people and that worrying actually serves to reduce this arousal, perhaps
by distracting the individuals from their unpleasant physical feelings. In short,
the avoidance theory holds that people with generalized anxiety disorder worry
repeatedly in order to reduce or avoid uncomfortable states of bodily arousal.
When, for example, they find themselves in an uncomfortable job situation or
social relationship, they implicitly choose to intellectualize (that is, worry about)
losing their job or losing their friend rather than having to stew in a state of
intense negative arousal. The worrying serves as a quick, though ultimately maladaptive,
way of coping with unpleasant bodily states.
Borkovec’s explanation has also been supported by numerous studies. Research
reveals that people with generalized anxiety disorder experience particularly fast and
intense bodily reactions, find such reactions overwhelming and unpleasant, worry
more than other people upon becoming aroused, and successfully reduce their arousal
whenever they worry (Mennin et al., 2005, 2004, 2002; Roemer et al., 2005; Turk
et al., 2005). Cognitive Therapies Two kinds of cognitive approaches are used in cases of generalized anxiety disorder. In one, based on the pioneering work of Ellis and Beck, therapists help clients change the maladaptive assumptions that characterize their disorder. In
the other, new-wave cognitive therapists help clients to understand the special role that
worrying may play in their disorder and to change their views about and reactions to
CHANGING MALADAPTIVE ASSUMPTIONS In Ellis’s technique of rational-emotive therapy,
therapists point out the irrational assumptions held by clients, suggest more appropriate
assumptions, and assign homework that gives the individuals practice at challenging
old assumptions and applying new ones (Ellis, 2008, 2005, 2002). Studies suggest that
this approach and similar cognitive approaches bring at least modest relief to persons
suffering from generalized anxiety (Ellis, 2008, 2005; Tafet et al., 2005). Ellis’s approach
is illustrated in the following discussion...
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