When living with intense anxiety and panic, you may not know where to turn. Many people experience a feeling of being overwhelmed, wondering what to try and how to proceed. “What kind of therapy helps? Do I need medication?” As an anxiety counselor in Woodland Hills, I know that people are always seeking answers and options when it comes to addressing their anxiety. They want to feel understood, feel safe, feel better. While one shoe won’t fit all, one highly effective approach involves blending two powerful therapeutic models: Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT).

Why Blend CBT and DBT for Anxiety?

CBT and DBT are evidence-based therapies that offer different, yet complementary, tools for anxiety. While CBT helps you identify and challenge distorted thoughts, DBT helps you accept your emotions and stay grounded, even in the face of distress. When used together, they provide a more well-rounded toolkit for managing anxiety both logically and emotionally. Anxiety can manifest in many ways; it can be related to what is occurring in front of you, or it can arise seemingly out of nowhere. Because there is only so much we can control in life, being able to use different approaches in dealing with anxiety allows us to cover our bases more thoroughly, increasing the chances of improved symptoms.

How CBT Helps with Anxiety:

• Identifies anxious thinking patterns (“What if…?”, catastrophizing, black-and-white thinking).
• Challenges irrational beliefs with evidence and logic.
• Helps to identify unhelpful behaviors that are related to thought patterns.
• Replaces past behaviors with those more in line with goals and ideals.
• Builds problem-solving skills to reduce avoidance and increase confidence.

How DBT Helps with Anxiety:

• Teaches mindfulness, allowing us to stay present instead of spiraling into “what-if” thoughts.
• Offers distress tolerance tools to manage panic symptoms in the moment.
• Encourages radical acceptance of what you can’t control, reducing inner resistance.
• Increases confidence in approaching and handling challenges, rather than participating in avoidance of certain scenarios, emotions, or thoughts.
• Reduces the strain of triggers and anxiety by allowing us to make positive interventions earlier in an incident.

2 Tools That Blend CBT and DBT for Anxiety Relief

1 – Learn to identify your thoughts and emotions:

Those who see us for anxiety therapy in Woodland Hills find that CBT and DBT force them to confront what they truly feel and the exact nature of their circumstances. The good thing is that these treatment methods also provide the tools to deal with these thoughts and emotions head-on.

• CBT gets honest about what is really going on. One of the core features of CBT is to guide you in asking yourself, “What’s the thought behind this anxiety? Is it true? Helpful?” In the past, you might have experienced anxiety and assigned a cause of it, whether what you were thinking was based in reality or not. From there, you might have made a choice, or followed a series of actions, that were in response to your worry as opposed to being in response to you actual situation. This pattern not only fails to alleviate the actual source of anxiety, it can also lead to decisions further and further outside your goals and character. When there is an actual problem to solve and a solution to be found, CBT can help you to identify what is wrong, what story you are telling yourself that aligns with what you are feeling, and how to identify the behavioral response that isn’t serving you.
• DBT helps you accept and weather what you cannot control. As you identify your thoughts and inner dialogue, DBT tools will give you the power to observe them non-judgmentally, e.g. “How do I feel about this—and can I name that emotion without judgment?” Sometimes, we feel a generalized anxiety that we cannot quite determine the source of – in these times, there is a lot of concern to be had about many different issues, and that can weigh on us. Other times, we can identify what the issue is but we cannot change the circumstance. Being able to identify what is causing the anxiety allows us to know whether or not there are practical steps to be taken in alleviating it. Having the ability to properly identify a thought or emotion allows us to recognize when we need to practice DBT in order to go through the feeling until our anxiety lessens.
• Practicing identification improves your skills at recognizing the issue and approaching it in the way that is most appropriate. This tactic helps create space between the thought and the reaction, so you can respond, not just react. Knowing that you have the skills and abilities to determine how best to tackle a variety of situations can help you to increase your inner peace. Both CBT and DBT rely on your being able to identify your thoughts and feelings. When you are able to determine what is going on, you can utilize whichever modality is best for you at that time.

2 – Reframe Your Thoughts and Use Opposite Actions:

We hear a lot in our Woodland Hills anxiety therapy sessions that people get stuck in patterns of thinking that aren’t benefiting them but that they can’t see a way out of. The solution is not to lie to yourself or gaslight yourself, but to find ways to confront what is going on in a beneficial manner.

• You can be honest with yourself while still encouraging yourself. CBT technique focuses on reframing a negative thought like, “I can’t handle this,” to “I’ve gotten through hard things before.” Notice how there is no denial of the struggle or pain in telling yourself you’ve gotten through hard things before; it simply redirects what you are telling yourself. When you are able to talk to yourself about what is happening without your thoughts running away with you, you are then able to address what is going on thoughtfully. You may take note of some thoughts that are persistent, and recognize that you struggle to rewrite these narratives. This is where it is important to bring those thoughts to light in a neutral time and safe space. It may turn out that there is some work to be done on healing old wounds connected to these stories. Some thoughts will be easier to reframe than others, but that doesn’t mean that you can’t make progress, or that CBT won’t work for you.
• There will be some things you cannot control through CBT. Not all situations can be managed through self-awareness and modified behaviors. There will always be a relative amount of stress tolerance required when navigating life, and especially life with anxiety. No matter how well you plan, there can always be traffic. No matter how much you adjust your responses to various triggers, that can always be a surprise. CBT can help you to identify misinformation in your thoughts and choose helpful reactions. The DBT technique helps you confront what is real and inevitable. You can use DBT to change your behaviors by utilizing the opposite action—doing the thing you’re avoiding (like going to the event or making the call), even with the anxiety present. Where your instinct might be to avoid, you instead tolerate the discomfort of what you are doing by grounding yourself and accepting your circumstance for the time being. DBT helps you to not only identify your emotion, but be aware of what your instinctual response to that feeling is. From there, you choose to do the opposite. Staying instead of running, leaving instead of freezing, calling instead of avoiding, and so on.
• Be adaptable when utilizing both modalities. Sometimes CBT will be more helpful, and sometimes DBT will be; let them work together in whatever proportion is most helpful. Allow yourself time and space to practice, and recognize that various situations will lead to different needs when it comes to your management. Check in with your therapist if you find that you struggle with some patterns, or you’re having trouble changing from CBT to DBT or vice versa. During in-person and/or online anxiety therapy sessions, you may find that having a sounding board will help you to identify what is working well about combining CBT and DBT, and where you could use some adjustment.

Key Takeaways

• Many people struggle with anxiety, and aren’t sure how to address their feelings.
• Avoiding (or trying to avoid) your anxiety won’t help you feel better in the long run; it is through addressing anxious thoughts and feelings and being proactive that you can improve your anxiety symptoms.
• CBT and DBT work beautifully together to treat chronic anxiety and panic.
• CBT targets anxious thoughts, while DBT offers tools for emotional acceptance and regulation.
• A mental health professional can help guide and support your therapy process; anxiety therapy utilizes research-based tools to improve your quality of life.
• You don’t have to choose between changing your thoughts and accepting your feelings—you can do both.

Anxiety Therapy at Embracing You Therapy

Do you find yourself caught in constant worry or feeling overwhelmed by stress? Is maintaining work-life balance, navigating life transitions, or setting healthy boundaries a struggle?

Through Anxiety Therapy in Woodland Hills, CA, you’ll learn practical CBT and mindfulness techniques to regulate your emotions, shift unhelpful thought patterns, and build healthier behaviors that support your well-being. Contact us today for your complimentary 20-minute phone consultation with our Admin Team today!