Tags: cortisol | fear | therapy | anxiety

Why Morning Psychotherapy Sessions Are Best

Why Morning Psychotherapy Sessions Are Best


By    |   Friday, 07 October 2016 09:57 AM

Those who receive therapy for fear and anxiety might get more out of their sessions when that therapy is scheduled in the morning.

That's the conclusion of a study on therapeutic sessions for those who suffer from panic, anxiety, and phobias. The results point to fluctuations of cortisol — the hormone that regulates changes in the body from stress. Early therapy might be best because there are higher levels of cortisol produced by the body in the morning.

Lead author, clinical psychologist Alicia E. Meuret, Southern Methodist University, Dallas, said: "The hormone cortisol is thought to facilitate fear extinction in certain therapeutic situations . . . the findings of our study promote taking advantage of two simple and naturally occurring agents — our own cortisol and time of day. We did not know whether cortisol would act as a mediator between time of day and therapeutic gains. This is what our study investigated."

The study was based on treating anxiety and phobias through exposure and with corrective information. By direct exposure, patients learn to overcome their fears. However, not all patients benefit equally from exposure therapy.

Cortisol is thought to help by suppressing the fear memory established by earlier distressing encounters while at the same time helping remember new curative information.

Study participants received weekly sessions over three weeks, each lasting about 40 minutes. Exposure situations included tall buildings, highways and overpasses, enclosed places such as elevators, supermarkets, movie theaters, and public transportation. Cortisol levels were measured at various times during exposure. Researchers then measured patients' appraisals of threats, their avoidance behavior, how much control they perceived themselves as having, and the severity of their panic symptoms.

Researchers found the exposure therapy in general resulted in significant improvements in all measures over all time periods. Participants made the biggest gains after sessions that started earlier in the day. And at the next session, patients reported less severe symptoms for threat misappraisal and panic symptoms. They also perceived greater control over their symptoms.

"Higher cortisol was related to greater reductions in threat appraisal, perceived control, and panic symptom severity at the next session," Meuret said. She cautioned that the precise mechanism by which cortisol enhances the effectiveness of morning exposure sessions remained unclear and can't be determined wholly from the results of the study. Other contributing factors might include memory and learning, and the body's natural circadian rhythm, and quantity and quality of sleep.

The results were reported in the journal Psychoneuroendocrinology.

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Those who receive therapy for fear and anxiety might get more out of their sessions when that therapy is scheduled in the morning.
cortisol, fear, therapy, anxiety
Friday, 07 October 2016 09:57 AM
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