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However because they can never really be sure that a

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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 worrying. 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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