Psychoeducation is done during the first group therapy session and consists of explaining the patterns of anxiety for patients who are phobic, have OCD, or have generalized anxiety disorders. The models help explain the causes and mechanisms of anxiety, the goal is to get patients to understand what is going on in their brains. Ignorance leads to fear. In group therapy, it is important to establish a dialogue with your patients and to set up an exchange, giving patients the opportunity to participate as often as possible.
In this article, we will look at Gray’s neurobiological model and its implication in anxiety, phobias and OCDs.
The first step: The situation
According to Gray’s model the first step is the situation. This is the time for the first question to be asked of patients: “Give me a situation that scares you?” (patient answers).
When you are in this situation … (stated by candidates) that you consider threatening, you make a primary assessment of the danger present in the situation. Continue the dialogue:”When you are faced with dangers… (listed according to the fears stated) what do you pay attention to ?” Patients will pay attention to the elements present in the situation, generally related to the danger. For example, the ventilation grids in the elevator for patients suffering from claustrophobia, the expression of the hostess and the exits for aviophobes etc..
This primary evaluation is possible thanks to a functional entity of the brain: BIS (Behavioral Inhibition Systeme) It is this system in the brain that will provoke anxiety, an increase in vigilance, and it is this entity that will provoke a secretion of adrenalin at the level of the suprarenal medulos, these are glands situated above the kidneys. This adrenaline will cause symptoms, make them talk about their symptoms:” What are your symptoms ? ”(patients answers) everything you described to me: increased sweating, heart rate, muscle tone etc… this is what causes the adrenaline.
The realization of the FFS action
Once the situation has been assessed, according to Gray’s model, the patient carries out an action called Fight or Fly System (FFS). He will have two choices: either he fights and stays in the situation, or he will choose flight to avoid the situation. New question to ask: “What do you do?” (patients answers).
Most of them usually avoid the situation. Some may say that they have confronted the situation, but forcing themselves to do so is not helpful in therapy because it will reinforce the conditioning and cause bad memories.
Anxiety exists in all people and all mammals and is the result of millions of years of evolution. : “What do you think anxiety is for?” (patients answers)
Anxiety was created by evolution to protect itself, it is a mechanism of protection of the individual. Anxiety was present in human beings 20 000 or 30 000 years ago. New question: ”Where your ancestors lived ?” (patients answers) Our ancestors lived in hostile environments, to survive they needed a system that allowed them to react quickly to dangers and this system is anxiety. It is thanks to anxiety that our species has been able to live until now. Anxiety serves to protect us. Take the symptoms your patients mentioned earlier, for example, if the symptoms are increased heart rate:“ Why does your heart beat fast?” (patients answers)
The heart speeds up to bring more oxygen and sugar into the body because it needs it, if we take the survival model of the ancestors, the increase in heart rate served in case of a fight with a bear to give the body superhuman energy. The symptoms caused by anxiety are therefore preparations for action.
An example on anxiety
New question : “Give me an example in which anxiety saved a life?” (patients answers) Angela Cavalo is an American who lived in the 80s. She saved her son’s life by lifting a Chevrolet Impala. Her son was repairing it, had set up trestles allowing him to be under the car. The trestles gave way and began crushing her son. Angela realized the situation, did her primary assessment, her heart beat very fast, she started to sweat. Angela lifted the car and saved her son. Anxiety gave her superhuman strength that saved her son.
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Découvrez Beck’s cognitive model, and the Barlow’s cognitive model