Question
What is the underlying mechanism that connects the various anxiety disorders?
Answer
Anxiety disorders, though diverse in presentation—from panic disorder and phobias to PTSD and OCD—are unified by a shared mechanism: dysregulation within the nervous system in response to perceived threats. This dysregulation often stems from how the brain interprets and reacts to both internal and external stimuli. The ABC model provides a foundational framework for understanding this process. It starts with an "alarm" (A), which can be any triggering stimulus. This is followed by a "belief" (B), the interpretation the individual attaches to the stimulus (e.g., danger or threat), and concludes with a "coping behavior" (C), which is typically automatic and reactive.
This model highlights that while we may not have control over the initial trigger, especially when it's internal like intrusive thoughts, significant therapeutic leverage exists at the belief and behavior levels. By helping clients reframe their interpretations and adopt adaptive coping responses, clinicians can intervene effectively in the anxiety cycle. Additionally, understanding the brain’s role—particularly the interplay between the amygdala and prefrontal cortex—reinforces why anxiety can feel overwhelming. The amygdala triggers fast, fear-based reactions, often bypassing rational assessment. Strengthening the connection to the prefrontal cortex through therapeutic strategies allows clients to move from reactivity to regulation, regaining a sense of safety and control.
This Ask the Expert is an edited excerpt from the course, From Overwhelm To Ease: OT Strategies For Anxiety Management, presented by Zara Dureno, MOT.
