The biochemical basis of anxiety seems to be closely linked to the protein serotonin, exuded at the synaptic connections of neural cells. Low amounts of it lead to anxiety disorders such as social anxiety disorder, or obsessive compulsive disorder. The foremost and popular therapy for anxiety is still selective serotonin reuptake inhibitors (SSRIs) which raise intersynaptic serotonin concentrations. Concurrently, there movement among psychiatric population to lessen dependencies on medications and encourage treatment choices with the possibility of addressing root causes instead of than symptoms. Moreover, the prospect of permanent neuralchemical changes or side-effects due to administration of SSRIs has turned away many from using these products, and increased attention for novel, holistic methods of curbing anxiety. One of these is cognitive-behavioral therapy (CBT), or behavioral modification therapy, which tries to affect the cognitive processes that lead to anxiety and reshape it such that fundamental causes are eliminated. Cognition describes how one interpret input, anticipates, and responds. Thus, CBT aims to guide the thinking which force one to anxiety, and reshape it such that root causes of anxiety are eliminated. The operating principle of CBT is that long-term anxiety is a problem that sustains and worsens on itself via a negative reinforcement loop. Breaking the connection between anxiety and the thought machinations that feed them is the central target of CBT.

In what way does one perform CBT? In what way does it operate ? While psychiatrists follow differing procedures for CBT, and people with anxiety disorders exhibit differing underlying causes, there are approximately three general principles of CBT that are used as guidelines for performing the treatment. The first is one of recognition : a person with anxiety disorder must obtain a thorough insight of the origins of anxieties. As an example, one may have experienced a panic attack. Following, he or she finds a growing fear in anticipating the next attack. These fears compound each other, resulting in even more anxiety. The practioner of CBT would lead a line of questioning to demonstrate that the source of anxiety is the anxiety ironically. In another situation, a person realizes he or she becoming anxious and feeling fear because an unplanned event causes tremendous distress. In reaction, the person dwells upon the uncertainty of the future and discovers other unpredictable things in life. This conclusion then turns into a powerful driver for future anxiety. Again, the practioner of CBT could draw attention to the fact that no one's life is exempt from uncertainty, and asking for its removal is all but impossible.

The next and second tenet of CBT is that of taking charge. A person who has disorder must attempt to take control of worrying before it takes over. There are a few structured methods to do so: (1) Filling out a schedule and isolating an hour when worrying takes place, thereby actively relegating it instead of trying to suppress it. (2) Note anxious thoughts which pop up during other times of the day, but put them off consciously them to the "worry" period. (3) During the "worry" period, cycle each item in the list, and unemotionally consider their meaning. As answers crop up, record them. This list should be transferred over to the next day's activities. There exists one goal for structured fretting : wresting control back from anxiety, and repurposing it to better one's well-being. After all, anxiety serves a very utilitarian function by focusing our thoughts on problems. The key is to balance, curb it, and ensure it does not overwhelm other emotions. Doing so requires an objective view of anxiety, as something that can be shaped and recast to desire.

The third principle is that of proactive positive thinking. Anxious thinking must not only be managed properly, but must be met with optimistic thinking. There is some scientific basis for doing so. Computer tomography scans demonstrate that subjects have long term brain vascular alterations under reinforcement. By inadvertently making important and magnifying anxiety, a person experiencing anxiety may be promoting permanent developements in neural structure which become geared to anxiety. Reversing this learning of anxiety is the goal of self-reinforcmeent.

It is true that these tenets are highly challenging to assess scientifically, as we do not have a method to measure brain behaviors. Nonetheless CBT is a promising path of treatment for anxiety as the mind has always demonstrated itself to be very malleable. The malleability implies a targeted attempt to redirect its way of processing input and responding could be a tenable alternative to taking SSRIs.