Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic

Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic

Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic

Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic


This landmark work is indispensable for anyone studying anxiety or seeking to deliver effective psychological and pharmacological treatments. Integrating insights from emotion theory, recent advances in cognitive science and neuroscience, and increasingly important findings from developmental psychology and learning, David H. Barlow comprehensively examines the phenomena of anxiety and panic, their origins, and the roles that each plays in normal and pathological functioning. Chapters coauthored by Barlow with other leading experts then outline what is currently known about the classification, presentation, etiology, assessment, and treatment of each of the DSM-IV anxiety disorders. A definitive resource for researchers and clinicians, this is also an ideal text for graduate-level courses.


To provide some background on the genesis of this book, first published in 1988, it seems worthwhile to revisit a few paragraphs from the preface to the first edition. At that time I observed:

"This tale grew in the telling," as J.R.R. Tolkein put it. After years of research and practice, it
seemed a straightforward enough task to write a book on the nature and treatment of anxiety
disorders. The surge of interest in these disorders during the past 5 years sparked rapid-fire
advances in both psychological and pharmacological treatments, and I felt that such a book
would be timely. After reviewing these advances, I planned to describe newly developed treat
ments for the anxiety disorders at our Center for Stress and Anxiety Disorders in Albany that
take into account innovations from around the world. These treatments would be described
in the framework of anxiety disorders as defined and described in the revisions to DSM-III. I
told my publisher that I would have it for him in 12 to 18 months.

During this time, our own treatments changed dramatically as exciting new discoveries
emerged from our research center and elsewhere on the nature and treatment of panic. These
developments seemed to require, at the very least, a full explication of the nature of anxiety
and panic based on these new developments. But these developments could not be described
adequately without putting them in the framework of current theoretical conceptions of anxi
ety in general. I found that repeating tried and true theories of anxiety proved totally inade
quate, since new conceptual approaches, ranging from neurobiological to social-constructivist,
have appeared only in the past 2 years. These models are beginning to affect our view of anxi
ety. And then there is the mystery of panic!

This confusing combination of new and old perspectives on anxiety and panic led inexora
bly to a consideration of the nature of emotion. The book stood still for a half a year while I
absorbed once again the views of emotion theorists and attempted to integrate our rapidly
emerging clinical knowledge of anxiety and panic with the old and distinguished tradition of
emotion theory dating back to Darwin over 100 years ago. For anxiety disorders, in the last
analysis, are emotional disorders. It became increasingly clear that it was impossible to say
something fresh about emotional disorders without considering the traditions of emotion theory.

At this point, I started working backward, rewriting the book from the point of view of the
accumulated wisdom of emotion theory. After the integration of relevant recent developments
in cognitive science and neuroscience, what emerged was a new model of panic and anxiety
with implications for treatment. These theories and concepts were then integrated with newly
developed treatment protocols for the various anxiety disorders. Only then was I able to write
the book I intended.

In writing this second edition I had the good fortune to be subjected to some of my own illusions of control. First, with the prospect of revising the book rather than writing . . .

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