Beating Relapse to the Punch

How to Preempt Anxiety Relapse

Rich Simon


After months of working through his anxiety and depression, Eric leaves therapy on a euphoric note. Overcoming his crippling symptoms has allowed him greater freedom to explore new interests, establish relationships, and just plain feel good. But after only three weeks of experiencing life beyond anxiety, all of his old panic and worry come rushing back to him. “That recovery was just a fluke,” he tells himself. “The therapy didn’t work.”

This hypothetical scenario is one Feeling Good author and cognitive behaviorist David Burns works hard to avoid. Before he wraps up therapy with recovered clients, he makes sure they’re well prepared for relapse. In this brief video clip, he breaks down the components of his Relapse Prevention Training, which includes 1) letting clients know that the techniques they’ve learned in therapy will work for life, 2) assuring them that they will relapse, and 3) role playing as the voice of relapse so that clients can practice defeating their negative self-talk before it happens.

David calls the role playing portion of Relapse Prevention Training the “externalization of voices” technique. He voices the typical thoughts that occur after a relapse of symptoms, such as, “I was fooling myself. I’m hopeless after all.” He then has his clients talk back to and conquer them. That way, instead of leaving therapy under the delusion that they’ll never have to do battle with their negative thoughts again, clients learn just what to say to the part of the mind that wants to cave in during relapse.

This is just one of the many cognitive behavioral techniques in David’s arsenal. In his session from the Networker Webcast series Treating Anxiety, David shares more powerful methods for changing the negative thought patterns that fuel anxiety.

Treating Anxiety
A Toolkit for Your Practice

Click here for full course details

Topic: Anxiety/Depression

Tags: anxiety and depression | cognitive behavioral | David Burns | depression | relapse prevention | relationships | therapy | treating anxiety

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3 Comments

Thursday, June 19, 2014 3:25:41 PM | posted by jodyg
my one main objection to this clip is the notion of the placebo effect.Yes relapse is possible and often likely but how about empowering the client to manage their own symptoms of anxiety by teaching them the effective techniques of using meridian tapping like EFT emotional freedom techniques.Much time and clients money is needed with these approaches described above. There are (relatively) new and very effective interventions now that reduce the stress response and can induce a state of relaxation within 10 min.

Thursday, June 19, 2014 2:55:37 PM | posted by Jim McKinley-Oakes
I have no doubt that this technique can silence the voices of doubt, fear, sadness, and shame-temporarily. I doubt that it does much to heal or help with somatic symptoms. I believe that a more healing approach would to view these voices as vulnerable parts to be healed with listening, respect, compassion, and guidance.

Thursday, June 19, 2014 2:37:34 PM | posted by Pam Sleeper
I think the CBT folks should give credit to Michael White for externalizing the symptom. On occasion they do, but typically they have amnesia for the fact.