by ADAA Board Member Ken Goodman, LCSW

You’re getting ready for a peaceful night sleep when you see something moving on the floor next to your bed. A spider! You yell for your braver-half to kill it. Your hero jumps into action. The shoe slams down on the hardwood. Thank goodness! Then you see the spider scurry under the bed.

“NOOO! I can’t sleep in here tonight.”

Your poor aiming hero tries to convince you that it’s a small spider who is more afraid of you. But you don’t see it that way.

“What if he crawls on me when I’m sleeping?”

Your partner thinks you’re overreacting and climbs under the covers. “Come on. It’s just a little spider.”

You’re horrified! “Aren’t you afraid it’s gonna bite you?”


You point to your mouth. “It could crawl into your mouth when you’re asleep.”

With a roll of the eyes, your knight in shining armor turns in for the night… while you sleep on the couch in the living room.

Why is it that two people can experience the same situation, but react so differently?
Their perception! Anxiety is based on a perception of danger. By avoiding what we fear, we protect ourselves from danger or what we perceive to be dangerous. Anxiety is a protective mechanism meant to keep us safe. But when anxiety interferes with our life, impacting enjoyment and functioning, it has risen to the level of a disorder. This occurs when our perception of danger is distorted.

Perception is distorted as it feels like the spider is huge. Distress becomes intolerable as you dwell on the thought of it lurking under your bed. Possibility and probability are confused as it seems likely to crawl into your mouth. And danger is amplified as the spider is likely to be deadly.

It’s difficult to remain calm when your imagination is running wild with possibilities.
Even if you know your thoughts are irrational you may be unable to control them, which is one reason why people who suffer with anxiety feel like they are crazy. The frightening thoughts often result in physical symptoms like racing heart, sweating, difficulty breathing, sleeplessness, stomach issues, and lightheadedness; just to name a few. Seemingly, the choice is to endure symptoms or avoid the situation altogether. Thankfully there is a third option. This is where treatment comes in.

What is the most effective treatment for anxiety?
The gold standard for the treatment of anxiety is Cognitive Behavioral Therapy (CBT). This therapeutic modality has been empirically validated with research as the most effective treatment for all types of anxiety disorders. CBT is a therapy model that focuses on our cognition, the way we think, and our behaviors, the way we act. Our thoughts about a situation (a huge deadly spider) effect how we feel (afraid) and how we behave (avoid the bed). We tend to assign meanings to specific situations and the things that happen in our lives.

Most often it’s not the actual situation causing our anxiety, but the meanings we attribute; accurate or not. In our example, meanings have been assigned to spiders. It isn’t the spider causing anxiety; it’s the meaning assigned to the spider. When you suffer with an anxiety disorder, thoughts are given a lot of meaning, are taken very seriously, are repeated in the mind, and therefore have a lot of power.

Cognitive Behavioral therapists provide tools and techniques to gain control of thoughts and reduce symptoms.

By changing irrational thought patterns and confronting fears, patients learn to step beyond their comfort zone to attain the freedom they desire. CBT therapists give homework and insist on out of session practice. Similar to acquiring any new skill (typing, speaking a language) practicing therapeutic tools helps the sufferer rewire their brain. By learning a certain mindset, anxious situations are approached differently as you learn to tolerate uncertainty and distress. What was once uncomfortable becomes comfortable with repeated practice.

With the tools and techniques learned in Cognitive Behavioral Therapy, people can learn to escape the web of anxiety so the next time a spider crawls on the bedroom floor, there won’t be a need to call your hero. You will be able to calmly handle the situation yourself… hopefully with better accuracy.

About the Author

ADAA_Ken-Goodman-websize-1.jpgADAA Board Member Ken Goodman, LCSW, treats anxiety and OCD in Los Angeles.  He is the author of The Anxiety Solution Series, a step-by-step audio program, and Break Free from Anxiety, a coloring, self-help book for anxiety sufferers. Ken Goodman is an ADAA Clinical Fellow.

Ken is the producer of The Anxiety Solution Series: Your Guide to Overcoming Panic, Worry, Compulsions and Fear, a step-by-step self-help audio program. Visit Ken's website.