Anxiety is one of the most frequent pathologies among the adult population. We live in a society marked by haste, great demands and little time for rest and reflection.

All this is a breeding ground for psychological disorders such as stress or anxiety, which means that the affected person lives in a permanent state of alertness, worry and uneasiness.

Interview with psychologist Tomás Santa Cecilia

With the aim of exploring in depth the causes and possible treatments of anxiety, we have talked to Tomás Santa Cecilia, a psychologist from Madrid with a very distinguished career who has effectively treated hundreds of clinical cases.

We have not missed the opportunity to learn more about what anxiety is and how we can manage and treat it.

Bertrand Regader: What are the main reasons why people with anxiety problems go to the psychologist?

Tomás Santa Cecilia: If we consider anxiety as a natural emotional reaction when a person finds himself in a certain situation that constitutes a risk or a demand of the environment, then we can assure that anxiety becomes a state that affects his well-being, understanding emotional well-being with a state of calm and tranquility, which is what we all aspire to.

When it comes to a demand from the environment, the anxiety remains until we find a way to solve such a demand; for example: to finish a committed task, to execute a work that is entrusted to us urgently…

In other cases, anxiety occurs when we live in a situation of uncertainty, of doubts about what can happen, without it being up to us what to do. A good example is the anxiety that is activated before a lottery draw or what bingo or other betting players feel.

This emotional state of uncertainty can be paralyzing for many people. For others, however, it can be challenging, and this is one of the most important differences. For this reason, it is important to determine when the demands of the environment, our thoughts, desires, tastes or expectations are an obstacle to progress in the work, family, social or personal environment. It is in this moment where we can count on a Professional of Psychology.

It is often assumed that anxiety always comes from outside the subject, from the environment. In what ways do we tend to feed anxiety through our actions and thoughts?

As I mentioned earlier, if we take into account that anxiety is defined as a feeling, an emotion, and this depends largely on how we interpret the environment and how we think about the situation we are living, then we can say that it is extremely important to know how to interpret our relationship with the environment in a healthy way.

The healthy way to do this is established by our value system, our beliefs, and ultimately our learning history.

In your opinion, does one tend to assume that anxiety burnout over long periods of time is normal? Is there a lack of awareness that it’s a real problem that deserves to be treated?

Without a doubt, we are living in a rather complicated social moment, we are carrying out exhausting work rhythms. Once we’re done at work, we get in the car and, uh, get stuck. Then we go to the supermarket, then we get home and we have to start with family commitments: homework, dinner, baths, etc.

And it is at the end of the night or in the early hours of the morning when we decide to rest, many watching television: an action film, a frantic debate on football or politics; it doesn’t matter the subject, it is impossible for our body and brain to relax. This pace is impossible to keep up if we do not have the right strategies or skills to manage the time and demands we receive or make on ourselves.

I always make people think about Western films from 30 years ago and current action films. This is a clear example of the pace we’re at. Watching one of the Westerns from 30 years ago is an excellent strategy to relax, but how many of us can stand this slow, leisurely pace?

Cognitive-behavioral methodology is the type of psychological intervention with the most scientific support in its favor regarding its effectiveness in solving people’s problems. What is known about its effects on people with anxiety problems?

Cognitive-behavioral methodologies have been shown to be extremely effective for anxiety because the main basis for working with people is simple. People are taught that their way of interpreting the demands of the environment influences their emotional state.

Similarly, they are educated to process these demands or stimuli and to make decisions based on appropriate values and beliefs so that they can recover and maintain their well-being. At the same time, we educate them to make the right decisions in situations of stress. It is remarkable the fact that insurance companies only take care of professional assistance bills with this methodology.

What are the main stages of this form of psychological work?

The main work is to teach people to become aware of their emotions and to relate them not so much to what happens to them in life, but to how they think, how they value these situations. “It is not outside, but inside us, where the weather is good or bad”.

The psychologist teaches people to know their emotions, to understand them, to manage them efficiently, to not be afraid to express feelings and, in general, to think and act assertively.

Many people have scales of values or beliefs that from my point of view do not allow them to live in peace. On many occasions the environment creates conditions that cause emotional reactions that are detrimental to well-being, as can be the case in the workplace; let’s not forget that 30% of all sick leave in Spain is caused by stress. However, the environment has always threatened the human being. Faced with the demands or requirements of the environment, one can only acquire certain skills: new ways of thinking to make more effective decisions and neutralize the anxiety associated with stress.

What made you interested in this type of methodology, and what advantages does it have compared to others?

There have been three main sources of influence, the first being the University: I studied at the Universidad Autónoma de Madrid and was committed to this model more than 20 years ago. The second important source has been my work in recent years. I have been dedicated for many years to the prevention of traffic accidents, I still do, and it is in this field that I was able to apply this methodology.

I met with drivers who drank alcohol and then took the car, others did not wear their seat belts and many of them did not care about the penalties, the fines. I had to apply cognitive behavioural methodology, creating awareness campaigns to change habits so that drivers would be convinced that wearing a seat belt could save their lives.

We have gone from 5,600 deaths in the last 20 years on the roads to less than half this last year, and one of the primary strategies has been psycho-education, I have no doubt. And finally, a professional, non-university master’s degree in advanced behavioural methodology, carried out with the ALBOR-COHS Group, a benchmark in Spain, with more than 35 years of experience in this field.

As far as stress and anxiety are concerned, how long does it take for the first results of cognitive-behavioral therapy to appear, approximately, and when is the time of maximum effectiveness?

It all depends on the person’s interest in change and the professional you work with. There are people who learn very quickly and others whose learning is slow. In any case the result is what matters, not so much the time.

I always say the same thing, you don’t get there first by running, life is a long-distance race and many times with obstacles.

In this sense, I think we have to go through 5 phases: learning knowledge, understanding it, internalizing the key messages, practice and automation, it is in this last phase where we get the maximum efficiency.

To this specific question, a more concrete answer would be to indicate that four months of professional assistance is usually the average time to achieve the desired results.

Beyond the advances that can be made in sessions on anxiety, what can people do on a daily basis to improve their situation? What about their families?

I usually recommend three big and powerful habits that are extremely effective: learning to breathe, learning to go to bed to sleep, not to watch TV and practicing some non strenuous sport, the latter is important.