The Anxiety and Phobia Workbook, Edmund Bourne, New Harbinger Publications.

I just love this book. I have to do a book review on it because I recommend, in fact direct, every client who enters into treatment with me for anxiety disorders to purchase this book. The main reason is that it takes a holistic approach to treatment and pretty much follows the same framework that I use in therapy. If a client uses the book for information and does the exercises as homework, I find the therapy process is shortened because I don’t have to go over all of this within the therapy sessions.

The book is in its 4th printing and has sold over 600,000 copies. The first edition was published in l994. The issuing of 4 editions in 10 years is an attempt to keep current with the developing field of Anxiety Treatment. The recent edition talks about new discoveries in brain chemistry and chromosomal differences. In addition, there have been changes in nutritional information, new medications, such as Lexipro and Gabitril (and the phasing out of Serzone).

Bourne has refined and updated throughout the book, but also has added two completely new chapters. Chapter 16, Health Conditions that May Contribute to Anxiety, lists adrenal exhaustion, thyroid imbalance, candidiasis, body toxicity, PMS, menopause, Seasonal Affective Disorder. The other new Chapter 18 introduces Meditation.

It’s not that Bourne has come up with anything new in psychological treatment. He talks about what anxiety is, what are the types, and major causes of anxiety, and the cognitive behavioral treatment, including self talk, relaxation, exposure, mistaken beliefs, and self esteem. What I like about the book is that he doesn’t stop there. He draws from other fields to take a holistic approach. He considers medical factors, exercise, nutrition, meditation, and spiritual issues. This book is a one-stop treatment source.

It is 432 pages long and is filled with questionnaires, assessments, exercises, and focus questions. At the end of each chapter are further readings and he also lists resources in the back of the book.

The book is broken down into 19 Chapters:

1) Anxiety Disorders
2) Major Causes of Anxiety Disorders
3) Recovery: A Comprehensive Approach
4) Relaxation
5) Physical Exercise
6) Coping with Panic Attacks
7) Help for Phobias: Exposure
8) Self-Talk
9) Mistaken Beliefs
10) Personality Styles that Perpetuate Anxiety
11) Visualization
12) Expressing Your Feelings
13) Asserting Yourself
14) Self Esteem
15) Nutrition
16) Health Conditions that May Contribute to Anxiety
17) Medications for Anxiety
18) Meditation
19) Personal Meaning.

In Chapter 3, Recovery, Bourne provides weekly goals and weekly practice record forms to record progress in all areas. His exercises are generously scattered throughout. For example, in Chapter 6, Coping with Panic Attacks, he has a Panic Attack Worksheet for both Bodily Symptoms and Catastrophic Thoughts. In Chapter 7 on Phobias he outlines Exposure Therapy and gives forms to help with that. The chapter on Self Talk is as good as I’ve seen, and I do this type of work daily. He helps the reader identify if they are The Worrier (promotes anxiety); The Victim (promotes depression);or The Perfectionist.

Chapter 9, Mistaken Beliefs, is also part of cognitive therapy. He provides questionnaires that help the reader identify which of these beliefs has governed his/her life:

“My worth depends on what I accomplish.”
“I am powerless, have little or no control over outside circumstances, or am unable to do much that could help my situation.”
“I can’t trust, rely on, or receive help from others.”
“My self worth is dependent on others’ approval.”
“My self worth is dependent on the love of someone else.”
“I have to be perfect in some or many areas of my life.”

Chapter 10 talks about Personality Styles: Perfectionism, Excessive Need for Approval; Tendency to Ignore Physical and Psychological Signs of Stress; Excessive Need for Control. These personality characteristics tend to set one up to develop an anxiety disorder.

In Chapter 12, Bourne talks about learning to express your feelings, a basic tenet for emotional health. Assertiveness is talked about in Chapter 13 with exercises that help you identify your style of dealing with people. He also presents situations that allow the reader to practice assertive responses, presents the Personal Bill of Rights, and gives sample scenarios for identifying the assertive approach to life problems. It is just good basic assertiveness training.

Bourne uses Maslow’s Hierarchy of Needs to talk about Self Esteem in Chapter 14. He discusses the “Inner Child” and has a guided visualization for healing the inner child. He presents affirmations, a personal wellness questionnaire, and personal goals and accomplishments.

His Chapter on Nutrition reflects some of the new thinking about eating and healthy diet. One of two new chapters, Health Conditions is essential to a holistic approach. The other, Meditation, incorporates principles of eastern philosophy and yoga. Chapter 17, Medications, talks about psychotropic medications as well as natural remedies. The book concludes with a section on personal meaning, the spiritual part of the human experience.

Bourne provides the reader an opportunity to delve further into a particular interest by listing additional readings. As far as a practical, useful, holistic workbook for dealing with anxiety disorders, I can’t think of a better book to recommend than The Anxiety and Phobia Workbook by Edmund Bourne.

Anxiety Disorders

Post Traumatic Stress Disorder

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