The answer is “both.” Psychotherapy for anxiety disorders works best within the framework of a cognitive-behavioral approach. From the name it becomes clear that this approach includes working with both a cognitive component (thoughts, beliefs) and a behavioral one. How does this actually work? The cognitive component is all our thoughts, attitudes and beliefs about what is happening in our lives. When working with a neurotic state, we will be interested in those thoughts that are negative, cause corresponding emotions and, at times, lead to distress. There are so-called core beliefs, intermediate beliefs/thoughts and automatic thoughts. Based on deep-seated (global beliefs about oneself or the world) intermediate beliefs are formed (in accordance with the deep-seated belief, I should/I shouldn’t; I can/can’t), and from those, in turn, automatic thoughts emerge ( instant evaluative thoughts as a reaction to triggers that are familiar and therefore accepted as truth). For example: “I am an absolutely stupid person” - a deep-seated belief. “I should read more, I need to make a list of literature and read at least 5 books this month” / “I shouldn’t even try to enter a university, I won’t succeed anyway, why waste time” - intermediate thoughts (beliefs). “I will 100% fail this test” is an automatic thought. Deep beliefs (which may or may not be conscious) determine those thoughts and emotions that permeate many areas of our lives and inevitably influence our behavior in various situations. Let's return to the automatic thought “I will 100% fail this test”: emotions: sadness, anger at yourself, guilt, shame, self-flagellation; behavior: I won’t even try to carefully read the questions in order to try to pass it well/I won’t pass. This is a rather clumsy example for understanding the essence. How would this look in the example of an anxiety disorder? Client A always walks her fifth-graders to school to the stop, before leaving the house she always checks several times that she has locked the door with the key, and knows by heart the schedule of all the buses and minibuses that go towards the school and her place of work. Automatic thoughts: “something might happen to the children on the way to the stop; thieves can break into the apartment; I could be late for work and get fired.” Intermediate thoughts: “I must protect the children and monitor them because I am a responsible mother; I must always check that the door is closed so that we do not get robbed; I need to know the different routes to my work so that if my bus deviates from the schedule, I can take another one and not be late for work.” Deep conviction: “Our world is tough and dangerous.” Does it make sense in this particular case to work directly with the deep conviction that the world is definitely always cruel if a person is 100% convinced of this and has no experience to the contrary? Most likely, no, it will be very long and, most likely, useless. The key word is “experience” - to understand whether a belief is wrong, you need to understand it in practice, so working with intermediate beliefs will be more effective. What is cognitive restructuring? This is a process of analyzing automatic thoughts and intermediate beliefs, aimed at exposing existing ones and searching for new and, most importantly, adaptive ones. But how to believe new thoughts and beliefs? This is where behavioral experiments come into play, when a person can actually either confirm or refute his judgment. No matter how long the therapist tries to help the client form new useful beliefs, successfully challenging old ones and bringing a bunch of counterarguments or arguments in favor of new thoughts, it will be useless until the client independently confirms this in real life. What can be obtained from a behavioral experiment? You can both confirm the uselessness (unfoundedness) of your judgment (thoughts, beliefs), and discover its cleardiscrepancy with reality. “Something might happen to the children on the way to the bus stop, so I have to accompany them, because I am a responsible mother, and all because our world is cruel and unsafe.” How to determine whether the world is really unsafe, does this make sense, is it worth arguing with the deep-seated belief of client A, because the world is really unsafe to one degree or another? Or we can actually test the validity of the intermediate belief “I should accompany the children to the bus stop because I am a responsible mother”: will something bad necessarily happen to the children if they are not accompanied? Do they know how to behave if a stranger approaches them? Does your presence 100% protect against negative incidents? Does this often happen in your area to other children who come to the stop on their own? And even if client A gives the “correct” answers to all the questions, indicating that her beliefs are unfounded, this will not become true for her until she actually tries it. Behavioral experiment for client A: Walk the children to the bus stop only every other day in the first week of the experiment. Will something bad happen to the children? In the second week, do it only every 2 days, then once a week, then once every 2 weeks. All this, of course, will be accompanied by an increase in anxiety and tension, however, the actual absence of negative situations with children who go to the bus stop on their own, together with cognitive restructuring in sessions with a therapist, will give results, because In addition to a logical analysis of situations, the client also receives factual experience, which in total helps to come to the conclusion that the intermediate belief is, in fact, unfounded. Yes, the world is indeed not a very safe place, but protecting yourself and your loved ones from everything is unrealistic; in addition, there are facts that prove the safety of at least the area where client A lives - there have been no cases in the last 10 years where something bad happened to the children on the way to the bus stop. The same example can exist in another, more complex way: the belief “I am a responsible mother” can be either part of an intermediate belief or be a deep one. In the latter case, it is worth working directly with him, restructuring the intermediate beliefs “I should...”. In this case, working with the cognitive component will have more weight than the behavioral one. As a behavioral experiment, you can suggest client A to reduce the frequency of actions from the “I must” list and ask for feedback from her relatives - husband and children, whether this has made her an irresponsible mother. Or, on the contrary, with the cognitive component it may be more or less normally, client A agrees with the unfoundedness of her beliefs, does not trust them, notices their uselessness or negative impact, completely agrees with the therapist’s arguments, but she is so used to living in a certain way that she has already “trained” herself to this model of behavior. As you know, we knock out a wedge with a wedge - the behavioral component in this case should be given greater importance, and behavioral experiments will be situations in which the client simply reduces the frequency and severity of habitual forms of behavior: getting the children ready for school, closing the door behind them and looking out the window as they walk to the stop without leaving with them; then, after a while, he simply closes the door behind them and goes to the bathroom to wash himself/make a face mask/wipe the mirror - whatever to occupy himself while tension increases. Thus, in the psychotherapy of anxiety disorders, both components take place - cognitive and behavioral . Only in sum will they give a successful result, but in different cases the emphasis may be on either one or the other component. This can also be determined by what stage the therapy is at: at the very beginning, more time is devoted to cognitive restructuring, then, after a certain number of sessions, the client independently