In any treatment of anxiety disorders the therapist will often stress the significance of interpretations. We are constantly taking stock of our environment, the people and situations we encounter. It doesn’t necessarily happen at a conscious level but we can see the significance of interpretations in a variety of ways.
One day I came to the aid of someone with a morbid fear of spiders. She’d called for help from the kitchen where she was rooted to the spot, face half turned from the object of terror, and pointing towards it. What she thought was a large spider lurking in the shadows turned out to be nothing more intimidating than top of a tomato that had dropped to the floor. When this was pointed out it resulted in instant relief and laughter.
The point of the story is that emotional reactions come about as a result of the way we interpret a situation, not the situation or event itself. The significance is personal and in people who are very anxious the significance is usually evaluated as dangerous.
Cognitive therapists know that interpretation is highly significant. In anxiety the form of interpretation is largely centered on the fact that an event is viewed as much more threatening than it really is. Depending on the disorder the content of interpretation will differ. In the case of panic disorder, for example, it is the interpretation of normal bodily functions that causes problems. A fast beating heart may give rise to the belief that a heart attack is imminent. We can contrast this with social anxiety disorder where the content of interpretation is more likely to relate to an intense fear of being judged negatively by other people.
But there are other examples. In OCD, the person is likely to interpret unwanted intrusive thoughts as signs of madness or badness. People with a generalized anxiety disorder may interpret their worrying as a sign they are caring and kind and their worrying is a way of somehow preventing bad things happening.
Interpretations are of course a way of thinking. This simple but fundamental fact helps inform the principles of cognitive therapy. Interpretations can appear as truths and a big part of cognitive therapy is helping a patient accept that the way they think is an incredibly important feature in helping to promote their anxiety.